Towards Effective Emerging Infectious Diseases Surveillance: Evidence From Egypt (NAMRU-3), Kenya (USAMRU-K), Peru (NMRCD), and The US-Mexican Border (EWIDS)
“Towards Effective Emerging Infectious Diseases Surveillance: Evidence from Egypt (NAMRU-3), Kenya (USAMRU-K), Peru (NMRCD), and the US-Mexican Border (EWIDS)”, DTRA-ASCO Visit, FY11 Proposal Presentations, Naval Postgraduate School, 8 July 2010.
Original Title
Towards Effective Emerging Infectious Diseases Surveillance: Evidence from Egypt (NAMRU-3), Kenya (USAMRU-K), Peru (NMRCD), and the US-Mexican Border (EWIDS)
“Towards Effective Emerging Infectious Diseases Surveillance: Evidence from Egypt (NAMRU-3), Kenya (USAMRU-K), Peru (NMRCD), and the US-Mexican Border (EWIDS)”, DTRA-ASCO Visit, FY11 Proposal Presentations, Naval Postgraduate School, 8 July 2010.
Towards Effective Emerging Infectious Diseases Surveillance: Evidence From Egypt (NAMRU-3), Kenya (USAMRU-K), Peru (NMRCD), and The US-Mexican Border (EWIDS)
“Towards Effective Emerging Infectious Diseases Surveillance: Evidence from Egypt (NAMRU-3), Kenya (USAMRU-K), Peru (NMRCD), and the US-Mexican Border (EWIDS)”, DTRA-ASCO Visit, FY11 Proposal Presentations, Naval Postgraduate School, 8 July 2010.
Surveillance: Evidence from Egypt (NAMRU-3), Kenya
(USAMRU-K), Peru (NMRCD), and the US-Mexican Border (EWIDS) DTRA-ASCO Visit FY11 Proposal Presentations Sophal Ear, Ph.D. 8 July 2010 Disclaimer: Material contained herein is made available for the purpose of peer review and discussion and does not necessarily reflect the views of the Department of the Navy or the Department of Defense. Indonesia, Cambodia, and Mexico Update: 1 st draft of Cambodia-Indonesia paper (April) Mexico Research Trip (June) Key Issues Identified by Interview Subjects by Country Cambodia Indonesia Issue Respondents emphasizing issue (percent)* Issue Respondents emphasizing issue (percent) Low salaries 5 of 12 (42%) Poor host-donor relationship 13 of 26 (50%) Donor dependence pathologies 5 of 12 (42%) Differing host and donor priorities 8 of 26 (31%) Poor staff management/HR 4 of 12 (33%) Low salaries 7 of 26 (27%) Patronage networks 4 of 12 (33%) Decline in the MoH quality 6 of 26 (23%) No compensation for culling 4 of 12 (33%) NAMRU-2 is misunderstood 6 of 26 (23%) Differing host and donor priorities 3 of 12 (25%) Poor compensation for culling 4 of 26 (15%) Local levels dont see reporting translated into response 4 of 26 (15%) * By proportion of interview subjects By proportion of interview sessions Difference in calculation due to prevalence of group interviews in Indonesia Puzzle/Research Question Focus: Effective surveillance of EIDs via understanding of the political / economic / cultural factors inherent to each country. How do we accomplish this? Having looked at Cambodia, Indonesia, Mexico, and the US (1976), add case studies of Egypt, Kenya, Peru, and US-Mexican border (both successes and failures). Early Warning Infectious Disease Surveillance Outcome: Insight into the political, economic, and cultural challenges to effective surveillance of EIDs Questions: What infrastructure is necessary to conduct effective (timely, cost-effective) disease surveillance? What would it take to actualize effective surveillance in developing countries? What challenges to effective EID surveillance would we find in developing countries? What can be done to mitigate or overcome these challenges? Why should we care? No report or no surveillance? Why? US-Mexican border is 1,969 miles and the most frequently crossed international border in the world, with about 250 million people crossings per year. Early warning of EIDs is crucial. Myriad problems exist in the political economy of pandemic preparedness: Poor to non-existent surveillance in the developing world Poor diagnostic laboratory capability in the developing world Disincentive to report (bad publicity, bad for business => Cambodia) Viral sovereignty (=> Indonesia) Why and how is this important to US national security? This study specifically touches upon two areas: U.S. national security and its safety via interaction with developing countries. The methods and lessons from my case studies tie back to U.S. national interest and security. Cross-Border Issues Transnational Threats UNCLASSIFIED UNCLASSIFIED Anticipating Threats & Opportunities Strategic Vision Over-The- Horizon Proliferation Track II Strategic Dialogues on Threat Reduction Countering WMD Proliferation Strategic Foundations 21 st Century Deterrence Countering WMD Terrorism Sustaining Communities of Interest Preparing the Next Generation How will this help DTRA-ASCO meet its objectives? Priorities (Referenced DTRA/ASCO Priorities) Ties into goals outlined in President Obamas National Strategy for Countering Biological Threats (proactive confrontation of WMD threats at their source and as far from American borders as possible) Development of analytical tools to detect and actively confront the full spectrum of WMD threats Sustaining communities of interest, specifically referring to developing countries whose health have the potential to affect U.S. homeland security. Preparing the next generation (U.S. and global policy makers) to have a body of knowledge that analyzes and understands the infrastructures underlying the political economy of successful and unsuccessful national programs for EID surveillance. Politics Trumps Science Scientists too frequently see the surveillance of EIDs as a technical problem of science, pure and simple. The reality, however, is that on the ground, even the most advanced technology cannot trump politics. Namru-2 Jakarta is shutting down. I have been very sad. Not only because I am losing my job, but more than that, Indonesia will loss [sic] an established laboratory research coz [sic] of political reasons --Senior Indonesian scientist E-mail 11 April 2010 Scientists should be on tap, but not on top. Churchill By which he meant scientists have a duty to inform politics, but they have no special insights beyond that, and must allow politicians to formulate policy based on social, economic and ethical principles.* Barriers to effective preparedness span not only the technical and scientific, but cultural, political, and economic realms. * http://www.newscientist.com/blogs/thesword/2010/05/time-for-scientists-to-go-into.html Objective: To produce three more case studies that would be part of a third installment of a collection of policy reports studying the necessary components of an effective EID surveillance system. Deliverables: Set of policy reports on Egypt, Kenya, Peru, and US-Mexican border Refereed journal articles Book chapters (even a book) Established Record of Productivity on Political Economy of Avian Flu Research in 2009/10: Stanford Working Paper University of Sussex/ESRC Working Paper Book chapter Worlds Poultry Science Journal article