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Two years after the SARS epidemic, and during the early years of H5N1’s emergence – the World Health Organization promoted the first major revision to the IHR (International Health Regulations) in 35 years, which was voted upon and approved to go into effect in 2007.
With expanded global travel and trade, along with a growing number of emerging disease threats, it was glaringly obvious the world needed a more cohesive, and cooperative approach to managing emerging infectious diseases.
The new 2005 IHR required – among other things – that countries develop mandated surveillance and testing systems, and that they report certain disease outbreaks and public health events to WHO in a timely manner.
While IHR 2005 was well intentioned, more than 15 years later many countries have still failed to implement these mandated systems, and every couple of years the WHO has been forced to grant `extensions' to countries who have not complied.
Timely reporting of outbreaks, and sharing of viruses, by many countries has been haphazard at best, since there are few penalties for ignoring the IHR (see Adding Accountability To The IHR).
Seven weeks ago, in Flying Blind In the Age Of Pandemics & Emerging Infectious Diseases, I mentioned that Saudi Arabia had not updated their MERS-CoV daily report since the end of May, and that the last monthly MERS-CoV Outbreak report from WHO EMRO was from January of 2020.
The World Health Organization did publish a DON report in early July (see WHO DON: Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia), but it only reported details on the cases reported through May.MERS reporting out of Saudi Arabia has always been a bit erratic, including a nearly 3-month gap during the summer of 2018 (see The Saudi MOH Breaks Their Silence On MERS-CoV). In that case they did eventually back fill the data on their website, and continued to report to the WHO during their `outage'.
But as of today, KSA has gone 154 days (22 weeks, or 5 months) without updating their MOH MERS surveillance website, and WHO EMRO has now gone 8 months without publishing their (previously) monthly MERS-CoV outbreak report.
While it is possible that MERS-CoV has abruptly disappeared after 8 years of more-or-less continual (zoonotic & H-2-H) transmission in Saudi Arabia, it doesn't seem likely. Prior to January of this year, MERS-COV was considered the coronavirus with the greatest pandemic potential (see Study: A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia).
COVID may have beaten MERS-CoV to the finish line, but MERS could still show or place.
Sadly, we've seen a similar drop off in influenza surveillance and reporting since the start of the COVID-19 pandemic, which recently complicated the selection of vaccine strains for 2021's Southern Hemisphere flu shot.
And the UN FAO's most recent update on ASF in Asia was released on March 5th, with the next update promised in 2 weeks time. Since then . . . silence.
Seven months without an update from the FAO is less than reassuring.
As imperfect as the 2005 IHR might have been, over the past 7 or 8 months the quantity and quality of global surveillance and reporting has declined significantly. COVID-19 has undoubtedly complicated matters, and siphoned away resources, but may also be a handy excuse for some countries not to report `inconvenient' news.
Regardless of the reasons behind it, our lack of visibility in known infectious disease hotspots around the globe raises the risks of our being blindsided (again) by another pandemic.
While the next pandemic could be worse than SARS-CoV-2, even a much milder threat - while we are still battling COVID-19 - could prove quite challenging.
