Flu `great test' for new health regulations

The swine flu outbreak is providing a major test of new international health regulations designed to counter flu pandemics and other global health threats, University of Otago Associate Prof Michael Baker says.

The outbreak has sparked a historic first declaration of a "public health emergency of international concern" by the World Health Organisation since the updated regulations came into effect in June 2007.

"This will be a great test for whether the regulations help," Prof Baker said.

"If we can make the system work, it will be a major triumph of rationality over these potential natural disasters," he said in an interview.

The new regulations introduce a global health surveillance system, and with it a new legal concept, the "public health emergency of international concern".

This is declared in response to an "extraordinary event" which poses a public health risk to other states through international spread of disease and requires a "co-ordinated international response".

The regulations constitute the most comprehensive global agreement ever developed for managing emerging human health hazards.

It replaces antiquated regulations last updated in 1969, which focused oncholera, plague and yellow fever and had little flexibility in dealing with other health threats, such as pandemic influenza.

Prof Baker said that by far the biggest natural disaster to hit New Zealand had been the 1918 influenza pandemic, which had killed more than 8000 people in this country.

By contrast, about 258 people died in New Zealand's deadliest earthquake, the 1931 Hawkes Bay earthquake.

Prof Baker is a physician in the public health department at the university's Wellington campus and is the principal investigator in a collaborative $2 million study which explores how island nations such as New Zealand can counter the global spread of infectious diseases.

The collaborative study is funded by the Centres for Disease Control and Prevention in the United States.

The new regulations, which New Zealand helped to develop, have been driven by concerns about global health threats, including 2003's severe acute respiratory syndrome (Sars) outbreak, and the need to provide more effective surveillance and control.

Many commentators have stated that China's initial failure to report Sars cases in 2003 hindered the international response.

Mexican authorities have also been faulted for allegedly slow notification of initial cases of the new swine flu, also known as Influenza A virus, subtype H1N1.

Prof Baker said the new regulations were a major advance, incorporating "some great principles", but at this relatively early stage their effectiveness in countering the latest outbreak was still unclear.

This is partly because some aspects of the new surveillance scheme have not fully come into effect.

Some developing countries still have limited capability, including in testing for illness, and have been given until 2012, or, in some cases, 2016, to fully meet their new obligations.

Prof Baker said New Zealand's national planning to counter a global pandemic was "highly evolved" but, such was the unpredictability of viral outbreaks, New Zealand had become one of the first nine countries in the world to have confirmed cases of the new flu.

Sars had arisen in China and New Zealand had had time to make preparations before the disease could arrive.

The latest outbreak had occurred in an unexpected quarter and arrived more quickly than expected.

"You can have a bunch of people in Mexico one day and a day later they're in New Zealand."

 

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