Towards Effective Emerging Infectious Diseases Surveillance: Evidence from Kenya, Peru, Thailand, and the U.S.­-Mexico Border

Abstract

This paper examines the political economy of emerging infectious disease (EID) surveillance programs. It provides lessons learned for U.S. military medical research laboratories collaborating with developing countries and is comprised of four case studies: Kenya (U.S. Army Medical Research Unit-K or USAMRU-K), Peru (U.S. Naval Area Medical Research Unit-6 or NAMRU-6), Thailand (Armed Forces Research Institute of Medical Sciences or AFRIMS), and the U.S.-Mexico Border (Early Warning Infectious Disease Surveillance or EWIDS). The paper provides policy makers tools for improving the effectiveness of new or existing EID surveillance programs. Moreover, it offers host countries the opportunity to incorporate ideas, provide opinions, and debate the management of political and economic constraints facing their programs. Constraints are found for each case study and general recommendations are given for improving global emerging infectious disease surveillance across political, economic, and cultural dimensions. Recommendations: Involve local experts in EID surveillance; Support technology that facilitates communication (e.g. U.S.-Mexico); Develop projects in a way that benefits both parties (e.g. host country Principal Investigator instead of a foreign PI); Centralize health networks, and separate civilian and military sector influence in EID surveillance so functions do not overlap; To improve outcomes, use lessons from other regions that have experienced outbreaks.