Transcript Bio and Health Security in the Asia-Pacific Region

Bio and Health Surveillance in
the Asia-Pacific Region
James R. Campbell, Ph.D., M.P.H.
Asia-Pacific Center for Security Studies
Biosurveillance
• Moving to “One Health” –
integrated management of
human, veterinary and
environmental health
• Requires methodologies, tools
and models to systematically
harvest and contextualize all
sources of biosurveillance data
• Defines trigger points for policy
decisions on countermeasure
and response options
• Requires planning exercises to
incorporate all sources of
biosurveillance information
Emerging infections: concept
becomes reality
Usutu
Rift Valley
Alkhumra
Chikungunya
Sin
Nombre
VEE
Guanarito
Mayaro
Oropouche
Machupo
Andes
TBE
West Nile
Avian flu
SARS
Ebola (Reston)
DHF
Arthropod-borne
Lassa
Ebola
Nipah
Chandipura
Barmah Forest
Rocio
Chikungunya
Marburg
Rodent-borne
O’nyong nyong
Other (including bats)
Kyasanur
Forest
Disease
JE Ross
River
Hendra
What Can Technology Offer?
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A biosecurity predictive, assessment and
analysis database and software system
that would build a meta-structure of the
problem and solution space
Capture of all kinds of information
including expert opinion
Facilitate structured information retrieval
Provide tools to assess the problem and
solution space to identify the most critical
information gaps
Forecast unenvisioned problems and
events, and identify the precursors to
such events
Facilitate structured risk assessments and
informed risk management decisions
Interconnectedness of Surveillance Data
• HIV/AIDS incidence tracks along international
drug smuggling routes
• Immunocompromise associated with AIDS,
and with aging, create new vulnerabilities in
the Asia-Pacific region.
• International human trafficking, illegal crossborder movements correlate with spread of
disease
Asia-Pacific Regional Security is
Dependent on Health Security
• Ecologically, demographically and
epidemiologically the Asia-Pacific
is “ground zero” for epidemics of
new human pathogens, both
imported and “home grown.”
• Dense populations of humans
and animals (especially birds)
• Wide open for international
trade, giving exposure to agents
arising elsewhere that make their
way to the region
• Biosurveillance for recurrent
epidemics is an important lens
through which to examine trends
in a variety of other aspects of
regional change.
Emergent Disease Tests National and
Regional Public Health Safety Nets
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Water and Sanitation
Disease surveillance
Laboratory capacity
Epidemic investigation and containment
Health care systems (often found in urgent
need of repair)
• In epidemics, “ripple effects” across legal
regimes, trade, travel
Increasing Regional Economic
Integration brings:
• Intensive investment in
transnational science and
research collaboration
• Common interest in preventing
the heavy human and economic
costs that disruption of trade and
travel causes
• Increasingly robust electronic
communications architecture
within and across borders
• Public Private Partnerships –
health systems and business
• Enduring regional health security
change by increasing whole-ofnation resilience, by building
capacity, capability and regional
interoperability
Where are the Gaps?
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Need cross-country communications
between Ministries of commerce,
finance, tourism and health (Use APEC
EIN, Access Grid video-teleconference)
Need capability to “regionalize” trade
sanctions, limiting imports only from
affected areas of a given country
(infected vs “disease-free” areas), so
trade in poultry can continue, at a
reduced rate, throughout the crisis –
GIS?
Data-sharing protocols for stockpiling
shared resources
Data on labor movements, within and
between countries
Non-communicable disease (NCD)
surveillance (Oceania – public health
emergency)
Implications for the Rebalance
• U.S. must be viewed as a reliable partner in public
health surveillance in the region
– U.S. – Singapore: Regional Emergency Disease
Intervention (REDI) center
• Demonstrate that U.S. actions in public health are
collaborative, and not simply directed toward
thwarting bioterror attack against the American
people
• US PACOM has taken a leadership role in preparing
the region’s militaries for cooperative response
planning
Organizations Working Regionally on
Biosurveillance
• CAREID (Canada Asia Region Emerging Infectious
Disease project
• APEC Emerging Infections Network
• GPHIN (Global Public Health Information Network)
• WHO Geneva, WHO – APSED 2010 (Asia Pacific
Strategy for Emerging Diseases
– WPRO Manila (ROK), SEARO New Delhi (DPRK)
– competition, suboptimal coordination and cooperation
• TEIN4 (Trans-Eurasia Information Network) Connects
17 Asian countries via a high speed link