The World Health Organization has issued a warning about the need for international co-operation to tackle “new and emerging threats” carried by the spread of infectious diseases.

In its latest report, entitled A safer future: global public health security in the 21st century , the WHO makes six “key recommendations” to secure the highest level of public health safety. These all involve “global co-operation, in terms of outbreak alert and response, as well as “open sharing of knowledge, technologies and materials,” cross-sector collaboration within governments and “global responsibility for capacity building within the public health infrastructure of all countries”.

The reports notes that “in our increasingly interconnected world, new diseases are emerging at an unprecedented rate, often with the ability to cross borders rapidly and spread”. Since 1967, at least 39 new pathogens have been identified, including HIV, Ebola, Marburg fever and SARS, while other “centuries-old threats”, such as pandemic influenza, malaria and tuberculosis, continue to cause concern through “a combination of mutation, rising resistance to antimicrobial medicines and weak health systems”.

The WHO report notes that “high and rapid mobility of people” is one factor that is causing the spread of disease. Airlines now carry more than two billion passengers a year, “enabling people and the diseases that travel with them to pass from one country to another in a matter of hours”. The “potential health and economic impact” was seen in 2003 with SARS, which cost Asian countries an estimated $60 billion of gross expenditure and business losses.

The report also goes into some of the “human factors behind public health insecurity,” including:

– inadequate investment in public health resulting from “a false sense of security in the absence of infectious disease outbreaks”;

– unexpected policy changes such as a decision temporarily to halt immunisation in Nigeria, which led to the re-emergence of polio cases;

– conflict situations “when forced migration obliges people to live in overcrowded, unhygienic and impoverished conditions heightening the risk of epidemics”; and

– microbial evolution and antibiotic resistance.

The WHO added that it has been closely involved in the response to an outbreak of Marburg fever in Uganda and to global moves to deal with H5N1 avian influenza, which has caused at least 308 deaths since it was first isolated in humans in 1997. Pandemic influenza is described as “the most feared threat to health security in our times” and sets out the WHO’s strategic action plan to respond to a pandemic.

The report concludes by calling for “continued vigilance in managing the risks and consequences of the international spread of polio and the newly emerging strain of extensively drug-resistant tuberculosis (XDR-TB). Also, new health threats have also emerged, linked to potential terrorist attacks, chemical incidents and radionuclear accidents. Margaret Chan, the WHO’s director-general, says that "international public health security is both a collective aspiration and a mutual responsibility. The new watchwords are diplomacy, cooperation, transparency and preparedness."