World Health Organization global conference on severe acute respiratory syndrome.

Abstract

On June 17–18, 2003, in Kuala Lumpur, Malaysia, the World Health Organization (WHO) sponsored a conference entitled SARS: Where Do We Go From Here? The purpose of the conference, which was attended by over 900 scientific and public health experts from 43 countries, was to review available knowledge and lessons learned and to identify key priorities for the future. Three overarching questions were addressed: Can severe acute respiratory syndrome (SARS) be eradicated? Are current control measures effective? Are current alert and response systems robust enough? The first day included summaries of the history of the epidemic, global, and regional responses coordinated by WHO through its headquarters in Geneva and the Western Pacific Regional Office in Manila, respectively; and national responses in the People’s Republic of China (PRC), including in the Hong Kong Special Administrative Region of PRC, Singapore, Vietnam, Canada, and United States. Nine presentations summarized scientific, clinical, public health, psychosocial, and communications aspects of the SARS outbreak. On the second day, breakout groups met and presented recommendations on the topics of epidemiology and public health, possible role of animals, environmental issues, modeling the epidemic, clinical diagnosis and management, reducing transmission in healthcare settings, blood safety, reducing community transmission, preventing international spread, surveillance and response coordination, effective communication, and preparedness. Background materials for the conference, slide presentations at the plenary sessions (including the breakout group reports), and the text of speeches by the Director General of WHO and other dignitaries are available on the Web (URL: www.who.int/csr/sars/conference). Beginning in March 2003, after WHO recognized, through its Global Outbreak Alert and Response Network (GOARN), an outbreak of severe respiratory illness with high transmissibility in healthcare settings and international spread through airline travel, WHO issued a series of global alerts, travel advisories, and recommendations for diagnosis, clinical management, and prevention of transmission. Evolving information was discussed by virtual networks of experts, including virologists, clinicians, and epidemiologists. Field teams composed of staff from GOARN partners were quickly mobilized to assist affected countries in enhancing surveillance and containment measures, which included isolating cases, implementing strict infection control measures, identifying and following-up with contacts, and making recommendations to travelers to prevent international spread. From a global perspective, the SARS epidemic demonstrated the importance of a worldwide surveillance and response capacity to address emerging microbial threats through timely reporting, rapid communication, and evidence-based action. The importance of international collaboration coordinated by WHO and the need for partnerships among clinical, laboratory, public health, and veterinary communities were emphasized. From the national perspective, lessons learned included the need for the following: strong political leadership at the highest levels to mobilize the entire society; speed of action; improved coordination between national and district levels in countries with federal systems; increased investment in public health; updated legislation regarding surveillance, isolation, and quarantine measures; and improved infection control in healthcare and long-term-care facilities and at borders.