2.2 Public health surveillance and response in a globalised world

The rise of holidays abroad, cheap air travel, and the mass population migrations triggered by conflict and economic hardship are characteristics of the modern world. It is not that people did not travel in the past, but that the opportunities and the speed of travel are much greater now, so public health systems are faced with the challenge of controlling new infections that can spread globally in a very short time. Similarly, trade routes still transport infected goods within countries as they have always done, but air freight enables infectious agents in foodstuffs to travel between continents in less than a day.

Globalisation requires global responses to prevent potential infectious disease pandemics. The gradual expansion of global health surveillance and response systems during the twentieth century through the efforts of governments and international organisations, such as the United Nations (UN) and WHO, was given new urgency by the HIV/AIDS pandemic from the mid-1980s onwards (Castillo-Salgado, 2010). This trend was accelerated by the emergence of SARS in 2003 and the identification of at least 30 other previously unknown human pathogens in recent decades. Ongoing concerns about possible pandemic strains of influenza virus and the rapid increase in drug-resistant strains of TB and malaria were additional factors in prompting the 194 member states of the WHO to approve revised International Health Regulations in 2005.