Impediments to global surveillance of infectious diseases: consequences ofopen reporting in a global economy

Globalization has led to an increase in the spread of emerging and re-emerg ing infectious diseases. international efforts are being launched to contro l their dissemination through global surveillance, a major hindrance to whi ch is the failure of some countries to report outbreaks. Current guidelines and regulations on emerging and re-emerging infectious diseases do not suf ficiently take into account the fact that when developing countries report outbreaks they often derive few benefits and suffer disproportionately heav y social and economic consequences. In order to facilitate full participation in global surveillance by develop ing countries there should be: better and more affordable diagnostic capabi lities to allow for timely and accurate information to be delivered in an o pen and transparent fashion; accurate, less sensationalist news reporting o f outbreaks of diseases; adherence by countries to international regulation s, including those of the World Trade Organization and the International He alth Regulations; financial support for countries that are economically dam aged by the diseases in question. The article presents two cases - plague in India and cholera in Peru - that illuminate some of the limitations of current practices. Recommendations a re made on measures that could be taken by WHO and the world community to m ake global surveillance acceptable.