Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-05-19T09:34:56.922Z Has data issue: false hasContentIssue false

The New International Health Regulations: Considerations for Global Public Health Surveillance

Published online by Cambridge University Press:  08 April 2013

Abstract

Global public health surveillance is critical for the identification and prevention of emerging and reemerging infectious diseases. The World Health Organization recently released revised International Health Regulations (IHR) that serve as global legislation and provide guidelines for surveillance systems. The IHR aim to identify and prevent spread of these infectious diseases; however, there are some practical challenges that limit the usability of these regulations. IHR requires Member States to build necessary infrastructure for global surveillance, which may not be possible in underdeveloped countries. A large degree of freedom is given to each individual government and therefore different levels of reporting are common, with substantial emphasis on passive reporting. The IHR need to be enforceable and enforced without impinging on government autonomy or human rights. Unstable governments and developing countries require increased assistance in setting up and maintaining surveillance systems. This article addresses some challenges and potential solutions to the ability of national governments to adhere to the global health surveillance requirements detailed in the IHR. The authors review some practical challenges such as inadequate surveillance and reporting infrastructure, and legal enforcement and maintenance of individual human rights. (Disaster Med Public Health Preparedness. 2007;1:117–121)

Type
Original Research and Critical Analysis
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Feldmann, H, Czub, M, Jones, S, et alEmerging and re-emerging infectious diseases. Med Microbiol Immunol. 2002;191:6374.Google Scholar
2.Heymann, DL, Rodier, GR.Hot spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases. Lancet Infect Dis. 2001;1 (5):345353.CrossRefGoogle Scholar
3.Lederberg, J, Shope, RE, Oats, SC.Emerging Infections: Microbial Threats to Health in the United States. Washington, DC: Institute of Medicine, National Academy Press; 1992.Google Scholar
4.Saker, L, Lee, K, Cannito, B, Gilmore, A, Campbell-Lendrum, D.Globalization and Infectious Diseases: A Review of the Linkages. Geneva: UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases; 2004.Google Scholar
5.Wilson, ME.Travel and the emergence of infectious diseases. Emerg Infect Dis. 1995;1:3946.Google Scholar
6.Heymann, DL, Rodier, GR.Global surveillance of communicable diseases. Emerg Infect Dis. 1998;4:362365.Google Scholar
7.Woodall, JP.Global surveillance of emerging diseases: the ProMED-mail perspective. Cad Saude Publica. 2001;17 (Suppl):147154.Google Scholar
8.Gostin, LO.International infectious disease law: revision of the World Health Organization’s International Health Regulations. JAMA. 2004;291:26232627.Google Scholar
9. 58th World Health Assembly. Revision of the International Health Regulations. 2005. http://www.who.int/csr/ihr/IHRWHA58_3-en.pdf. Accessed July 8, 2007.Google Scholar
10.How is WHO responding to global public health threats? PLoS Med. 2007;4:e197.Google Scholar
11.Baker, MG, Fidler, DP.Global public health surveillance under new international health regulations. Emerg Infect Dis. 2006;12:10581065.CrossRefGoogle ScholarPubMed
12.Gostin, LO, Bayer, R, Fairchild, AL.Ethical and legal challenges posed by severe acute respiratory syndrome: implications for the control of severe infectious disease threats. JAMA. 2003;290:32293237.CrossRefGoogle ScholarPubMed
13. World Health Organization. The Designation or Establishment of National IHR Focal Points. http://www.who.int/csr/ihr/English2.pdf. Accessed July 15, 2007.Google Scholar
14. World Health Organization. Guiding Principles for International Outbreak Alert and Response. http://www.who.int/csr/outbreaknetwork/guidingprinciples/en/index.html. Accessed July 15, 2007.Google Scholar
15.Cash, RA, Narasimhan, V.Impediments to global surveillance of infectious diseases: consequences of open reporting in a global economy. Bull WHO. 2000;78:13581367.Google Scholar
16.Gostin, LO.Pandemic influenza: public health preparedness for the next global health emergency. J Law Med Ethics. 2004;32:565573.CrossRefGoogle ScholarPubMed
17.Gear, JS, Cassel, GA, Gear, AJ, et alOutbreake of Marburg virus disease in Johannesburg. BMJ. 1975;4:489493.Google Scholar
18.Johnson, KM, Lange, JV, Webb, PA, Murphy, FA.Isolation and partial characterisation of a new virus causing acute haemorrhagic fever in Zaire. Lancet. 1977;1:569571.Google Scholar
19.Frame, JD, JrBaldwin, JM, Gocke, DJ, Troup, JM.Lassa fever, a new virus disease of man from West Africa: I. Clinical description and pathological findings. Am J Trop Med Hyg. 1970;19:670676.CrossRefGoogle ScholarPubMed
20.Ramamurthy, T, Garg, S, Sharma, R, et alEmergence of novel strain of Vibrio cholerae with epidemic potential in southern and eastern India. Lancet. 1993;341:703704.Google Scholar
21.Sharp, PM, Bailes, E, Chaudhuri, RR, Rodenburg, CM, Santiago, MO, Hahn, BH.The origins of acquired immune deficiency syndrome viruses: where and when? Philos Trans R Soc Lond B Biol Sci. 2001;356:867876.Google Scholar
22.Mandl, KD, Overhage, JM, Wagner, MM, et alImplementing syndromic surveillance: a practical guide informed by the early experience. J Am Med Inform Assoc. 2004;11:141150.Google Scholar
23. ART on the frontline PlusNews Special. Cote D’Ivoire: Access to HIV/AIDS treatment in rebel north precarious. Irin News. January 9, 2007.Google Scholar
24.Van Herp, M, Parque, V, Rackley, E, Ford, N.Mortality, violence and lack of access to healthcare in the Democratic Republic of Congo. Disasters. 2003;27:141153.Google Scholar
25.Spiegel, PB.HIV behavioural surveillance surveys in conflict and post-conflict situations: A call for improvement. Global Public Health. 2006;1:147156.Google Scholar
26.Chretien, JP, Blazes, DL, Coldren, RL, et alThe importance of militaries from developing countries in global infectious disease surveillance. Bull WHO. 2007;85:174180.Google Scholar
27.Sharp, TW, Luz, GA, Gaydos, JC. Military support of relief: a cautionary review.Leaning J, Briggs SM, Chen LC. Humanitarian Crises: The Medical and Public Health Response. Cambridge, MA: Harvard University Press; 1999: 273291.Google Scholar
28.Torres-Slimming, PA, Mundaca, CC, Moran, M, et alOutbreak of cyclosporiasis at a naval base in Lima, Peru. Am J Trop Med Hyg. 2006;75:546548.Google Scholar
29.Woodall, J.Official versus unofficial outbreak reporting through the Internet. Int J Med Inform. 1997;47:3134.Google Scholar
30.Heymann, DL, Rodier, G.Global surveillance, national surveillance, and SARS. Emerg Infect Dis. 2004;10:173175.Google Scholar
31. Mawudeku A, Blench M. Global Public Health Intelligence Network (GPHIN). 7th Conference of the Association for Machine Translation in the Americas. http://www.mt-archive.info/MTS-2005-Mawudeku.pdf. Accessed April 26, 2007.Google Scholar
32.Grein, TW, Kamara, KB, Rodier, G, et alRumors of disease in the global village: outbreak verification. Emerg Infect Dis. 2000;6:97102.Google Scholar
33.M’Ikanatha, NM, Rohn, DD, Robertson, C, et alUse of the internet to enhance infectious disease surveillance and outbreak investigation. Biosecur Bioterror. 2006;4:293300.Google Scholar
34.Chase, V.ProMED: a global early warning system for disease. Environ Health Perspect. 1996;104:699.Google Scholar
35.Hugh-Jones, M.Global awareness of disease outbreaks: the experience of ProMED-mail. Public Health Rep. 2001;116 (Suppl 2):2731.Google Scholar
36.Woodall, J, Calisher, CH.ProMED-mail: background and purpose. Emerg Infect Dis. 2001;7 (3):563.Google Scholar
37.Madoff, LC, Woodall, JP.The internet and the global monitoring of emerging diseases: lessons from the first 10 years of ProMED-mail. Arch Med Res. 2005;36:724730.Google Scholar
38.Mykhalovskiy, E, Weir, L.The Global Public Health Intelligence Network and early warning outbreak detection: a Canadian contribution to global public health. Can J Public Health. 2006;97:4244.CrossRefGoogle ScholarPubMed
39. Brownstein JS, Freifeld C. HealthMap: Global Disease Alert Map. http://www.healthmap.org. Accessed August 29, 2007.Google Scholar
40.Larkin, M.Technology and public health: Healthmap tracks global diseases. Lancet Infect Dis. 2007;7:91.CrossRefGoogle Scholar
41. Health Threats Unit at Directorate General Health and Consumer Affairs of the European Commission. MedISys (Medical Intelligence System). http://medusa.jrc.it. Accessed September 14, 2007.Google Scholar
42. Tolentino H. Scanning the Emerging Infectious Diseases Horizon: Visualizing ProMED Emails Using EpiSPIDER. Paper presented at International Society for Disease Surveillance Annual Conference; Baltimore, 2006.Google Scholar
43.Keystone, JS, Kozarsky, PE, Freedman, DO.Internet and computer-based resources for travel medicine practitioners. Clin Infect Dis. 2001;32:757765.Google ScholarPubMed
44.Brodie, M, Flournoy, RE, Altman, DE, Blendon, RJ, Benson, JM, Rosenbaum, MD.Health information, the Internet, and the digital divide. Health Aff (Millwood). 2000;19:255265.Google Scholar
45.Bhatnagar, S, Schaware, R.Information and Communication Technology in Development: Cases from India. Thousand Oaks, CA: Sage Publications; 2000.Google Scholar
46.Arita, I, Nakane, M, Kojima, K, Yoshihara, N, Nakano, T, El-Gohary, A.Role of a sentinel surveillance system in the context of global surveillance of infectious diseases. Lancet Infect Dis. 2004;4:171177.CrossRefGoogle ScholarPubMed
47.Guerin, PJ, Grais, RF, Rottingen, JA, Valleron, AJ.Using European travellers as an early alert to detect emerging pathogens in countries with limited laboratory resources. BMC Public Health. 2007;7:8.Google Scholar
48.Bloom, BR.Lessons from SARS. Science. 2003;300:701.Google Scholar
49.Deodhar, NS, Yemul, VL, Banerjee, K.Plague that never was: a review of the alleged plague outbreaks in India in 1994. J Public Health Policy. 1998;19:184199.Google Scholar
50.Fidler, DP.Emerging trends in international law concerning global infectious disease control. Emerg Infect Dis. 2003;9:285290.Google Scholar
51.Schuklenk, U, Gartland, KM.Confronting an influenza pandemic: ethical and scientific issues. Biochem Soc Trans. 2006;34 (Pt 6):11511154.Google Scholar
52.Butler, D.Disease surveillance needs a revolution. Nature. 2006;440:67.Google Scholar
53.Beyrer, C, Suwanvanichkij, V, Mullany, LC, et alResponding to AIDS, tuberculosis, malaria, and emerging infectious diseases in Burma: dilemmas of policy and practice. PLoS Med. 2006;3:e393.Google Scholar
54.Koh, H.Why do nations obey international law? Yale Law J. 1997;106:25992659.Google Scholar
55.Fidler, DP.Globalization, international law, and emerging infectious diseases. Emerg Infect Dis. 1996;2:7784.Google Scholar
56.Tanne, JH.Tuberculosis case exposes flaws in international public health systems. BMJ. 2007;334:1187.Google Scholar