Global assessment and recommendations for the development of international disease surveillance capacity

In 2005, the World Health Organization (WHO) revised its International Health Regulations (IHR (2005)), requiring countries to develop and maintain disease surveillance and reporting mechanisms to strengthen national response capacities. IHR (2005) expands the WHO 1969-mandated notifiable events from cholera, plague, and yellow fever to all events that may constitute a public health emergency of international concern, including existing, new, and reemerging diseases. The new surveillance requirements set forth by IHR (2005) aim to provide WHO with early warning of potential outbreaks and epidemics; however, many developing countries where these types of events have historically occurred are notably lacking in their surveillance capabilities.

In the following study, we focus on the second of four key areas of work within IHR (2005): to strengthen national disease surveillance, prevention, control, and response systems. We provide an assessment of international disease surveillance systems, including a catalog of systems and regional analysis of disease surveillance capacity, as well as a discussion of qualities of successful surveillance systems for communicable diseases. The authors also will discuss recommendations for the minimum resources, such as infrastructure, technology, and personnel necessary for WHO Member States to meet IHR (2005) global detection and reporting obligations. Beyond providing early warning of potential outbreaks, these recommended improvements in surveillance and health communications also can provide warning of accidental laboratory leaks or bioterrorist attacks.