Abstract
BackgroundThis study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap.MethodsWe recorded the initial release dates of each report related to avian flu or H1N1 listed on the WHO Disease Outbreak News site and the matching outbreak report from ProMED-mail, a non-governmental program for monitoring emerging diseases, from 2003 to the end of June 2009. The timeliness gap was calculated as the difference in days between the report release dates of the matching outbreaks in the WHO and ProMED-mail systems. Civil liberties scores were collected as indicators of the transparency of each country. The Human Development Index and data indicating the density of physicians and nurses were collected to reflect countries’ development and health workforce statuses. Then, logistic regression was performed to determine the correlation between the timeliness gap and civil liberties, human development, and health workforce status, controlling for year.ResultsThe reporting timeliness gap for avian flu and H1N1 outbreaks significantly decreased after 2003. On average, reports were posted 4.09 (SD = 7.99) days earlier by ProMED-mail than by the WHO. Countries with partly free (OR = 5.77) and free civil liberties scores (OR = 10.57) had significantly higher likelihoods of longer timeliness gaps than non-free countries. Similarly, countries with very high human development status had significantly higher likelihoods of longer timeliness gaps than countries with middle or low human development status (OR = 5.30). However, no association between the timeliness gap and health workforce density was found.ConclusionThe study found that the adoption of IHR 2005, which contributed to countries’ awareness of the importance of timely reporting, had a significant impact in improving the reporting timeliness gap. In addition, the greater the civil liberties in a country (e.g., importance of freedom of the media), the longer the timeliness gap.
Highlights
This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the World Health Organisation (WHO) and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap
The components of the systemic rapid assessment method, which represents the capacity for timely reporting, were analysed in previous studies with the Systemic Rapid Assessment (SYSRA) Toolkit, a framework that includes: External contexts such as demographic, economic, political, legislative, epidemiologic, socio-cultural and technological factors; stewardship, which refers to organisational systems and laboratory and drug networks; financing, resource generation and allocation; and healthcare provision and information systems [23,24]
To evaluate the timeliness gap between the public and private global disease outbreak surveillance systems, we conducted a comprehensive survey, obtaining the initial release dates of the reports for each avian flu and H1N1 disease outbreak listed on the WHO Disease Outbreak News from 2003 to the end of June 2009and matching them to the corresponding outbreak report from ProMED-mail
Summary
This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap. The global pandemic was exacerbated by the initial delay in information release by the Chinese government due to the Previous studies have emphasised that timeliness is the key to the success of surveillance systems and to reflecting the time delay between response steps in the surveillance process [3,4,5]. Internet-based sources of information allow the timely detection of outbreaks and increase reporting transparency, these sources still cannot overcome the problems of non-transparency by authorities who deliberately conceal information
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