Newsletter 03 - Meet the Expert
Meet the experts
Urban epidemics
The Office for National Epidemic Preparedness and Response (World Health Office, Lyon), in collaboration with the world competitive cluster Lyonbiopôle, held an international consultation, “Cities and public health crises” on 29-30 October 2008 in Lyon, France. Its purpose was to develop WHO guidelines for public health and municipal authorities. It was part of the preparation of the BioVision 2009 session entitled “Life in the City: Managing urban epidemics”. Fifty international experts identified and addressed the specific challenges posed by public health emergencies that occur in urban settings, particularly in large and megacities. Dr Guenael Rodier, Director of International Health Regulations Coordination at the World Health Organization, reflects on the main points.
"The world requires a global system that can rapidly identify and contain public health emergencies and reduce unneeded panic and disruption of trade, travel and society in general."
What is the debate today?
Epidemics and pandemics can place sudden and intense demands on health systems. They expose existing weaknesses in these systems and, in addition to their morbidity and mortality, can disrupt economic activity and development.
Often the megacities rely on national preparedness plans, since they have none of their own, despite controlling large resources –security, hospital and medical facilities, emergency services, communications – and often having more resources than governments. But there remains a lack of coordination. This is especially true of communications where large cities contain people of disparate languages and cultures are often overlooked in the communication of outbreak management and relief. Outbreak responses need to trace contacts and gather data. This is difficult in the cities where a person will not know whom they have infected on public transport, for example, or where investigators may face harassment or where collaboration between relevant agencies is not the norm.
What are the solutions?
The WHO would like to see more timely and enhanced epidemic intelligence, real-time exchange of situational reports and other data for decision-making, enhanced information management and risk communications, risk analysis and decision support, action planning and coordination of response activities, and technical partnerships to support international health security.
What is the added value of BioVision according to you?
Unique to BioVision is the participation of major city mayors, which brings a much needed political aspect to the debate and moves it beyond the realm of the technical experts.
Health and Disease in Global Cities
Will global or world cities evolve into socially infected breeding grounds for the rapid transmission of disease? Or can they become critical spatial entities for the protection and promotion of population health? The inhabitants of these cities are increasingly vulnerable to infectious disease, particularly those that may spread rapidly across global city networks. In an age when infectious disease are on the increase as witnessed by epidemics such as SARS and avian flu, current debate focuses on such issues as whether global cities can take effective measures to protect themselves against emerging threats to population health or will they be increasingly viewed as risky places in which to live?
"These problems will challenge any big city to develop a solid public health infrastructure."
These are among some of the issues investigated recently by Professor Victor G. Rodwin in a comparative analysis of four global cities (New York, London, Paris and Tokyo). “Despite the vast medical, financial, cultural and learning resources of these cities they still confront onerous health risks for at least four problems” said Professor Rodwin («Health and Disease in Global Cities: A Neglected Dimension of National Health Policy»).
These are the return of infectious diseases such as drug resistant TB and the emergence of new threats such as AI DS, SARS, terrorism, including bioterrorism; barriers in access to health care services for ethnic minorities and/or the poor and rising inequalities among social groups.
Drawing on his World Cities Project which he co-directs with Professor Michael K Gusmano at the International Longevity Center-USA, Rodwin asserts that comparative surveillance of health status and access to health care, as well as careful monitoring of disease outbreaks in large cities, is an important function of our global public health infrastructure. The capacity to assess risk in strategic urban locations will increasingly become recognised as an important component of national health policy.
“BioVision provides a unique opportunity for all stakeholders to debate how global cities are addressing these risks and how they may learn from their respective failures and successes. An important key to the development of enhanced protection for global cities is to begin systematic comparative analyses of how cities address these risks”.
Missing biodiversity target
puts peop le at risk - WWF
Future generations face hunger, thirst, disease and disaster if we carry on trashing the environment, warned WWFInternational in its ‘2010 and Beyond: Rising to the BiodiversityChallenge’ report. This report contains the latest
Food, clean water, medicines and protection from natural hazards are important ingredients in maintaining our security and quality of life. If they are to be maintained then the species, natural habitats and ecosystems that support them need to be protected. In 2002 the world’s governments set themselves a target to reduce the rate of biodiversity loss by 2010 but WWF’s report shows that they are clearly not on track.
Biodiversity underpins the health of the planet and has a direct impact on all our lives. Put simply, reduced biodiversity means millions of people face a future where food supplies are more vulnerable to pests and disease and where water is in irregular or short supply.
Among WWF’s recommended solutions are:
- develop joint implementation plans between environment, agriculture, food, water, finance, and health in order to take urgent action to reduce the rate of biodiversity loss by 2010
- live up to their commitment to put in place effective protected area systems, with the full and effective participation of indigenous and local communities and promoting equity and benefit sharing
- adopt a target to achieve zero net annual deforestation by 2020 and initiate collaboration between the CBD and the United Nations Framework Convention on Climate Change to reduce green house gas emissions from deforestation and degradation
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