Strengthening national health systems’ capacity to respond to future global pandemics

Effective pandemic governance is more important now than ever, especially given that pandemic risk factors like urbanization, hypermobility, trans-border trade, rapid population growth and changes to the environment and food systems have all increased in tandem with the demands of globalization (Lee and Fidler 2007). These transformative global shifts have fundamentally changed the way pathogens are spread around the world and thus challenged the conventional operations of pandemic surveillance systems (World Health Organization 2007b). The World Health Organization (WHO) estimates that newly emerging infectious disease outbreaks in one country are now only hours away from affecting many others. Pandemics previously spread over years (e.g., bubonic plague in the fourteenth century), months (e.g., cholera epidemics in nineteenth century) or weeks (e.g., Spanish inÀuenza of 1918-1919), but in today’s globalized world, Severe Acute Respiratory Syndrome (SARS) took only 17 hours to spread half-way around the world from China to Canada. Future disease outbreaks are expected to take similarly short periods before they affect multiple countries across geographically distinct regions (Hoffman 2010). The 2013 outbreak of H7N9 bird inÀuenza in China – which allegedly spread from infected fowl to humans than the H5N1 strain did in 2003 – is a stark reminder that the threat of a pandemic exists as an imminent threat to human health and international security (Wong 2013). Also of notable concern is the fact that more than 30 unexpected outbreaks of previously unknown pathogens and re-emerging diseases were observed in the past two decades alone (World Health Organization 2007b). Although the great majority of new and re-emerging diseases have not caused pandemics, national health systems that can respond adequately to pandemic threats are fundamental to controlling pandemic-prone local disease outbreaks within a country, throughout a region and around the world.