Infectious Disease Control Policies and the Role of Governmental and Intergovernmental Organisations

Public health is generally regarded as the typical domain of national if not local governments, which takes into account local necessities arising from the epidemiologic situation, the health-care system and the government structures. Therefore in theory, public health policy is in the sovereignty of countries. However, the spread of infectious diseases has never been restricted to national borders; thus the principle of national sovereignty is largely theoretical. This is especially true in a world with unprecedented international mobility of goods and persons. Moreover, particularly public health actions in the field of infectious diseases within one country may well affect public health issues in other countries. One of the best recent examples is the Chinese management of the initial phase of the SARS epidemic, which was characterised by failing surveillance structures, insufficient control measures and restricted public information policy. Abba Ebban has described it as a paradox that in order for countries to effectively execute their public health sovereignty, they would consequently have to give up some of their sovereignty to intergovernmental organisations (Ebban 1995).