Global novel disease surveillance: Majority of countries lack preparednes

In a recent study posted to the Preprints with The Lancet / SSRN´s First Look* preprint server, researchers explored national surveillance for new diseases in different countries.

Study: National Surveillance for Novel Diseases: A Systematic Analysis of 195 Countries. Image Credit: WorldDay/Shutterstock.com

*Important notice: Preprints with The Lancet publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Background

Novel pathogen-induced pandemics have severe worldwide consequences. The International Health Regulations (IHR) (2005) mandate that countries document outbreaks of unknown causes since early detection is crucial.

However, the scope of new disease surveillance on a global scale remains uncertain. Baseline information facilitates novel global preparedness initiatives such as the Pandemic Treaty.

About the study

In the present study, researchers identified the number of nations considering emerging diseases in their public health infrastructure.

The study included 195 out of 196 countries that were a part of the IHR(2005). Data were collected from July to December 2022. In January 2023, the dataset was updated by re-examining all sources for any new publications.

The definition of novel disease consideration involves written material at the national level on new diseases, which can be found in public health laws, health professional guidelines, laboratory guidelines, or notifiable disease lists.

Public health laws encompass various types of legislation related to epidemics, public health, surveillance systems, and infectious diseases. The nationally notifiable disease lists include all infectious diseases that require mandatory reporting.

A search strategy was assembled to analyze government sources and determine if countries had publicly accessible proof of novel disease consideration available. The team identified potential resource locations for each country by examining existing databases and resources, such as World Health Organization (WHO), Joint External Evaluation reports, and the 2021 Global Health Security Index (GHSI).

The study screened resources in four categories to find evidence of novel disease considerations for each country. These categories included national public health laws, health professional guidelines, laboratory guidelines, and nationally notifiable disease lists.

Results

73 out of 195 countries showed proof of novel disease consideration among the four resource types analyzed. The proportion of countries with evidence of a new disease varied greatly across different WHO regions, ranging from eight out of 47 nations in the African Region to 30 out of 54 nations in the European Region.

The study found a correlation between the consideration of novel diseases and the income stratification of nations, with a higher number of high-income countries showing evidence of such consideration compared to low-income countries.

In total, novel disease consideration was found for all four resource locations in only eight out of 195 countries. None of the assessed countries had health professionals as well as laboratory guidance.

Almost 38 out of 195 countries have evidence for requirements for reporting novel diseases included in their national public health law. The presence of legal instruments varied among World Bank income strata, from one out of 27 low-income countries to 17 out of 53 upper-middle-income countries.

National public health law's consideration of novel diseases was positively associated with income level. The number of countries that reported the inclusion of novel diseases in their national public health law varied greatly across different WHO Regions, ranging from one out of 21 nations in the Eastern Mediterranean region to 22 out of 54 in the European Region.

Approximately 29 of 195 countries included new diseases in their list of nationally notifiable diseases. Adding new diseases to the list was linked to the country's income level but not the WHO region. Health professional guidance concerning novel diseases was found in 47 countries, varying based on the WHO region and the World Bank income strata.

Out of the 47 countries having evidence of novel disease guidance, 20 provided written health professional guidelines, ten showed written guidelines as well as a form, two revealed a reporting form, and 15 countries only reported novel diseases in publicly accessible resources.

Countries with evidence of novel disease consideration had a higher average 2021 GHSI score and a higher average 2021 State Party Self-Assessment Annual Reporting (SPAR) score than those without evidence.

In 2021, countries with novel disease considerations performed better than those without in all capacity groups in the GHSI and SPAR.

Conclusion

The study findings revealed that most countries lack consideration of novel diseases as a part of their public health infrastructure.

It is crucial to have effective and swift outbreak detection techniques in all countries to protect global public health.

The team suggests that while the Pandemic Treaty negotiations are a positive step, it is important for public health policymakers to take action promptly to improve national surveillance systems. It is also crucial to prepare for potential future disease threats as soon as possible.

*Important notice: Preprints with The Lancet publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Bhavana Kunkalikar

Bhavana Kunkalikar is a medical writer based in Goa, India. Her academic background is in Pharmaceutical sciences and she holds a Bachelor's degree in Pharmacy. Her educational background allowed her to foster an interest in anatomical and physiological sciences. Her college project work based on ‘The manifestations and causes of sickle cell anemia’ formed the stepping stone to a life-long fascination with human pathophysiology.