15. WHO shall promote nations’ use of Incident Management System for early detection and response to pandemics

Rapporteur: Ronald St. John

Basic Premise:

There will be pandemics at some time in the future.

Small outbreaks of infectious diseases occur daily throughout the world. Depending on the transmission potential for specific or unknown pathogens, a small cluster of infected people can rapidly become an epidemic at a local, district/provincial or national level. In the absence of a comprehensive and internationally accepted definition of what constitutes a pandemic, for purposes of this paper, a pandemic is an epidemic that is occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people with a high degree of morbidity and mortality. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127276/

Why are pandemics inevitable?

The worst kinds of pathogens – ones with the highest mortality rates and limited countermeasures – are increasing globally due to population increases, population density, more global travel, and changing migratory and environmental patterns that result in encroachment upon animal and other ecological systems. Social determinants such as poor housing, poverty, and lack of access to clinical and preventive health care can favour the transmission of communicable diseases and result in more morbidity and mortality, which can be pre-conditions to a global pandemic.

  • Population density – Around 55 percent of the world’s population is thought to be living in an urban area or city, with that figure set to rise to 68 percent over the coming decades, according to the “Population Division” report. Source: UN’s Department of Economic and Social Affairs. May 17, 2018.
  • Rapid Population Movement – The International Air Transport Association (IATA) expects 7.2 billion passengers to travel in 2035, a near doubling of the 3.8 billion air travelers in 2016. https://www.iata.org/pressroom/pr/Pages/2016-10-18-02.aspx
  • War/Insurgency – armed conflict interrupts health services, both clinical and preventive.
  • Emergence of New/novel pathogen – there is on-going mutation of known pathogen or exposure to novel pathogen, e.g., by human encroachment on deforested land
  • Cultural resistance – the risks of transmission and poor disease outcomes may be amplified by unfavourable behaviours by affected populations, with reluctance to adopt prevention and risk mitigation strategies (e.g., cultural resistance to vaccination or “western” medicine).
  • Fear and resistance to intrusion of outsiders who arrive to stop an epidemic.
  • Governments may wish to cover-up or minimize an incipient epidemic due to concern for economic impacts (e.g., a negative impact on tourism or foreign investment).

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