In 2009, the European Centre for Disease Prevention and Control (ECDC) published guidance on chlamydia (Chlamydia trachomatis) control in Europe.1 In it we recommended that EU/EEA member states ensure the provision of basic resources and systems (for diagnosis, case and partner management) before embarking on any expanded screening programme. This guidance was based on evidence first that there was a huge variation in availability of clinical services for chlamydia across member states, and second that the evidence for population level programmes was missing.1 ,2 This month ECDC has released updated guidance that we developed with the support of ECDC experts following a programme of work to update the evidence, including an extensive review of the epidemiology and natural history of chlamydia and the clinical and cost-effectiveness of screening programmes.3 The team also repeated the survey of member states, and assessed the impact of the original guidance.4 ,5

The survey showed that more countries had established essential diagnostic and management facilities and guidelines;6 it was hard to attribute this …