While influenza-like-illness (ILI) surveillance is well-organized at primary care level in Europe, little data is available on more severe cases. With retrospective data from ICU's we aim to fill this current knowledge gap and to explore its worth for prospective surveillance. Using multiple parameters proposed by the World Health Organization we estimated the burden of severe acute respiratory infections (SARI) to ICU and how this varies between influenza epidemics.

The West Africa Ebola outbreak of 2014-2016 demonstrated the importance of strong disease surveillance systems and the severe consequences of weak capacity to detect and respond to cases quickly. Challenges in the transmission and management of surveillance data were one factor that contributed to the delay in detecting and confirming the Ebola outbreak. To help address this challenge, we have collaborated with the U.S.

The 2014-2016 Ebola outbreak in Guinea revealed systematic weaknesses in the existing disease surveillance system. The lack of public health workers adequately trained in Integrated Disease Surveillance and Response (IDSR) contributed to underreporting of cases and problems with data completeness, accuracy, and reliability. These data quality issues resulted in difficulty assessing the epidemic's scale and distribution and hindered the control effort (McNamara, 2016; Bell, 2016).

Healthcare systems are often evaluated using comparative health care rankings. Simulations have shown that maximally inequitable health care systems can perform well in published, influential health care system rankings by excelling in non-equity categories, resulting in highly ranked yet grossly inequitable healthcare systems. Recently, despite below average equity rankings, the healthcare systems of Australia and New Zealand ranked among the top four in The Commonwealth Fund's international comparative study Mirror, Mirror 20172.