Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases (2009) / Chapter Skim
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5 Incentives for Disease Surveillance, Reporting, and Response
5 Incentives for Disease Surveillance, Reporting, and Response
Pages 165-186
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From page 165... ...
Morse "Global Infectious Disease Surveillance and Health Intelligence" Health Affairs, 00 An important lesson from disease outbreaks such as severe acute respiratory syndrome (SARS) is that the ability of the global human and animal health system to respond is only as good as the ability and willingness of local and national systems to detect and report outbreaks.
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From page 166... ...
. Government officials may also try to downplay human and animal health system shortfalls and disease outbreaks if those issues lead critics to question an official's performance and the ability of the government to provide basic services to its citizens (Farmer, 1992)
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From page 167... ...
. Therefore, local authorities need effective disease surveillance to identify local outbreaks and to rapidly contain them to reduce the risks of zoonotic disease spread to human and animal populations.
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At the National, Regional, and Global Levels National authorities face conflicting incentives to report disease outbreaks (Malani and Laxminarayan, 2006)
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From page 169... ...
To avoid the problem of outbreak concealment, it is important to incentivize outbreak reporting within countries by designing outbreak control measures and providing adequate compensation schemes. Economic considerations are not the only reasons why countries do not 1 Eradication carries geographically distinct meanings in human and animal medicine.
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From page 170... ...
likely occurred in most countries, as shown by the proximity of the dates the outbreak was declared in different countries -- Vietnam, January 8, 2004; Lao PDR, January 14; Thailand and Cambodia, January 23; and Indonesia, January 25 -- which is epidemiologically highly unlikely. The delayed notification may be partly attributed to inadequate diagnostic facilities and the lack of skilled staff, and partly to political pressure on human and animal health services to suppress information because of the economic consequences in lost domestic and export markets for poultry products and tourism (O'Neill, 2004)
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From page 171... ...
Reporting by the Food Production Industry Voluntary reporting by industry could play an important role in detecting zoonotic disease outbreaks. In developed countries, food producers sometimes issue safety warnings or withdraw their products from the market to protect themselves from legal action from affected consumers.
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• Environmental impacts of carcass disposal • Requires funding that many poorer states do not have Sanction National governments, • Prevents importation of diseased animal • Discourages disease reporting because of regions WTO, international products anticipated sanctions impacted countries • Compartmentalized rather than fully national • Difficult to sanction human cases by disease trade sanctions imposed upon the occurrence of • Loss of income for affected areas, even if no an emerging infectious disease disease present on individual farm Strengthen WHO, FAO, OIE, • Obtains more information about disease • Increases in false positives that have to be informal NAHLN outbreaks for quicker alerts investigated disease • Greater awareness of overall health status, • Attribution/retribution concerns for whistleblowers surveillance locally to globally networks
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From page 173... ...
fewer false negatives, reagents veterinary laboratories, which decreases missed outbreaks • Decreases in feasibility discourages local reporting organizations with • Earlier detection reduces cost of outbreak • Increases need for sharing outside of country or international oversight control, which is more timely region decreases control of the information on reporting and • A simpler test possibly reduces costs, provides • Less feedback from national authorities: In laboratory practices more information resource-constrained countries, local reporting standard setting • Cost effectiveness combined with a safer test might decrease vis-à-vis failed feedback from the (WHO, FAO, OIE) • Feasibility of test, leads to better sample quality national level • Safety of laboratory personnel due to new safety requirements Strengthen National governments • Increases the feasibility of response to an • Increases costs associated with strengthening capacity and international outbreak infrastructure and training at country partners proving • More timely response, thus encouraging early • Increases bureaucracy at all levels level to technical assistance or reporting respond to funding • Improved communication across all levels outbreaks • More control in country of the containment of outbreaks, resulting in less dependency on foreign technical support NOTES: FAO = Food and Agricultural Organization of the United Nations, NAHLN = National Animal Health Laboratory Network, OIE = World Organization for Animal Health, WHO = World Health Organization, WTO = World Trade Organization.
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From page 174... ...
animals is an important part of the human and animal health response to disease outbreaks in animal populations. There are several reasons to compensate private stakeholders for losses incurred as a result of public action, such as paying farmers an indemnity for culling diseased or suspected infected animals for an emerging disease.
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when available except as otherwise identified in the SPS Agreement. Trade measures that protect animal and plant life or health usually fall within the scope of the SPS Agreement, meaning that the TBT Agreement would not apply.
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Economic Losses from Trade and Travel Sanctions Outbreaks of zoonotic diseases impose significant effects on human and animal health and lead to economic consequences on affected countries. Disease outbreak reporting often leads unaffected countries to enact travel and trade restrictions on the affected country that far exceed the actual disease threat (Merianos and Peiris, 2005)
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From page 177... ...
During the outbreak in Hong Kong, a number of Southeast Asian countries, including Singapore, Malaysia, and Thailand, issued travel warnings, which resulted in an 80 percent reduction in visitors to Hong Kong from these countries as compared to the previous year (Bradsher, 2003)
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From page 178... ...
. INCENTIVES TO IMPROVE DISEASE SURVEILLANCE AND REPORTING Disease Outbreak Control Assistance as an Incentive Countries unable to contain outbreaks are far less likely to report them, and providing assistance for outbreak control is perhaps the most important form of external motivation for disease surveillance and prompt reporting (Laxminarayan et al., 2008)
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From page 179... ...
IHR 2005 now calls on national governments to report a wide range of unusual human and animal health events and allows WHO to announce an outbreak, even if it has not first been reported by the government of country of origin (Nicoll et al., 2005)
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From page 180... ...
Such a framework would also give all countries an incentive to improve their disease surveillance system because a demonstration of prompt disease outbreak reporting would help reduce their rate of risk and alleviate trade and tourism concerns in the event of an unconfirmed outbreak. Any risk identified by the risk-rating framework would alone be insufficient to support a restrictive trade measure for health reasons.
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From page 181... ...
Capacity assessment information for both human and animal health is essential. It is useful in devising national and local incentives, establishing a disease surveillance system, and in timely disease reporting by local and national participants to protect human and animal health and livelihoods.
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The Safe Supply of Affordable Food Everywhere (SSAFE) initiative is a public-private partnership that includes multinationals such as Cargill, Nestle-Purina, McDonald's, Pfizer Animal Health, and Coca-Cola.
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With the multiplicity of actors, there is a need for improved intersectoral and international coordination, communication, and community of practice to enable environments that facilitate working toward cross-disciplinary collaboration for disease surveillance and response, practice, and research. The committee concludes that participation by partners at various levels in disease surveillance, monitoring changes in community perception and response to the presence and threat of zoonotic disease, and media coverage of such diseases are essential and should be included for comprehensive disease surveillance systems in human and animal health.
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Presentation, Third Com mittee Meeting on Achieving Sustainable Global Capacity for Surveillance and Response to Emerging Diseases of Zoonotic Origin, Woods Hole, MA, September 30. Ahmad, K
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From page 185... ...
2006. Surveillance and reporting of disease outbreaks: Private incentives and WHO policy levers.
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From page 186... ...
2006. Enhancing control of highly pathogenic avian influenza in developing countries through compensation: Issues and good practices.
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