This funding is not currently available, but a recent conclusion sellckchem adopted by the Council of the EU recognizes the importance of the sustainability of health monitoring [17]. Obtaining high participation rates is a major challenge in all population surveys. The EHES Joint Action tested various approaches in different cultures; further development of innovative approaches is needed. It is also likely that more resources will be required for participant recruitment in the future. It is a prerequisite for EHES that the national and European regulations and principles on ethics and data protection recognize the role of HESs for the benefit of public health. In one piloting country, the national principles for limited contacts with the selected persons seriously restricted the efforts to obtain a high participation rate and therefore the ability to obtain representative information.

The EU Data Protection Directive has now been opened for revision: we hope it will facilitate future public health monitoring and research in all countries [18]. In addition to data demands expressed in the EU��s policy statements when the pilot phase of EHES started, EHES can provide much of the key data called for in the Political Declaration of the United Nations High-level Meeting on Non-communicable Diseases in 2011 and in the WHO/Euro Action plan for the Strategy for the Prevention and Control of Non-communicable Diseases for 2012�C2016 [11,14,19,20]. EHES will also be a unique data source for epidemiologic and public health research, with high potential to contribute to the objectives of the Europe 2020 Flagship Initiative Innovation Union [21].

The EHES Pilot Project is creating data sharing principles which will facilitate wide research use of the data while respecting the legitimate interests of the survey participants and organizers. Conclusions There is wide recognition of the importance of HESs as a part of national health monitoring systems. The EHES Pilot Project has set up the structure for obtaining comparable high quality health indicators on health and important modifiable risk factors of major non-communicable diseases from the European countries. The European Union is now in a key position to make this structure sustainable. The EHES core survey can be expanded to cover other measurements.

Abbreviations EHES: European Health Examination Survey; EHIS: European Health Interview Survey; EU: European Union; HES: Health examination survey. Competing interests The authors declare that they have no competing interests. Drug_discovery Authors�� contributions All authors participated in the design of the study and data preparation. KKu drafted the paper. HT was the Project Manager of the EHES Pilot Project and helped in drafting the manuscript. PK was responsible for the EHES Training programme and was involved in evaluating the pilot surveys and helped in drafting the manuscript. KKi coordinated the EHES Pilot Joint Action.