Wed, May 07, 2008 - Page 8 News List

Facing the challenges of outbreak prevention

By King Chwan-chuen Wu Tsung-shu 金傳春, 吳宗樹

One of the greatest challenges facing the country is how to cope with outbreaks of disease and protect public health.

The SARS epidemic in 2003 highlighted the need for a sound outbreak prevention system, the means for rapid analyzing outbreaks, ready emergency responses, transparency in information on outbreaks and proper public health education.

Dengue fever broke out for the first time in Kaohsiung, Pingtung and Tainan after the government opened the country to tourism in 1987.

In recent years, the scale of the disease has extended and the number of dengue hemorrhagic fever cases has increased, a warning that serious challenges will come in the wake of global warming.

Moreover, the early outbreak of critical cases of enteroviral infections this year has shown that there is still room for improvement in the integration of an outbreak prevention system and epidemiological research.

As cross-strait direct charter flights, which are scheduled to start in July, will greatly increase the number of people entering the country every day, we may wonder whether the nation’s disease prevention systems are sufficiently prepared for impending challenges.

There are several actions the government should take to protect the public.

First, a flexible, pragmatic and time-efficient epidemic prevention system should be developed.

After the SARS epidemic and terrorist attacks using anthrax in the US, depending solely on passive reporting by hospitals is not enough to provide correct and effective emergency responses. It is necessary to upgrade the system to one in which a public health unit actively reports information on outbreaks, including integration of the acute disease syndromes prevention system with microbiology experiments or examination and surveillance of drug sales. Most importantly, the government must keep up with the latest trends in advanced countries.

Second, it should promote open, impartial and transparent policies of outbreak prevention, research and emergency responses through interdisciplinary cooperation.

Taiwan’s past epidemic prevention policies were mostly centralized.

When an outbreak began to spread or the central government made a wrong decision, it usually failed to address the situation and the bottom-up emergency response capability was lost as well.

It is necessary that government officials avoid conflicts of interest and that amateur personnel not end up leading professional personnel.

Third, the country should join and help build international systems for cooperative outbreak prevention.

Although Taiwan has long been excluded from access to the epidemic prevention systems of the WHO because of political reasons, when faced with a drastic increase of new outbreaks, the incoming government should actively participate in Asia-Pacific regional outbreak prevention systems.

Taiwan should provide outbreak surveillance techniques and support in international information exchange, taking a position as a joint epidemic prevention center with surrounding countries in order to fulfill its obligations and responsibilities to promote international health.

King Chwan-chuen is a professor at the Institute of Epidemiology in the College of Public Health at National Taiwan University. Wu Tsung-shu is a former substitute service draftee in public health for the Malawi medical mission.

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