Expert Report

Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases (2009)

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Recent outbreaks of pandemic H1N1 (so-called "swine flu"), avian influenza H5N1 ("bird flu"), and severe acute respiratory syndrome (SARS) are examples of how zoonotic diseases -- those transmissible between humans and animals -- can threaten health and economies around the world. Zoonotic diseases have caused more than 65 percent of emerging infectious disease events in the past six decades, and increasing global interconnectedness means that humans, animals, and animal products can circumnavigate the globe in hours, making virtually all locations vulnerable to the diseases they may carry. This report from the Institute of Medicine and National Research Council assesses global disease surveillance capacity and makes recommendations for improving that capacity for early detection and response to zoonotic diseases outbreaks.

Key Messages

  • Another problem is the mismatch of surveillance capabilities in locations where diseases are most likely to emerge. The industrialized world has the most robust surveillance systems for both humans and animals health, however most recent zoonotic diseases have emerged in the developing world, where surveillance systems are weaker.
  • Because the U.S. government is among the world leaders in disease surveillance, and has a considerable stake in the emergence and spread of zoonotic diseases, that it should lead efforts to coordinate a globally integrated and sustainable zoonotic disease surveillance system.
  • Build Human Resources Capacity. To produce and retain a skilled multidisciplinary workforce capable of conducting integrated surveillance and response, new and existing personnel need to be trained in field-based, integrated emerging zoonotic disease surveillance and response.
  • Confronting the threat of zoonotic disease emergence benefits governments and people of all states thus the committee concluded that a global zoonotic disease surveillance system is a global public good.
  • Create an Audit and Rating Framework. At present, there is no independent mechanism to review progress towards achieving integrated surveillance and response system capabilities, increasing the likelihood of uneven or incomplete progress.
  • Deepen Engagement of Stakeholders. The complexity of achieving sustainable, integrated national and global surveillance and response systems for zoonotic diseases requires deliberate and intensified efforts to engage and connect all relevant stakeholders at each governance level local, national, and global.
  • Detecting and responding to zoonotic diseases is challenging, because the underlying drivers of zoonotic disease emergence and spread result from an evolving complex of biological, genetic, ecological, political, economic, and social factors.
  • Establish a Zoonotic Disease Drivers Panel. The drivers of zoonotic disease are individually and collectively complex, and the measures for controlling them are transnational in nature.
  • Improve Use of Information Technology. Information technology is essential for early disease detection, monitoring, and disease surveillance by enabling real-time collection and sharing of detailed information about outbreaks.
  • In the U.S. and elsewhere, traditional systems of infectious disease surveillance in humans operate separately from those for animals. This separation impedes communication between animal and human health officials on zoonotic disease occurrences that can threaten human health.
  • Mitigate Disease Threats from Wildlife and Trade. The legal and illegal trade in wildlife and wildlife products is an often ignored conduit for zoonotic pathogens, and it is apparent that ability to monitor and control this trade is limited. There is also noted lack of coordination, even within the United States, for disease detection in livestock and animal product imports and in wildlife.
  • Recent concerns about a potential highly virulent human influenza pandemic have resulted in coordinated international action to help countries improve their ability to detect disease outbreaks
  • Revise OIE Governance Strategies. OIE rules lack important provisions found in the IHR 2005 that should be operative to promote animal health.
  • Strengthen Incentives for Country and Local Reporting. An important lesson from disease outbreaks such as HPAI H5N1 is that the ability of the global human and animal health systems to respond is only as good as the willingness and ability of local and national systems to detect and report outbreaks.
  • The committee was unable to identify a single example of a well-functioning, integrated zoonotic disease surveillance system across human and animal health sectors.
  • The long-term infrastructure for disease surveillance and response has been underfunded in part due to the historical practice of time-limited donor funding for specific diseases.
  • The movement of goods and people across borders such as trade in food animals and exotic pets, international travel, and the movement of refugees into compromised living conditions has increased the risk of disease spread.