WHO report highlights the ongoing pandemic risk caused by established and new pathogens

More than at any previous time in history, global public health security depends on international cooperation and the willingness of all countries to act effectively in tackling new and emerging threats. That is the clear message of this year's WHO World health report entitled ‘A safer future: global public health security in the 21st century’, which concludes with six key recommendations to secure the highest level of global public health security:

* Full implementation of the revised International Health Regulations (IHR 2005) by all countries;
* 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;
* Global responsibility for capacity building within the public health infrastructure of all countries;
* Cross-sector collaboration within governments; and
* Increased global and national resources for training, surveillance, laboratory capacity, response networks, and prevention campaigns.

In our increasingly interconnected world, new diseases are emerging at an unprecedented rate, often with the ability to cross borders rapidly and spread, warms the report. Since 1967, at least 39 new pathogens have been identified, including HIV, Ebola haemorrhagic fever, Marburg fever and SARS. 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.

"Given today's universal vulnerability to these threats, better security calls for global solidarity," said Dr Margaret Chan, Director-General of WHO. "International public health security is both a collective aspiration and a mutual responsibility. The new watchwords are diplomacy, cooperation, transparency and preparedness."

The report shows how and why diseases are increasingly threatening global public health security. High and rapid mobility of people is one factor. Airlines now carry more than 2 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 US$ 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 Nigeria, which led to the re-emergence of polio cases;
* Conflict situations when forced migration obliges people to live in overcrowded, unhygienic and impoverished conditions heightening the risk of epidemics;
* 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.

Pandemic influenza is described as the most feared threat to health security in our times. The report sets out the WHO strategic action plan to respond to a pandemic, 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 TB (XDR-TB). New health threats have also emerged, linked to potential terrorist attacks, chemical incidents and radionuclear accidents.

www.who.int

•Date: 24th August 2007• Region: World •Type: Article •Topic: Pandemic planning
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