Driving improvements in emerging disease surveillance through locally relevant capacity strengthening

Abstract

Emerging infectious diseases (EIDs) threaten the health of people, animals, and crops globally, but our ability to predict their occurrence is limited. Current public health capacity and ability to detect and respond to EIDs is typically weakest in low- and middle-income countries (LMICs). Many known drivers of EID emergence also converge in LMICs. Strengthening capacity for surveillance of diseases of relevance to local populations can provide a mechanism for building the cross-cutting and flexible capacities needed to tackle both the burden of existing diseases and EID threats. A focus on locally relevant diseases in LMICs and the economic, social, and cultural contexts of surveillance can help address existing inequalities in health systems, improve the capacity to detect and contain EIDs, and contribute to broader global goals for development.

Trained health care professionals treat a boy aboard a hospital ship that provides responsive medical outreach to isolated communities along the Brahmaputra River, Bangladesh.

Canine rabies vaccination campaigns achieve community engagement to improve disease control and surveillance in Siaya County, Kenya.

Fig. 1. Surveillance cycles for current and potential disease problems.

The lower cycle illustrates the self-reinforcing nature of effective surveillance processes for existing disease problems. The upper cycle illustrates the equivalent processes for potential disease problems. Because it is difficult to implement interventions for potential disease threats that provide a useful response, and thus motivate further grassroots data collection, this cycle is less intrinsically sustainable, limiting the long-term effectiveness of approaches that focus on EIDs and potential threats alone. The vertical arrows show how capacity for potential disease problems and EID surveillance overall can be built by “borrowing” critical capacities (shown by the vertical arrows) from approaches that focus on existing diseases.