This commentary discusses the causes and consequences of diversity in how European countries organize communicable disease control. Drawing on the historical record of the US Centers for Disease Control and Prevention, it first reviews the main explanations of that diversity, with a focus on the political dynamic of building institutional capacity in the field of public health. It then examines the significance of institutional diversity in the process of Europeanization, and closes with a few thoughts on factors that have shaped the development of communicable disease control capacities in the United States and the European Union.

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