Quick post; I’ve a 2-page article in Nature tonight on the need to reinvent the world’s disease surveillance systems, in particular with respect to avian flu. The problem is so large, that it could have been 15 pages, or a book.
I have my thoughts on what are the roles and responsibilities of international agencies such as WHO, FAO, and OIE, and their own agendas, and their diplomatic and other constraints, and also what are the glaring elements lacking in the current international system, but I’ll save that for a later date in Nature… And yes we can also talk about cats and H5N1; see my article from two weeks ago on this risk.
Here are a few excerpts from tonight’s article:
“With avian flu spreading around the world at a frightening rate, scientists are welcoming an international proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world’s veterinary and disease-surveillance systems.
Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa. “H5N1 has focused the spotlight of the world on disease surveillance, and it’s showing up all the pimples and warts,” says Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information systems company in Redlands, California.
Developing countries, in particular, lack decent human-disease surveillance, and animal monitoring is often virtually nonexistent, with few basic laboratory and epidemiological resources available. “On the ground in Indonesia, there is no systematic programme at all,” says Peter Roeder, a field consultant with the United Nations’ Food and Agriculture Organization (FAO). “It’s just a bloody mess.””
“But many feel that alongside setting up local centres, epidemiology needs a fundamental overhaul. Even in developed countries, the field has been chronically underfunded, says Antoine Flahault, director of Sentinelles, France’s national disease surveillance network. He adds that he is jealous of the multimillion-dollar satellites that climate scientists enjoy and the powerful accelerators being built for physicists. In comparison, epidemiologists “are still in the nineteenth century”, he says.”
“Another fundamental problem is the lack of strong international leadership: there is no global body able to take overall responsibility for emerging diseases, particularly those that jump to humans from animals. The World Health Organization would be an obvious choice, but although it has a strong remit for public health, it is not responsible for monitoring outbreaks in animals â€” that duty belongs to the FAO and to the Paris-based World Organisation for Animal Health (OIE).
Neither of those organizations traditionally monitors outbreaks from a public-health point of view, however â€” the FAO is concerned with food safety [that was an editing error in the published article; it should just read “food”] and the OIE is responsible for trade issues. “Veterinary services throughout the world, particularly in developing countries, are very weak on this. They are not set up to watch for emerging disease events,” says Roeder.”
And as Roeder concludes:
“The world has to get to grips with the fact that what is happening now is going to happen repeatedly,” says Roeder. “We have to develop a global structure to tackle emerging diseases.”