reporting of disease threats, the OIE offers guidance for establishing compensation systems. The OIE has also founded a “virtual vaccine bank,” which has supplied large quantities of vaccines to address severe outbreaks of avian influenza (in birds). “This mechanism allows countries to begin vaccinating with certified vaccines, immediately after the decision is made that vaccination is needed to control the serious outbreak, and without having to wait for the administrative process of securing the funds and identifying the supplier of vaccines,” Thiermann states.

In the final essay of this chapter, workshop speaker David Nabarro of the UN reflects on his experience as that organization’s coordinator for avian and human influenza and for global food security. While attempting to respond to the increasingly worrisome prospect of an avian influenza pandemic in humans, Nabarro and colleagues collaborated with stakeholders from the public, private, and volunteer sectors and found that most recognized the value of working together on disease surveillance, reporting, and response. “They found it both operationally useful and reassuring in a situation where there was considerable political urgency and need for concerted action by institutions,” he writes. “They have joined together to support the evolution of an inclusive movement that enables hundreds of different stakeholders to feel at home.”

From these observations, Nabarro distilled several “factors for success” and additional “incentives for success” for global health collaboration. He then explores major challenges to establishing surveillance as a foundation for global public health governance (as embodied in global efforts toward influenza pandemic preparedness, and more generally in the IHR 2005, OIE regulations, and One World, One Health® framework). In addition to the previously discussed needs for surveillance capacity-building and stakeholder engagement, Nabarro adds a third, more general necessity: creating trust, which he deems the most important incentive for participation, and one which requires active maintenance. “We need to insure against periods of mistrust that may build up in relationships that are otherwise very good,” he writes. “We have to know that we are able to cope with these periods.”


David M. Bell, M.D.2

Centers for Disease Control and Prevention

The melamine-contaminated milk that has sickened at least 53,000 infants is the latest public-health emergency to have triggered international concern and highlighted the need for improved global cooperation to prevent, detect and con-


Reprinted from The Far Eastern Economic Review © 2008 Review Publishing Company Limited. All rights reserved.


Dr. Bell is with the Division of Viral Hepatitis at the U.S. Centers for Disease Control and Prevention in Atlanta. The opinions expressed in this paper are the author’s own.

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