Trade, foreign policy, diplomacy and health

8. International Health Regulations and Epidemic Control

Johan Giesecke

Early control

  • Most developing countries will need outside assistance to control outbreaks
  • Assurance of such assistance could act as an incentive to notify
  • Developed countries should get net benefit this control of outbreak, rather than later treatment domestically

Many developed countries could probably manage to control most of their outbreaks themselves, without outside assistance, whereas most developing countries may not. Assurance that such assistance will be provided could even act as an incentive to notify the outside world of internal problems. Following the line of reasoning that it is better to eliminate epidemics early, it may also be a net saving for developed countries to provide assistance to a less-developed country immediately an outbreak situation occurs, rather than try to prevent importation or treatment of disease later.

Such an economic gain may be clearly visible when one country is directly threatened by an outbreak in another, but less so when there is a diffuse threat to a number of countries. In this case, some international mechanism is required to share the burden and co-ordinate the response for the public good of many. This view on concerted actions for the prevention of international outbreaks - lead for example by the WHO - is probably less prevalent than the purely humanitarian wish to save lives at an epicentre of an epidemic. Resources put into such an action could thus easily be regarded as expenditure rather than as investment, and the portions granted by individual countries would not automatically correspond to that country's share of the savings from the early control of an outbreak.

Also, by definition, outbreaks are rapid events. International assistance may be required urgently, and co-ordination is often a problem. The IHR does not automatically give this co-ordination role to the WHO, and, even if it did, this might not be recognised by NGOs and other organisations working in the field.