E Ditorial a Re There ‘new ’ and ‘old ’ Ways to Track Infectious Diseases Hazards and Outbreaks?

In May 2005 the World Health Assembly approved an innovative and ambitious revision of the International Health Regulations, known as IHR(2005), in order to detect and control, in a timely manner, all public health events that may have a serious international impact. It represents a dramatic move from administrative notification by Member States (MS) to the World Health Organization (WHO) of cases of a limited list of diseases to a systematic analysis of health events of international concern, infectious or not [1]. The analysis of the public health events will take into account severity, unexpectedness, potential for international spread, and interference with international movement of people and goods. National focal points are to be identified in each MS to interact with WHO. The philosophy behind the new IHR is to promote early dialogue between MS and WHO, leading early mutual risk assessment of events which may not necessarily have to be notified, depending on the results of the assessment and measures taken. WHO can also use informal sources to detect earlier events of international concern and then, together with the national focal point, conduct verification, risk assessment and implement appropriate measures. To be successful, IHR(2005) will need to rely on sufficient public health capacity at all levels within the MS, with a strong core surveillance function that can be summarised as the efficient management of health data and response from the first line health practitioner (eg, clinician, biologist) to local, regional and national public health structures. The key issues are the capacity and performance of the public health system and its ability to communicate and interact within its different sectors and with decision makers in a timely, authoritative and transparent way [1]. IHR(2005) add challenges and responsibilities for MS that may need to adjust their national public health infrastructure, often without the help of extra resources. Several events in recent years, such as SARS, avian influenza and the threat of bioterrorism, have served as an early introduction to the concept of IHR(2005). The experience of implementing a weekly early warning committee at the National Institute for Public Health and the Environment in the Netherlands [2] illustrates how some MS are already organised in this respect. The European Early Warning and Response System (EWRS) which has linked MS and the European Commission through an electronic real time secured system since 1998 (and the European Centre for Disease Prevention and Control since …