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Author Notes:

Correspondence: scottjnmcnabb@emory.edu

We both contributed to the conceptualization, writing, and editing of this manuscript.

We will both defend its findings.

We would like to recognize all the persons who contributed to the meeting on comprehensive global public health surveillance, especially our colleagues Drs. Rebecca Katz and Jose Fernandez and Jennie Gromoll.

Plus, we wish to thank Dr. Muzna Mirza for her insights and review.

We confirm that we do not have any conflicts of interest.

Drs. McNabb and Chungong have no financial or personal relationships that inappropriately influence (bias) their actions (such relationships are also known as dual commitments, competing interests, or competing loyalties).

Neither of us have financial relationships (such as employment, consultancies, stock ownership, honoraria, and paid expert testimony) likely to undermine our credibility.

We have no conflicts for other reasons, such as personal relationships, academic competition, and intellectual passion.

As a guest editor, Dr. McNabb will avoid selecting external peer reviewers with obvious potential conflicts of interest—for example, those who work in the same department or institution as any of the authors.

He has no personal, professional, or financial involvement in any of the issues he might judge.


Comprehensive effective and efficient global public health surveillance


Journal Title:

BMC Public Health


Volume 10(Suppl 1), Number S3


, Pages 1-7

Type of Work:

Article | Final Publisher PDF


At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources. Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR[2005]); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers. To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners. We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it’s needed, where it’s needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship of public health information; and second, the right of individuals to access real-time public health information that might impact their lives. The vision can be accomplished through an interoperable, global public health grid. Adopting guiding principles, the global community should circumscribe the overlapping interest, shared vision, and mutual benefit between the security and public health communities and define the boundaries. A global forum needs to be established to guide the consensus governance required for public health information sharing in the 21st century.

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