Global Outbreak Alert And Response Network Research Articles

Global Outbreak Alert and Response Network deployments during the COVID-19 pandemic, WHO Western Pacific Region.

The Global Outbreak Alert and Response Network (GOARN) has responded to more than 100 outbreaks during the past 23 years. The coronavirus disease (COVID-19) pandemic presented unprecedented operational constraints that challenged GOARN's core mission to rapidly deploy technical experts from its partners to support national in-country responses to public health emergencies. This paper describes the type and duration of GOARN deployments to and within the World Health Organization's (WHO's) Western Pacific Region during the COVID-19 pandemic. Despite strict border closures and ever-changing vaccination and quarantine requirements, GOARN continued to deploy international technical assistance to strengthen COVID-19 response operations within the Region, as requested. Data were analysed from the GOARN Knowledge Platform about deployments to and within the Region for responses to the COVID-19 pandemic between 1 January 2020 and 5 May 2023. Data were available about deployment duration, technical role requested, country or area, partner organization and deployed expert's demographics. Feedback from postdeployment briefings with the experts was collected and thematically analysed to determine ongoing needs and gaps to help improve deployment operations. There were 72 experts deployed on 89 missions through GOARN to 12 countries and areas in the Region, for a total of 4558 field days, to support the response to the COVID-19 pandemic. The volume of requests for assistance from countries and areas in the Region to respond to the COVID-19 pandemic uncovered a deficit in human resources available for domestic response to outbreaks and the reliance on international assistance. Strengthening the in-country capacity of ready-to-respond public health emergency staff is critical to meet the needs for outbreak response. The ongoing demand for technical experts to support national responses means that these lessons may have immediate implications.

Global Outbreak Alert and Response Network (GOARN) focal point engagement meeting with partners in Japan.

Global Outbreak Alert and Response Network (GOARN) focal point engagement meeting with partners in Japan.

Rapid Response Mobile Laboratories (RRML): Standardization as a Tool to Maximize Interoperability

Background/Introduction:Rapid Response Mobile Laboratories (RRML) are a crucial component of preparedness and response to health emergencies, both as a stand-alone asset and in conjunction with other rapid response capacities. The development of an RRML classification system in 20191 both defines laboratory structure and provides a foundation for the development of RRML minimum standards under the umbrella of the WHO Global Outbreak Alert and Response Network (GOARN).Objectives:These minimum standards define the requirements for RRMLs/GOARN in the field and facilitate their interoperability with other important operational assets of WHO, including Emergency Medical Teams (EMTs), contributing to the overall response and to enhanced collaboration among national and international health partners.Method/Description:The development of minimum standards brought together over 30 technical experts in various disciplines from European GOARN partner institutions to conduct a systematic applied literature review and consolidate field experiences and lessons learned from infectious disease outbreaks globally, as well as addressing the complete RRML deployment life cycle2 and for each RRML type.The RRML minimum standards focus on four workstreams: Operational Support & Logistics; Laboratory Information Management System; Biosafety & Biosecurity; and Quality Management Systems.Results/Outcomes:This standardization will ensure predictable response in the field and is the first step in strengthening RRML interoperability with other capacities and members of the global health emergency workforce, such as EMTs and Rapid Response Teams, as well as national-level counterparts.Conclusion:The standards contribute to strengthening of National Laboratory capacities, provide the basis for a forthcoming monitoring and evaluation Framework, and WHO RRML recognition process.

Perspectives on deployment of humanitarian workers through operational partnerships during the acute emergency health response to the Rohingya refugee crisis in Cox\u2019s Bazar

BackgroundThe unprecedented influx of Rohingya refugees into Cox’s Bazar, Bangladesh, in 2017 led to a humanitarian emergency requiring large numbers of humanitarian workers to be deployed to the region. The World Health Organization (WHO) contributed to this effort through well-established deployment mechanisms: the Global Outbreak Alert and Response Network (GOARN) and the Standby Partnerships (SBP). The study captures the views and experiences of those humanitarian workers deployed by WHO through operational partnerships between December 2017 and February 2019 with the purpose of identifying challenges and good practice during the deployment process, and steps to their improvement.MethodsA mixed methods design was used. A desktop review was conducted to describe the demographics of the humanitarian workers deployed to Cox’s Bazar and the work that was undertaken. Interviews were conducted with a subset of the respondents to elicit their views relating to their experiences of working as part of the humanitarian response. Thematic analysis was used to identify key themes.ResultsWe identified sixty-five deployments during the study period. Respondents’ previous experience ranged between 3 and 28 years (mean 9.7 years). The duration of deployment ranged from 8 to 278 days (mean 67 days) and there was a higher representation of workers from Western Pacific and European regions. Forty-one interviews were conducted with people who experienced differing aspects of the deployment process. Key themes elicited from interviews related to staffing, the deployment process, the office environment and capacity building. Various issues raised have since been addressed, including the establishment of a sub-office structure, introduction of online training prior to deployment, and a staff wellbeing committee.ConclusionsThis study identified successes and areas for improvement for deployments during emergencies. The themes and subthemes elicited can be used to inform policy and practice changes, as well as the development of performance indicators. Common findings between this study and previous literature indicate the pivotal role of staff deployments through partnership agreements during health emergency response operations and a need for continuous improvements of processes to ensure maximum effectiveness.

Facilitating the deployment of Japanese human resources for responding global outbreaks of emerging and Re-emerging infectious diseases: A cross-sectional study

IntroductionIn response to global outbreaks of infectious diseases, the need for support from organizations such as the World Health Organization Global Outbreak Alert and Response Network (GOARN) is increasing. Identifying the obstacles and support needs for applicants could increase GOARN deployments from Japan. MethodsThis cross-sectional study involved a web-based, self-administered questionnaire survey targeting Japanese participants in the GOARN Tier 1.5 training workshop, held in Tokyo in December 2019. ResultsAll 47 Japanese participants in the workshop responded to the survey. Most responders were male and in their 30s and 40s. Participants specialized in case management (42.6%), infection prevention and control (25.6%), epidemiology and surveillance (19.1%). Only two participants (4.6%) had experienced a GOARN deployment. Their motivations for joining the GOARN training workshop were “Desire to be part of an international emerging infectious disease response team” (44.6%), “Interest in making an international contribution” (19.1%), and “Interest in working for the Japanese government in the field of international infectious diseases” (14.9%). Obstacles to GOARN deployments were “Making time for deployments” (45.7%) and “Lack of required professional skills and knowledge” (40.4%). The support needs for GOARN deployments constituted “Periodic simulation training” (51.1%), “Financial support during deployments” (44.7%), and “Technical support for deployments” (40.4%). ConclusionsOur study revealed the obstacles and support needs of Japanese candidates for GOARN deployment. Making time and upskilling for GOARN deployment were the main obstacles. More practical training (like GOARN Tier 2.0) with other supports are needed. The national framework is desirable to realize these supports.

Role of Information Technology in COVID-19 Vaccination Drive: An Analysis of the COVID-19 Global Beliefs, Behaviors, and Norms Survey.

With the onset of the COVID-19 pandemic, information technology has played a critical role in healthcare. A broad spectrum of information technology tools and applications played an essential role to create awareness of the COVID-19 vaccination drive and its health benefits. Research conducted by Massachusetts Institute of Technology (MIT) in collaboration with information technology platforms like Facebook with inputs from World Health Organization (WHO), John Hopkins University (JHU), and Global Outbreak Alert and Response Network (GOARN) shows that 65.06% of people all over the globe are willing to get vaccinated. Vaccine acceptance depends upon social norms and human behavior. These organizations conducted the global survey in over 60 countries with a sample size of 437,236 responses. The international survey was organized using a pre-registered randomized experiment demonstrating the role of technology in reaching out to people based in diverse communities and evaluating their beliefs, behavior, and social norms. The study shows that vaccine acceptance can vary due to descriptive norms. All the respondents in the study were adults with access to the internet. Moreover, a large proportion of the population thinks that the COVID-19 pandemic is a viable threat to the community and preventive measures need to be taken including vaccination drives to eradicate the menace. The survey consisted of five blocks involving questions related to healthcare, demographics, vaccines, knowledge, and information exposure. Sampling and weighting were done using a pool of 3,000 respondents over two weeks, and weights were provided per respondent to represent the target population as a whole. It reduces the representation error and minimizes non-response biases.

Aftermath Melancholy of Devastating COVID-19 Issues

It is difficult to say authentically whether the COVID-19 virus is being developed in Chinese laboratory or shredded from the vet market of China. In any case it’s a Chinese virus affecting the human population, and one such major public health event occurs approximately one in every 100 years. It is as devastating, if not more, than the dinosaurs of past millennia, but as the size reduced from animal to nano particle, the devastating capability also increased in million times. The major pandemics have been usually pneumonic in nature whether plague, flue or Covid. The Global Outbreak Alert and Response Network (GOARN) of WHO (World Health Organization) has been launched as a Knowledge resource. But the role of China or WHO in declaring this pandemic is suspicious even today. This arouses a question, was the discovery actually Chinese in nature and with the help of higher public health organization (WHO?) the matter was hidden and bio-weapon was developed by China to be used for Indian, Taiwan, US or Japanese soldiers in cold seasons, with whom China is engaged in territorial expansion through encroachment? As such excepting US president Mr. Donald Trump, no one expresses it aloud. There has been economic crisis, socio-psycho-political melancholy, vaccine development delays and global health system failure.

A surveillance and control of Ebola Outbreak Disease at Télimélé, Guinea Conakry 2014

The Global Outbreak Alert and Response Network (GOARN) have been involved in infectious diseases outbreak response low-resource settings for many years. The current Ebola Virus Disease (EVD) outbreak in West Africa, originated in Conakry Guinea. Burial rituals, traditional healer practices, illegal healthcare practices, ineffective contact tracing of exposed persons and a weak healthcare infrastructure are major contributing factors to the ongoing Ebola transmission in this setting. The purpose of this study was to describe a successful attempt to stop the EVD outbreak through early, systematic isolation of cases.

The Global Outbreak Alert and Response Network

The Global Outbreak Alert and Response Network (GOARN) was established in 2000 as a network of technical institutions, research institutes, universities, international health organisations and technical networks willing to contribute and participate in internationally coordinated responses to infectious disease outbreaks. It reflected a recognition of the need to strengthen and coordinate rapid mobilisation of experts in responding to international outbreaks and to overcome the sometimes chaotic and fragmented operations characterising previous responses. The network partners agreed that the World Health Organization would coordinate the network and provide a secretariat, which would also function as the operational support team. The network has evolved to comprise 153 institutions/technical partners and 37 additional networks, the latter encompassing a further 355 members and has been directly involved in 137 missions to 79 countries, territories or areas. Future challenges will include supporting countries to achieve the capacity to detect and respond to outbreaks of international concern, as required by the International Health Regulations (2005). GOARN's increasing regional focus and expanding geographic composition will be central to meeting these challenges. The paper summarises some of network's achievements over the past 13 years and presents some of the future challenges.

The Promise and Challenge of Global Network Governance: The Global Outbreak Alert and Response Network

Abstract Networks are often heralded as a promising strategy of global governance. This article examines the challenges encountered in managing one relatively successful network—the Global Outbreak Alert and Response Network (GOARN). Over the past decade, this international network of public and private institutions has played a major role in organizing the global response to infectious disease outbreaks around the world. Despite its successes, GOARN confronts difficult challenges in balancing performance objectives with the goals of maintaining and developing the network. The imperative to integrate closely into World Health Organization (WHO) operations makes it difficult for GOARN to balance its obligations to the WHO with the need to maintain and cultivate its role as an independent network.

Labs form a new front against deadly pathogens

When four pig farm workers and a butcher in the Philippines tested positive for Ebola Reston virus antibodies in January but did not become ill, it was the latest example of an outbreak of a new and potentially dangerous pathogen passed from animal to human. It was not the first time humans became infected with Ebola Reston. Nor has the virus been recognized as the cause of human illness to date, although it remains unclear how it would affect people with weak immunity and underlying medical conditions, pregnant women and children. Animal diseases transmitted to humans, known as 'zoonoses' such as Ebola Reston, are the origin of many human diseases and can, therefore, pose a threat to human health since their potential remains unknown. case has highlighted the need for countries, such as the Philippines, to be able to identify dangerous pathogens and contain such outbreaks when they occur. Under the revised International Health Regulations, countries are now committed to reporting events that could have health implications beyond their borders. But not all countries have this capacity. In recognition of that, a WHO initiative has been working over the past year to create an international network of high-security laboratories known as the Emerging and Dangerous Pathogens Laboratory Network for Response and Readiness. growing network--currently of 25 high-security diagnostic laboratories in 20 countries--aims to detect and diagnose new and emerging disease threats found in humans and animals, such as viral haemorrhagic fevers, e.g. Ebola, Nipah virus and severe acute respiratory syndrome (SARS). It also provides training for staff and technology transfer to laboratories in countries, so that they can develop their capacity for outbreak detection and response. This network will help ensure that internationally available resources can be coordinated to achieve a more rapid response to emerging diseases, as well as to maximize the benefits of intervention, studies, diagnostics and research, says Dr Pierre Formenty of the department of Epidemic and Pandemic Alert and Response at the World Health Organization (WHO) in Geneva. The new labs network can help to provide people in the field with better diagnostic tools. Clinicians need the diagnostic tools to know if they are treating Ebola or severe measles, or if cases of acute encephalitis are caused by Nipah, Japanese encephalitis or other pathogens as the various diseases require very different biosafety measures, management and support, Formenty says. WHO initiative builds on a long-standing process, whereby countries call on the laboratory and disease control expertise of another country for help in responding to outbreaks of new diseases--often by tapping into the know-how of 250 institutions in the WHO-coordinated Global Outbreak Alert and Response Network (GOARN). [ILLUSTRATION OMITTED] For example, in 1999, when Malaysia detected 257 cases of febrile encephalitis among workers with exposure to pigs, and 11 cases were identified in Singapore, experts from Australia and the Centers for Disease Control and Prevention (CDC) in the United States of America (USA) teamed up to help find the cause. We were the only veterinary laboratory in the world able to work to biosafety level 4 at that time, explains Dr Peter Daniels, assistant director and theme leader, diagnosis, surveillance and response at the Australian Animal Health Laboratory, Geelong, Australia, a member of the new labs network. We were working with the Malaysians as part of a coordinated effort, helping on the animal health outbreak investigation side and setting up a Nipah testing laboratory in their national Veterinary Research Institute, while CDC worked on the public health side. Australian lab is also a Collaborating Centre for new and emerging diseases with the World Organisation for Animal Health (OIE) and a WHO Collaborating Centre for SARS. …

Epidemics: Lessons from the past and current patterns of response

Hippocrates gave the term ‘epidemic’ its medical meaning. From antiquity to modern times, the meaning of the word epidemic has continued to evolve. Over the centuries, researchers have reached an understanding of the varying aspects of epidemics and have tried to combat them. The role played by travel, trade, and human exchanges in the propagation of epidemic infectious diseases has been understood. In 1948, the World Health Organization was created and given the task of advancing ways of combating epidemics. An early warning system to combat epidemics has been implemented by the WHO. The Global Outbreak Alert and Response Network (GOARN) is collaboration between existing institutions and networks that pool their human and technical resources to fight outbreaks. Avian influenza constitutes currently the most deadly epidemic threat, with fears that it could rapidly reach pandemic proportions and put several thousands of lives in jeopardy. Thanks to the WHO's support, most of the world's countries have mobilised and implemented an ‘Action Plan for Pandemic Influenza’. As a result, most outbreaks of the H5N1 avian flu virus have so far been speedily contained. Cases of dengue virus introduction in countries possessing every circumstance required for its epidemic spread provide another example pertinent to the prevention of epidemics caused by vector-borne pathogens.

Marburg fever outbreak leads scientists to suspected disease reservoir

Marburg fever outbreak leads scientists to suspected disease reservoir

Taiwan's Potential to Assist Developing Countries to Combat Infectious Diseases

The article on influenza in tropical regions by Viboud and colleagues outlines an alarming global burden of influenza, with an estimated one million annual deaths worldwide [ 1]. We would like to give an example of the immense potential of Taiwan to assist developing world communities in fighting against emerging infectious diseases in the near future. Taiwan (area 36,000 km 2; population 23 million), officially known as the Republic of China, is located on the Tropic of Cancer. Taiwan lost its United Nation membership in 1971 to its rival, the People's Republic of China, but maintains official diplomatic relations with 25 countries and de facto relations with many nations. Taiwan has one of the highest levels of life expectancy in Asia, and it has eradicated infectious diseases such as the bubonic plague in 1948, smallpox in 1955, rabies in 1959, malaria in 1965, and polio in 2000. Taiwan became the first country in the world to implement a hepatitis B immunization program. Taiwan also initiated active vaccination programs against diptheria, pertussis, and tetanus in 1955, Japanese encephalitis in 1969, measles in 1978, hepatitis B in 1984, rubella in 1986, hepatitis A in 1995, and influenza in 1998. Valuable lessons may be learned from Taiwan's experience in public health and its response to disease outbreaks and crises. Taiwan provides a modern, world-class health-care system to its people [ 2]. According to Taiwan Department of Health's statistics, the average life expectancy in 1951 was 53.38 years, and it increased to 73.35 years for men and 79.05 years for women in 2003. The Centre for Disease Control in Taiwan was established in 1999 to consolidate disease control resources. When an epidemic of enterovirus took the lives of 78 people in 1998, Taiwan responded by setting up disease surveillance [ 3]. To fight influenza, Taiwan embarked on a free influenza immunization program aiming to increase the coverage rate to 80% for those above the age of 65. There has been an increase in immunization of the elderly from 59.9% in 2002 to 68.4% in 2003, with medical care providers and disease control staff immunization up to 91.3%. Taiwan is committed to retaining vaccination production capability in the event of an emergency. The government is supporting a plan for the domestic production of influenza vaccines over the next few years as a part of Taiwan's readiness for an avian flu epidemic. Taiwan is committed to work with the global medical community by contributing its resources and expertise. Unfortunately, it is not a member of the World Health Organization (WHO). It has therefore been excluded from the Global Outbreak Alert and Response Network (GOARN). During the time of the enterovirus outbreak, Taiwan did not get any assistance from the WHO but managed to combat the outbreak. The avian flu scare of 1997 was controlled in Hong Kong because of timely action, aided by the WHO. If Taiwan is to respond effectively to similar outbreaks of global epidemics in the future, it will certainly need the cooperation of the WHO. Although the WHO is a non-political agency, because of pressure from the People's Republic of China, which considers Taiwan as a renegade province, Taiwan has been marginalized. Regardless of this, Taiwan has contributed over US$180 million since 1995 in medical and humanitarian aid to 95 countries, and it plans to make further donations. Therefore, excluding Taiwan from the WHO's GOARN is counterproductive from both medical and ethical standpoints. Taiwan, through its own efforts, has managed to improve public health remarkably, despite having no assistance from the WHO. It certainly has the potential to assist developing nations in the fight against emerging disease outbreaks, so other countries can seek Taiwan's expertise to fight against infectious diseases in the near future.

Les pathogènes émergents, la veille internationale et le Règlement sanitaire international (2005)

In order to address the vitality of the microbial world, to detect emerging infectious diseases, to determine their potential threat to public health, and to establish effective interventions, the World Health Organization (WHO) has developed and coordinates the Global Outbreak Alert and Response Network (GOARN) which connects several surveillance networks. Some of these networks are specific to epidemic-prone diseases, such as influenza, dengue, yellow fever or meningitis. Others were especially designed to track unusual events —such as the emergence of SARS— that are naturally-occurring, accidental, or deliberately created (biological weapons, bio-terrorism). Lastly, a special effort is being made at the international level to modernize the International Health Regulations, now obsolete, and to support all the countries in the reinforcement of their outbreak alert and response capacity.

International Health Regulations (2005)

International Health Regulations (2005)

Dodging a Bullet: WHO, SARS, and the Successful Management of Infectious Disease

The purpose of this article is to analyze the policy decisions made by the World Health Organization (WHO) in working to fight the spread of the first truly global infectious disease, severe acute respiratory syndrome (SARS), of the 21st century. In particular, the author pays attention to the WHO’s Global Outbreak Alert and Response Network (GOARN) and analyzes how it was employed in coordinating a variety of response efforts around the world. In addition, he identifies and assesses the successes and failures of the GOARN’s policies with regard to the monitoring and containment of the SARS outbreak.

Smallpox containment updated: considerations for the 21st century

Smallpox containment updated: considerations for the 21st century

Smallpox containment updated: considerations for the 21st century

SummaryThe emergence and re-emergence of infectious diseases since the eradication of smallpox has had a direct impact on preparedness for a deliberately-caused smallpox outbreak, should one occur. The emergence of HIV has placed restrictions on the safe and effective use of smallpox vaccines and made the need for vaccinia immune globulin important for outbreak control. At the same time, the threat of international spread of emerging and re-emerging infections has prompted global investments in surveillance and response mechanisms such as the Global Outbreak Alert and Response Network (GOARN), a mechanism that would enhance the world's collaboration in smallpox containment as it did during the recent outbreak of SARS. Though global preparedness for a deliberately-caused smallpox outbreak has increased with the creation of GOARN, it does not replace the need for increased national public health investment to expand surge capacity for the management of patients and their contacts and to strengthen emergency communication networks to ensure effective response.