The Evolution and Expansion of Regional Disease Surveillance Networks and Their Role in Mitigating the Threat of Infectious Disease Outbreaks

Abstract

We examine the emergence, development, and value of regional infectious disease surveillance networks that neighboring countries worldwide are organizing to control cross-border outbreaks at their source. The regional perspective represented in the paper is intended to serve as an instructive framework for others who decide to launch such networks as new technologies and emerging threats bring countries even closer together. Distinct from more formal networks in geographic regions designated by the World Health Organization (WHO), these networks usually involve groupings of fewer countries chosen by national governments to optimize surveillance efforts. Sometimes referred to as sub-regional, these “self-organizing” networks complement national and local government recognition with informal relationships across borders among epidemiologists, scientists, ministry officials, health workers, border officers, and community members. Their development over time reflects both incremental learning and growing connections among network actors; and changing disease patterns, with infectious disease threats shifting over time from local to regional to global levels. Not only has this regional disease surveillance network model expanded across the globe, it has also expanded from a mostly practitioner-based network model to one that covers training, capacity-building, and multidisciplinary research. Today, several of these networks are linked through Connecting Organizations for Regional Disease Surveillance (CORDS). We explore how regional disease surveillance networks add value to global disease detection and response by complementing other systems and efforts, by harnessing their power to achieve other goals such as health and human security, and by helping countries adapt to complex challenges via multi-sectoral solutions. We note that governmental commitment and trust among participating individuals are critical to the success of regional infectious disease surveillance networks.

The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

“…These collaborations can help to address specific gaps in public health infrastructure and capacity through training and development and are particularly useful for infectious disease outbreaks. 259 Political and economic regional alliances such as the AU and Economic Community of West African States can greatly help in removing political and economic barriers to resource mobilisation and in fostering cooperation between member states, and were active in the Ebola response in West Africa. 258 Most important for Africa's epidemic preparedness is the recent launch of the Africa Centres for Disease Control and Prevention by the AU under the leadership of John Nkengasong with subregional hubs, and of centres of surveillance and disease control by the West African Health Organisation, are as is the establishment of WHO's African Public Health Emergency Fund 260 to support national efforts to respond to public health emergencies.…”

“…Engagement of global partners, such as philanthropic organisations, NGOs, and technical organisations, is also critical for system development and mobilising technical experts in public health emergencies as exemplified by the work of the WHO Global Outbreak Alert and Response Network. 259 Some countries like Nigeria, Senegal, and the three countries most affected by Ebola are consolidating or building national centres for epidemic preparedness and response. As these are all in their infancy, much will depend on the support and commitment from the AU and WHO and its member states.…”

Multinational Disease Surveillance Programs: Promoting Global Information Exchange for Infectious Diseases

“…A relatively isolated outbreak in Guinea began in December 2013 and spread across land borders into Liberia and Sierra Leone without detection until March 2014, and shortly thereafter spun out of control. [2][3][4] Multinational disease surveillance programs (MNDSPs), also known as regional disease surveillance networks, 5 can improve public health collaboration among neighboring countries by building trust and enhancing core response capacities. MNDSPs have self-assembled on a global scale.…”

“…MNDSPs have self-assembled on a global scale. [5][6][7][8] We conducted a survey of MNDSPs operating worldwide to assess program organization, goals, operations, and evaluation.…”

“…5 Three of 12 responding programs did not report dedicated operational funding. Program evaluations and quality assurance activities (such as data quality review, external protocol review, and laboratory testing assurance) might help demonstrate impact to secure additional domestic or international funding.…”