Disaster Medicine and Public Health Preparedness

Research Article

The New International Health Regulations: Considerations for Global Public Health Surveillance

Jessica L. Sturtevant, Aranka Anema and John S. Brownstein c1


Global public health surveillance is critical for the identification and prevention of emerging and reemerging infectious diseases. The World Health Organization recently released revised International Health Regulations (IHR) that serve as global legislation and provide guidelines for surveillance systems. The IHR aim to identify and prevent spread of these infectious diseases; however, there are some practical challenges that limit the usability of these regulations. IHR requires Member States to build necessary infrastructure for global surveillance, which may not be possible in underdeveloped countries. A large degree of freedom is given to each individual government and therefore different levels of reporting are common, with substantial emphasis on passive reporting. The IHR need to be enforceable and enforced without impinging on government autonomy or human rights. Unstable governments and developing countries require increased assistance in setting up and maintaining surveillance systems. This article addresses some challenges and potential solutions to the ability of national governments to adhere to the global health surveillance requirements detailed in the IHR. The authors review some practical challenges such as inadequate surveillance and reporting infrastructure, and legal enforcement and maintenance of individual human rights. (Disaster Med Public Health Preparedness. 2007;1:117–121)

(Received July 16 2007)

(Accepted August 29 2007)

Key Words

  • International Health Regulations;
  • infectious diseases;
  • global surveillance


c1 Address correspondence to John S. Brownstein, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02215(e-mail: john_brownstein@harvard.edu). Reprint requests to 1 Autumn St, Room 541, Boston, MA 02215.

Ms Sturtevant is with the Harvard School of Public Health and the Children’s Hospital Informatics Program (CHIP) at the Harvard-MIT Division of Health Sciences and Technology; Ms Anema is with the British Columbia Centre for Excellence in HIV/AIDS; and Dr Brownstein is with CHIP, the Division of Emergency Medicine at Children’s Hospital Boston, and the Department of Pediatrics at Harvard Medical School.