Global cooperation vital as new diseases emerge at unprecedented rate, warns UN

With new diseases emerging at an unprecedented rate in an increasingly interconnected world, often with the ability to cross borders rapidly, global public health security depends on international cooperation and surveillance more than at any previous time in history, the United Nations health agency warned in its annual report today.

“Given today’s universal vulnerability to these threats, better security calls for global solidarity,” UN World Health Organization (WHO) Director-General Margaret Chan said in releasing this year’s World Health Report, entitled “A safer future: global public health security in the 21st century.”

“International public health security is both a collective aspiration and a mutual responsibility. The new watchwords are diplomacy, cooperation, transparency and preparedness,” she added of the report, which calls pandemic influenza the most feared threat to health security in our times.

Experts fear that the current bird flu virus, which has so far infected 321 people, killing 194 of them, could mutate to easy human-to-human transmission. The so-called Spanish flu pandemic of 1918-1920, which spread easily between humans, is estimated to have killed from 20 million to 40 million people. The experts say a new flu pandemic is not a question of if but of when.

The report sets out the WHO strategic action plan to respond to a pandemic. It also draws attention to the need for stronger health systems and for continued vigilance in managing the risks and consequences of the international spread of polio and the newly emerging strain of extensively drug-resistant tuberculosis (XDR-TB).

It notes that since 1967, at least 39 new pathogens have been identified, including HIV, the deadly haemorrhagic Ebola and Marburg fevers, and Severe Acute Respiratory Syndrome (SARS), which emerged in China in 2003 and spread rapidly as far as Canada, infecting more than 8,000 people, over 800 of them fatally, before it was brought under control.

Other centuries-old threats, such as pandemic influenza, malaria and tuberculosis, continue to pose a threat to health through a combination of mutation, rising resistance to antimicrobial medicines and weak health systems. New threats have also emerged, linked to potential terrorist attacks, chemical incidents and radio-nuclear accidents, it adds.

Its recommendations include global cooperation in surveillance and outbreak alert and response; open sharing of knowledge, technologies and materials, including viruses and other laboratory samples, necessary to optimize secure global public health; and global responsibility for capacity building within the public health infrastructure of all countries.

The report also calls for cross-sector collaboration within Governments and increased global and national resources for training, surveillance, laboratory capacity, response networks, and prevention campaigns.

It shows how and why diseases are increasingly threatening global public health security, citing the high and rapid mobility of people as one factor. Airlines now carry more than two billion passengers a year, enabling people and the diseases that travel with them to pass from one country to another in a matter of hours.

The potential health and economic impact was seen in 2003 with SARS, which cost Asian countries an estimated $60 billion of gross expenditure and business losses.

The report outlines some of the human factors behind public health insecurity, including inadequate investment in public health resulting from a false sense of security in the absence of infectious disease outbreaks; unexpected policy changes such as a decision temporarily to halt immunization in northern Nigeria in 2003, which led to the re-emergence of polio cases; and conflicts where forced migration obliges people to live in overcrowded, unhygienic and impoverished conditions heightening the risk of epidemics.

Other factors include microbial evolution and antibiotic resistance and animal husbandry and food processing threats such as the human form of bovine spongiform encephalopathy (BSE) and Nipah virus.