The European Commission will establish four new EU Reference Laboratories (EURLs) to strengthen diagnosis and surveillance for some of the region’s highest-burden infectious threats, including tuberculosis, Clostridioides difficile, drug-resistant gonorrhea, and invasive bacterial diseases such as meningitis.

The new laboratories are expected to become operational in 2028 and will provide scientific advice and technical support to national reference laboratories while helping improve monitoring and alert notification systems across Europe.

“These are all pathogens we’re monitoring very closely at the European Centre for Disease Prevention and Control [ECDC], through our networks and through different processes,” Andreas Hoefer, PhD, specialist in microbiology and molecular epidemiology at the ECDC, told Medscape News Europe.

Ten EURLs have already been commissioned under the EU system. The first six, including the EU Reference Laboratory for Public Health on Antimicrobial Resistance in Bacteria, launched in January 2025. Three more, focused on foodborne and waterborne pathogens, will launch later this year. A further respiratory virus laboratory is expected to launch next year.

A Need for Common Standards

Establishing the new laboratories grew out of lessons from the COVID pandemic, said Hoefer, who coordinates the network of existing EURLs.

Early in an outbreak, laboratories often develop their own tests and diagnostic pathways, with different thresholds for positive and negative results. That can make results more difficult to compare and can slow efforts to build a clear public health picture.

“COVID highlighted how important it is to have high-level comparable laboratory data between different countries,” Hoefer said.

The new laboratories are intended to reduce that variation by helping to set common approaches to diagnostics, testing methods, and use of tests for surveillance and reporting.

“By having very quick access to all of the disease experts, we’d have a centralized authority to say, very quickly, ‘This is the test we need to be using; this is how we need to be testing,’” he said.

Consortia of specialist laboratories have been invited to apply to run the new EURLs by August 19.

Strengthening National Labs

For Chantal Reusken, PhD, the value of the system lies not only in coordination at the EU level but also in the support it can provide to national laboratories.

Reusken coordinates the EU Reference Laboratory for Public Health on Vector-Borne Viral Pathogens, launched last year and based at the National Institute for Public Health and the Environment (RIVM) in Netherlands. She said the EURL recently helped correct what initially appeared to be autochthonous dengue transmission in one European country. Further analysis showed the virus was Zika instead, requiring a different public health response.

RIVM, together with four institutions in Italy, Slovenia, Greece, and France, applied as a consortium to run the laboratory. Each partner brought expertise in specific viral pathogens, allowing the EURL to draw on a wider pool of technical knowledge when a new threat is detected.

Once a signal is received from a national reference laboratory, several core EURL functions are activated.

“We have to be alert. We inform laboratories in our network about the signal and advise on best diagnostic practices,” Reusken told Medscape News Europe.

The EURL then advises on testing, provides diagnostic materials, and trains laboratories in diagnostics and surveillance for the virus in question.

The laboratories are also intended to strengthen national reference capacity, particularly in countries with fewer resources. One way they do that is through proficiency testing — sending participating laboratories blinded samples with known identities so they can assess whether those laboratories are correctly detecting and characterizing pathogens. Where problems are identified, the EURL can follow up with mentoring, targeted training, or in-country support.

Older laboratory networks provided some of the same services, Reusken said, but they were more fragmented and dependent on shorter-term project funding.

Reusken said that long-term financing is a major step forward, but she also warned that dismantling earlier networks means that relationships need to be re-established.

“It has its maximum effect when there’s trust in the network. So that is what we’re in the process of building again.”

That rebuilding process could eventually have downstream benefits for clinicians and hospital laboratories. Clinicians who encounter unfamiliar pathogens in primary, secondary, or tertiary care cannot contact an EURL directly; requests must go through the relevant national reference laboratory. But Hoefer said the training, standardization, and country-level support should ultimately improve disease identification in national and local hospital laboratories.

Benefits Beyond Europe?

Some observers believe the EURLs could eventually matter beyond Europe.

Colin Russell, PhD, chair of the European Scientific Working Group on Influenza and Other Respiratory Viruses, said the planned EURL on respiratory viruses could help Europe generate stronger surveillance data and more authoritative technical guidance.

EURLs do not have a global mandate; they are designed to support national reference laboratories in EU member states and promote alignment in diagnostics, testing, surveillance, and reporting across Europe. But Russell said stronger European surveillance of influenza and other respiratory viruses could still improve the quality of data and guidance used more widely.

“What role new networks will play remains to be seen, but I am encouraged by the creation of these laboratories as a new source of information, good practice, and reliable surveillance,” he said.

Mel Spigelman, MD, president and CEO of TB Alliance, said the same logic could apply to tuberculosis surveillance.

“It would be a welcome step in reinforcing the EU’s leadership in the global TB response,” he said.

Better surveillance, he said, would help clinicians and public health authorities identify where TB infections are rising and target diagnostics and treatment for both active and latent disease before outbreaks spread more widely.

The planned EURL on mycobacteria could also keep countries up to date on successful prevention and treatment strategies.

“Despite conflict, Ukraine was the first country to approve and implement shorter, all-oral drug-resistant TB therapy,” Spigelman said. “Translating successes from one country or region to another starts with collecting and sharing information.”

Spigelman, Reusken, Russell, and Hoefer reported having no relevant financial relationships.

Tatum Anderson is a global health and medical journalist. For over 20 years, she has placed articles in publications from the Bulletin of the World Health Organization to The Lancet, BMJ, BBC News, Nature, SciDev.net, and The Economist. She reported having no disclosures.