PLoS Med. Preventing Pandemics Via International Development: A Systems Approach

Giuseppe · Dec 12, 2012

[Source: PLoS Medicine, full text: (LINK). Abstract, edited.]

Preventing Pandemics Via International Development: A Systems Approach

Tiffany L. Bogich1,2,3*, Rumi Chunara4,5, David Scales4,5, Emily Chan4,5, Laura C. Pinheiro4,5, Aleksei A. Chmura3, Dennis Carroll6, Peter Daszak3, John S. Brownstein4,5*

1 Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America, 2 Princeton University, Dept of Ecology & Evolutionary Biology, Princeton, New Jersey, United States of America, 3 EcoHealth Alliance, New York, New York, United States of America, 4 Children's Hospital Informatics Program, Division of Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts, United States of America, 5 Harvard Medical School, Department of Pediatrics, Boston, Massachusetts, United States of America, 6 Global Health Program, United States Agency for International Development (USAID), Washington (D.C.), United States of America

Citation: Bogich TL, Chunara R, Scales D, Chan E, Pinheiro LC, et al. (2012) Preventing Pandemics Via International Development: A Systems Approach. PLoS Med 9(12): e1001354. doi:10.1371/journal.pmed.1001354

Published: December 11, 2012

This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Funding: We acknowledge Google.org and a National Science Foundation Human and Social Dynamics ?Agents of Change? award (BCS ? 0826779 & BCS-0826840), two NIH National Library of Medicine grants (5G08LM009776 and 5R01LM010812), the Research and Policy for Infectious Disease Dynamics (RAPIDD) program of the Science and Technology Directorate, U.S. Department of Homeland Security, and the Fogarty International Center, NIH and the generous support of the American people through the United States Agency for International Development (USAID) Emerging Pandemic Threats PREDICT. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: DC is the director of USAID's Avian Influenza and Other Emerging Threats Unit. All other authors have declared that no competing interests exist.

Abbreviations: IHR, International Health Regulations; WHO, World Health Organization; IOM, Institute of Medicine

* E-mail: tbogich@princeton.edu (TB); John.Brownstein@childrens.harvard.edu (JB)

Provenance: Not commissioned; externally peer reviewed.

Summary Points

The way in which public health programs are designed and funded has changed significantly; however, the trend toward establishing vertical, disease-specific global health programs may be at the cost of strengthening basic public health infrastructure and development in the long term.
In a review of nearly 400 public health events of international concern, we found that a breakdown or absence of public health infrastructure was the driving factor in the largest fraction of outbreaks (39.5%). No single other driving factor accounted for more than 10% of outbreaks.
The relative roles of emergency response versus long-term development strategies to mitigate infectious disease threats are being debated within bilateral and intergovernmental aid agencies.
We propose a systems approach within development agencies to address pandemic prevention at the intersection of people and their environment where the risk of disease emergence is highest. To achieve this goal, mainstream development funding, rather than emergency funding, is required.

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PLoS Med. Preventing Pandemics Via International Development: A Systems Approach

Giuseppe

Emeritus