Emerging Infections, the International Health Regulations, and Macro-Economy

When breaches in the species barrier between animals and humans result in crossover of animal infections to humans, the result is an emerging infectious disease. Emerging infections have the potential to cause severe human illness and death, and to spread among human populations and across geographic borders. Direct costs associated with emerging infections are often high, caused by prolonged patient management, hospitalization, and convalescence. Indirect costs are caused by absenteeism from work, death, and permanent removal from the workforce. There may be additional costs if precautionary prevention measures are required, based on the known or potential risk. These costs result from culling and prohibited trade in animals and animal-based products if infected animals are a continuing threat to humans; or from postponement or cancellation of travel and tourism if transmission in the general population is uncontrolled. Emerging infections sometimes cause panic and/or fear because of misunderstanding of the risk, and can lead to actions that result in economic loss similar to that caused by legitimate public health precautionary measures. They include reactions such as avoiding animal-based foods mistakenly thought to be the source of infection; unnecessary cancelling travel plans to avoid geographic areas where there is a perception of risk of infection; and/or unwarranted culling of animals or destruction of animal-based foods. If the misunderstanding is transmitted widely by the press or through social media networks, the negative economic impact can be amplified. Economic loss caused by these perceived risks can generally not be disentangled from the losses causes by public health measures that may be in place, but it is thought that at times they add significantly to the economic burden. The International Health Regulations (IHR) were designed to respond to the international spread of infectious disease outbreaks in a manner that prevents unnecessary negative economic impacts. Agreed by all Member States of the World Health Organization in 2005, they are a legally binding global agreement with the specific purpose of ensuring maximum security against the international spread of diseases, with a minimum interference in world traffic and trade. They reflect current understanding of infectious disease risks, especially those that emerge at the animal/human interface; the realization that infectious diseases cannot be stopped from entering countries at borders; the vast increase in access to information through the internet; and globalization that increases the speed with which infectious diseases spread. Under the IHR, countries are able to work transparently with WHO and its scientific experts and collaborating laboratories to conduct joint risk assessments of public health events such as outbreaks of infectious diseases; to make evidence-based recommendations to help prevent or control their international spread; and, by providing valid and transparent information to national focal points, to help prevent unnecessary panic and misunderstanding about risk.