Nevertheless, a health information system is never ready. After the initial goals have been reached, work needs to concentrate on the improvement of the indicators, obtaining proof about their validity and comparability, assessing repeatedly the policy relevance, BTB06584? and ensuring that the whole system for gathering and disseminating the data and their interpretations is fully functional. A European central health monitoring capacity also needs to take care of health reporting, together with the national counterparts. Finally, there is a constant need to improve the ability of the national experts and other users to utilize the data and indicators to their best. Several of these tasks could best be carried out jointly by an EU center and by a number of high quality national Public Health Institutes.

At EU level the collaboration in health monitoring and reporting between EU, WHO and OECD should also be enhanced. In particular, the same core indicators should be used in all European countries. Understandably, not all countries are equally devoted to use the shortlist exactly as presented. Instead, they prefer slightly modified indicator sets. This is due to that not all indicators were equally relevant and that valid data for some of them cannot be obtained in many countries. The shortlist comprises a few indicators, which cannot be obtained by present means. On the other hand, some important indicators are not included in the list. An important example is the blood lipid levels, which should be added to the present short list.

Finally, it is to be expected that other changes may occur quite quickly in the needed indicator set. All this draws attention to the fact that the present version of the ECHI list requires repeated upgrades. Looking back fifteen years During the past fifteen years numerous high level health monitoring experts have put in their best knowledge and used a lot of time to improve health indicators and monitoring. Looking back to the beginning [6] in the late 1990s we have achieved a lot by voluntary collaboration. The amount and value of these resources far exceeds the financial input of the Commission. Therefore ECHIM really has been an endeavor by the countries for the countries. In this situation the views and wishes of the Member States must bear most of the European weight.

The only reasonable outcome is that the Commission ensures that ECHIM work can continue and that its outcome, the permanent EU health information and reporting system, Carfilzomib is established. The practical constructive solution is that the Commission provides further limited financial support, to enable the ECHIM network and the Member States to finalize the European Health Monitoring system. Competing interests The author declares that he has no competing interests.