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Abstract
Since the revisions to the International Health Regulations (IHR) in 2005, much attention has turned to how states, particularly developing states, will address core capacity requirements attached to the revised IHR. Primarily, how will states strengthen their capacity to identify and verify public health emergencies of international concern (PHEIC)? Another important but under-examined aspect of the revised IHR is the empowerment of the World Health Organization (WHO) to act upon non-governmental reports of disease outbreaks. The revised IHR potentially marks a new chapter in the powers of ‘disease intelligence’ and how the WHO may press states to verify an outbreak event. This article seeks to understand whether internet surveillance response programs (ISRPs) are effective in ‘naming and shaming’ states into reporting disease outbreaks.
Acknowledgements
I would like to acknowledge the Australian Research Council for funding this research for Discovery Project 0878792. I appreciate the blind reviewers' careful consideration of my article and their generous assistance in sharpening the argument, though faults remain my own. Finally, thanks to Alex J. Bellamy, Jeremy Youde and Stephen James for their generous help with this paper and preparation of the special section.
Notes
1 World Health Organization (WHO), A Framework for Global Outbreak Alert and Response, WHO/CDS/CSR/2000.2 (2000), 1; George J. Armelagos, ‘Emerging Disease in the Third Epidemiological Transition’, in The Changing Face of Disease: Implications for Society, ed. Nick Mascie-Taylor, Jean Peters, and Stephen T. McGarvey (Boca Raton, FL: CRC Press, 2004), 7.
2 David Sanders and Mickey Chopra, ‘Globalization and the Challenge of Health for All: A View from Sub-Saharan Africa’, in Health Impacts of Globalization: Towards Global Governance, ed. Kelley Lee (Basingstoke: Palgrave Macmillan, 2003), 106.
3 World Health Assembly (WHA), Revision and Updating of the International Health Regulations, WHA48.7, May 12, 1995; WHA, Global Health Security: Epidemic Alert and Response, WHA54.14, May 21, 2001.
4 WHA, Revision of the International Health Regulations, WHA58.3, May 23, 2005.
5 A PHEIC is defined in Article 2, IHR (2005) as involving the ‘international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade’. Annex 2 provides the criteria states are to use for assessing whether an outbreak is a potential PHEIC (WHO, Revision of the International Health Regulations, Annex 2).
6 WHO, International Health Regulations (2005; 2nd ed., 2008), http://whqlibdoc.who.int/publications/2008/9789241580410_eng.pdf (accessed October 10, 2011); Guénaël Rodier, ‘Global Health Security: Are We Ready to Face the Next Healthcare Crisis?’, INSEAD Swiss Healthcare Industry Club, Geneva, April 7, 2009, PowerPoint slide 26, http://iaa.insead.edu/_controltemplates/ContentEditorImages/File/INSEAD%20Health/2009-04-07_CH_Crisis_Presentation_Rodier.pdf (accessed 10 October 10, 2011).
7 Heymann, Rodier and The WHO Operational Support Team to the Global Outbreak Alert and Response Network, ‘Hot Spots in a Wired World: WHO Surveillance of Emerging and Re-emerging Infectious Diseases’, The Lancet Infectious Diseases 1, no. 5 (2001): 345–53.
8 World Health Assembly, Global Health Security – Epidemic Alert and Response, Report by the Secretariat, A54/9, April 2, 2001.
9 Ibid., para. 7–8.
10 Ibid., paras. 5, 7 and 8; Adam Kamradt-Scott. ‘The WHO Secretariat, Norm Entrepreneurship, and Global Disease Outbreak Control’, Journal of International Organizations Studies 1, no. 1 (2010): 72–89.
11 Heymann et al., ‘Hot Spots in a Wired World’, 348.
15 Guénaël R. Rodier, ‘New Rules on International Public Health Security’, Bulletin of the World Health Organization 85, no. 6 (2007): 428–30, emphases added.
12 WHO, International Health Regulations (2005), Article 9.
13 Ibid., Article 9.1.
14 Heymann et al., ‘Hot Spots in a Wired World’; Rodier, ‘Global Health Security’.
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21 Brownstein et al. ‘Surveillance Sans Frontières’.
22 Text mining points to sources of information by ‘mining’ volumes of data produced on the internet at various speeds and intervals (i.e. searching thousands of webpages every twenty-four hours, seven days a week for particular words and phrases, including search for meaning and context).
23 Castillo-Salgado, ‘Trends and Directions of Global Public Health Surveillance’.
24 Hartley et al., ‘The Landscape of International Event-based Biosurveillance’.
25 Heymann et al., ‘Hot Spots in a Wired World’.
26 House of Lords, Diseases Know No Frontiers: How Effective are Intergovernmental Organisations in Controlling their Spread?, Volume II: Evidence, Select Committee on Intergovernmental Organizations, 1st Report Session of 2007–2008, HL Paper 143–II, July 21, 2008, 211.
27 Heymann and Rodier, ‘Global Surveillance, National Surveillance and SARS’; Madoff and Woodall, ‘The Internet and the Global Monitoring of Emerging Diseases’.
28 Brownstein et al., ‘Surveillance Sans Frontières’, 1019.
29 WHO, International Health Regulations (2005), Article 9.1.
30 Adam Kamradt-Scott and Simon Rushton, ‘The Revised International Health Regulations: Socialization, Compliance and Changing Norms of Global Health Security’, Global Change, Peace & Security 24, no. 1 (2012).
31 Public Health Emergency of International Concern as defined in Article 1 of the IHR (2005) and then assessed by states under Annex 2 guidelines, WHO, International Health Regulations (2005).
32 Hitchcock et al., ‘Challenges to Global Surveillance’, 219.
33 Collier argues that PMM is the open source ISRP that has come closest to achieving the ‘gold standard’ that we presume GPHIN meets. Collier, ‘What's Unusual in Online Disease Outbreak News?’, 3; Brice Rotureau et al., ‘International Epidemic Intelligence at the Institut de Veille Sanitaire, France’, Emerging Infectious Diseases 13, no. 10 (2007): 1591.
34 Brownstein et al., ‘Digital Disease Detection’.
35 Interview with GPHIN staff, November 2010. Transcript on copy with author, staffer requested no attribution.
36 Mike Conway et al., ‘Developing a Disease Outbreak Event Corpus’, Journal of Medical Internet Research 12, no. 3 (2010): e43.
37 Madoff and Woodall, ‘The Internet and the Global Monitoring of Emerging Diseases’.
38 Clark C. Freifeld et al., ‘HealthMap: Global Infectious Disease Monitoring through Automated Classification and Visualization of Internet Media Reports’, Journal of the American Medical Informatics Association 15, no. 2 (2008): 150. doi:10.1197/jamia.M2544, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2274789/ (accessed October 10, 2011).
39 Rotureau et al., ‘International Epidemic Intelligence at the Institut de Veille Sanitaire’, 1591.
40 Freifeld et al., ‘HealthMap’, 150.
41 Conway et al., ‘Developing a Disease Outbreak Event Corpus’, e43.
42 Castillo-Salgado, ‘Trends and Directions of Global Public Health Surveillance’, 98–100; Hartley et al., ‘Landscape of International Event-based Biosurveillance’, 3.
43 Brownstein et al., ‘Surveillance Sans Frontières’, 1020.
44 Ibid., 1021–2.
45 Castillo-Salgado, ‘Trends and Directions of Global Public Health Surveillance’; Collier, ‘What's Unusual in Online Disease Outbreak News?’; Hartley et al., ‘Landscape of International Event-based Biosurveillance’; Rebecca Katz and Julie Fischer, ‘The Revised International Health Regulations: A Framework for Global Pandemic Response’, Global Health Governance 3, no. 2 (2010): 1–18.
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48 Brownstein et al., ‘Surveillance Sans Frontières’, 1022.
49 Michael Blench, Global Public Health Intelligence Network (GPHIN), Global Risk Forum Davos, April 2010, slide 19, http://www.slideshare.net/GRFDavos/idrcdavosmediumppt (accessed October 10, 2011).
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53 Rotureau et al., ‘International Epidemic Intelligence at the Institut de Veille Sanitaire’.
54 Jennifer Shkabatur, ‘A Global Panopticon? The Changing Role of International Organizations in the Information Age’, Michigan Journal of International Law 33, no. 1 (2011): 159–214, http://www.bu.edu/law/faculty/scholarship/workingpapers/2011.html (accessed October 10, 2011).
55 Hartley et al., ‘Landscape of International Event-Based Surveillance’, 6.
56 ProMED-mail, Avian Influenza, Human (65): Indonesia, Reporting. ProMED-mail, August 18, 2008: 20080818.2560, http://www.promedmail.org (accessed October 10, 2011).
57 Hartley et al., ‘Landscape of International Event-Based Surveillance’, 7.
58 Ibid., 1–7.
59 Rotureau et al., ‘International Epidemic Intelligence at the Institut de Veille Sanitaire’.
60 For example, Freedom House, Freedom of the Press 2011, Map of Press Freedom, http://www.freedomhouse.org/template.cfm?page=251&year=2011; and Freedom House, Freedom of the Net 2011, http://www.freedomhouse.org/template.cfm?page=664 (accessed October 10, 2011).
61 Rodier, ‘New Rules of International Public Health Security’; Brownstein et al., ‘Surveillance Sans Frontières’.
62 Brownstein et al., ‘Surveillance Sans Frontières’, 1021.
63 Ibid., 1022; Collier, ‘What's Unusual in Online Disease Outbreak News’, 12.
64 Rotureau et al., ‘International Epidemic Intelligence at the Institut de Veille Sanitaire’, 1591; Michael Blench, ‘Global Public Health Intelligence Network (GPHIN)’ (paper presented at 8th AMTA Conference, Hawaii, October 21–25, 2008), 299–303, http://www.mt-archive.info/AMTA-2008-Blench.pdf (accessed October 10, 2011).
65 John S. Brownstein et al., ‘Healthmap: Internet-based Emerging Infectious Disease Intelligence’, in Infectious Disease Surveillance and Detection: Assessing the Challenges – Finding Solutions, ed. Board on Global Health, Institute of Medicine (Washington: National Academies Press, 2007), 122–36, http://books.nap.edu/openbook.php?record_id=11996 (accessed November 1, 2011); Hartley et al., ‘The Landscape of International Event-based Biosurveillance’, 20.
66 Madoff and Woodall, ‘The Internet and the Global Monitoring of Emerging Diseases’, 729.
67 Ibid.
68 Celia W. Duger, ‘Cholera Epidemic Sweeping Across Crumbling Zimbabwe’, The New York Times, 11 December 2008, http://www.nytimes.com/2008/12/12/world/africa/12cholera.html?pagewanted=all (accessed December 12, 2008).
69 Sara E. Davies, ‘Is There an International Duty to Protect Persons in the Event of an Epidemic?’, Global Health Governance 3, no. 2 (2010): 1–23.
70 Mikaela Keller et al., ‘Use of Unstructured Event-based Reports for Global Infectious Disease Surveillance’, Emerging Infectious Diseases 15, no. 5 (2009): 689–95.
71 Rotureau et al., ‘International Epidemic Intelligence at the Institut de Veille Sanitaire’, 1591.
72 Collier, ‘What's Unusual in Online Disease Outbreak News’, 14–15.
73 ‘International Health Regulations – The Challenges Ahead’, The Lancet 369, no. 9575 (2007): 1763, doi:10.1016/S0140-6736(07)60788-0, http://download.thelancet.com/flatcontentassets/H1N1-flu/preparedness/preparedness-31.pdf (accessed October 10, 2011).
74 WHO, Implementation of the International Health Regulations (2005), Report of the Review Committee on the Functioning of the International Health Regulations (2005) in relation to Pandemic (H1N1) 2009, Report by the Director-General, A64/10, May 5, 2011, 51.
75 Rebecca Katz, ‘Use of the Revised International Health Regulations during Influenza A (H1N1) Epidemic, 2009’, Emerging Infectious Diseases 15, no. 8 (2009): 1166.
76 Herman Anthony Carneiro and Eleftherios Mylonakis, ‘Google Trends: A Web-Based Tool for Real-Time Surveillance of Disease Outbreaks’, Clinical Infectious Diseases 49, no. 10 (2009): 1557–64.
77 Alex R. Cook, Mark I.C. Chen, and Raymond Tzer Pin Lin, ‘Internet Search Limitations and Pandemic Influenza, Singapore’ (Letter), Emerging Infectious Diseases 16, no. 10 (2010): 1647–9, doi: 10.3201/eid1610.100840, http://wwwnc.cdc.gov/eid/article/16/10/pdfs/10-0840.pdf (accessed October 10, 2011).
78 Jeremy Youde, Biopolitical Surveillance and Public Health in International Relations (New York: Palgrave Macmillan, 2009), 147–76.
79 Chan et al., ‘Global Capacity for Emerging Infectious Disease Detection’.
80 Heymann et al., ‘Hot Spots in a Wired World’, 348; Castillo-Salgado, ‘Trends and Directions of Global Public Health Surveillance’, 97, 104.
81 Shkabatur, ‘A Global Panopticon?’, 1, 3–4; Rodier, ‘New Rules for International Public Health Security’, 428.