The Geneva Health Forum Abstracts

D.L. Heymann1 1Representative of the Director-General for Polio Eradication, World Health Organization, Geneva 27, Switzerland

Key issues: The emergence of new infectious diseases such as Severe Acute Respiratory Syndrome (SARS) and avian influenza A (H5N1); and the re-emergence of others such as cholera and yellow fever ? combined with the increased speed and volume of international travel and trade ? have alerted countries to the ease with which infectious diseases can cross national borders and defy traditional defences. The international spread of infectious diseases from any country is an external danger from which state citizens need to be shielded through stronger systems of public health defence. Infectious diseases also threaten national security when deteriorating health trends in any one country lead to instability and social upheaval. Endemic infectious diseases are a particular security challenge as they resurge, because they behave in ways that can overwhelm social and public health infrastructures and cause demographic disparity. The emergence of AIDS and its rapid progression to endemicity convinced the world that a previously unknown pathogen can cause social and economic upheaval on a scale that threatens to destabilize whole regions.
Meeting challenges: In developing countries, the destabilizing effect of AIDS, and other endemic diseases such as tuberculosis and malaria, is amplifi ed by emerging and epidemic-prone diseases. Outbreaks and epidemics disrupt routine control programmes and health services, often for extended time periods, due to the extraordinary resources and logistics required for their containment. The dramatic interruption of trade, travel, and tourism that can follow news of an outbreak or epidemic thus places a further burden on public health systems in already fragile economies.
Conclusion and recommendations: Foreign policy agendas that aim to build a more secure world are increasingly including the emergence and resurgence of infectious diseases as a security challenge that needs to be addressed. They have global causes and consequences that can only be addressed through international global partnership, supported by strong national public health capacity. In April 2000, WHO launched the Global Outbreak Alert and Response Network (GOARN) as a partnership to keep the volatile microbial world under close surveillance and ensure that outbreaks are quickly detected and contained. This network of networks interlinks, in real time, over 110 existing networks that, together, posses much of the data, expertise and skills required to keep the international community alert to outbreaks and ready to respond. It was GOARN that detected and responded to the SARS outbreak in 2003, and it is GOARN that continues to watch over the current avian influenza pandemic threat.