Trade, foreign policy, diplomacy and health

8. International Health Regulations and Epidemic Control

Johan Giesecke


Alert function

  • Weak incentive for an affected country to notify WHO
  • Full potential of alert function further restricted by short list of diseases reportable
  • WHO can only act on official information (cannot spread information if the country affected does not report it)

There is, generally, a weak incentive for an affected country to notify the WHO of its problems. It is also questionable whether the long-term goodwill from a reputation of always being open about infectious disease problems confers any advantage to a country.

The full potential of an alert function is further restricted by the short list of diseases reportable under the IHR, and by the fact that the WHO can only act on official information from a national government. Even if there is clear evidence of a dangerous outbreak that is threatening other countries, the IHR gives no mandate for the WHO to spread this information if the country affected does not report it.

The argument also presumes that it is the individual countries who are most apt to discover, or verify, outbreaks within their own territories. One alternative might be that one well-equipped, developed country assumed responsibility for global surveillance. Another route is indicated by the electronic forum ProMED, in which scientists and public health officials around the world exchange information on outbreaks daily. Both these options share the problem that national control of epidemics still remains a task for each country's government - with or without external assistance.

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