transnational health and security: emerging infectious disease surveillance in cambodia

8/11/2019 Transnational Health and Security: Emerging Infectious Disease Surveillance in Cambodia

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Transnational Health and Security: Emerging

Infectious Disease Surveillance in CambodiaSophal Ear, Ph.D.

Assistant ProfessorNaval Postgraduate School

27 October 2010

Disclaimer: Material contained herein is made available for the purpose of peer review and discussion anddoes not necessarily reflect the views of the Department of the Navy or the Department of Defense.


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Transnational

threats can only

be dealt with by

transnational

cooperation

PDIR Felizardo M.

Serapio, Jr. (Ret)


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A Thermal Scanner is placed at the corridor of the Ninoy Aquino International Airport to

monitor the body temperatures of arriving passengers in continuing Bird Flu watchWednesday Jan. 31, 2007 in Manila, Philippines.


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Contents

1. The Problems

2. Timeline Context

3. Cambodia Case Study

4. H1N1 (hitting closer to

home)

5. Conclusion: The End or

the Beginning?


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Myriad Problems

Poor to non-existentsurveillance

Poor diagnostic

laboratory capability Disincentive to report

(bad publicity, bad for

business) Viral sovereignty (in

Indonesias case)


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Page 213:

In 2006, Indonesia claimed viral

sovereignty over samples of

H5N1 collected within its bordersand announced that it would not

share them until the WHO and

developed countries established

an equitable means of sharing the

benefits (e.g., vaccine) that couldderive from such viruses.


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Page 3:

in the poorest countries per capita expenditure on all

aspects of health care [is] 3%

expenditure in high-income

countries staff in over 90%

not familiar with quality

assurance principles more

than 60% of laboratory

equipment is outdated or

not functioning

August 2001: the more

things change


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2010

Director of Laboratory Systems Development at

a major American university with whom the

GAOs description was shared for insights wrote

the following from my own experiences incountries (Southern Caucuses, Central Asia,

Southeast Asia, India, Sub-Saharan Africa) I

believe the status has not changed much fromthe date of the report.


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TimelineContextHuman Pandemic Flu Timeline

Spanish (H1N1) HK flu H3N2 HPAI H5N1 H7N2 H7N3 H10N7


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Downside of Globalization:

Global Reach of Diseases


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Quality of Health Care, 2002


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H5N1: Highly Pathogenic Avian Influenza


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Avian influenza

situation in China

8 June 2010 -- 22-year-old pregnant woman diedon 3 June exposed to sick and dead poultry.

Of the 39 cases confirmed to date in China, 26

have been fatal: mortality rate of 66%! http://www.youtube.com/watch?v=X6vFaMy0w0

0
http://www.youtube.com/watch?v=X6vFaMy0w00http://www.youtube.com/watch?v=X6vFaMy0w00http://www.youtube.com/watch?v=X6vFaMy0w00http://www.youtube.com/watch?v=X6vFaMy0w00


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Cambodia Case Study


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Lucky guy, thanks to Namru-2...


18/35H5N1 Animal Outbreaks 04-08

2008

2007

2006

2005

2004


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2007

2006

2005

2008

H5N1 Human Victims 05-08


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Issues Raised in Cambodia

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Low Staff

Compensation

Donor Dependence

Pathologies

Poor staff

management/HR

Patronage networks

detrimental to workenvironments

No compensation for

culling

Differing host and

donor priorities


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Goal: reduce pandemic potential that could

strike donor countries themselves


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Enter Super Chicken &

Pandemic Preparedness


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$$$


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Message: Behavior Change but $$$?


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Scientists Technology should be on tap,

but not on top.

Now this is not the end. It is not even thebeginning of the end. But it is, perhaps, the

end of the beginning.

--Churchill


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Thank

you

&Questions

transnational health and security: emerging infectious disease surveillance in cambodia

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