Volume 12, Number 7—July 2006
Perspective
Global Public Health Surveillance under New International Health Regulations
Michael G. Baker*
and David P. Fidler†
and David P. Fidler†
Table 2
Barriers to International Health Regulations (IHR) 2005 surveillance effectiveness, and potential responses
| Barrier | Description | Potential responses |
|---|---|---|
| Technical | Difficulty detecting previously unrecognized pathogens, especially those with asymptomatic transmission | Specialized surveillance approaches such as syndromic surveillance; improved diagnostic technologies; training and support for epidemiology, laboratory, and other staff |
| Resource | Limited resources for public health surveillance, particularly in developing countries | Systematic global strategy for assessment and development of surveillance and response capacities, particularly in developing countries |
| Governance | Lack of awareness about limitations of existing surveillance and lack of governance capabilities to develop and manage sophisticated systems | Training and support for public health professionals and managers; periodic surveillance system evaluations; performance monitoring focusing on attributes such as sensitivity and timeliness |
| Legal | Potential for countries to make reservations to some obligations in IHR 2005 and concerns it may not be consistent with domestic law in some countries | Formulation of reservations to ensure minimal effects on public health surveillance; development of "model" public health legislation that can be adapted for use in many countries |
| Political | Concern about potential negative effects on trade and tourism from reporting disease events | Strategies to limit excessive responses; fostering a collaborative, measured response to public health emergencies of international concern; awareness of self-defeating effects of withholding information |
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