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Feature Global Health

Would today's international agreements prevent another outbreak like SARS?

BMJ 2014; 348 doi: (Published 23 June 2014) Cite this as: BMJ 2014;348:g4123
  1. Sophie Arie, freelance journalist, London, UK
  1. sarie{at}

The world’s best efforts to protect itself from potential international health emergencies do not seem to be working. Sophie Arie investigates why

Middle East respiratory syndrome (MERS) emerged in Saudi Arabia in 2012 and has since spread to more than 20 countries and killed over 200 people.1 Yet the way the virus works and where it came from are still not known. Saudi Arabia has been accused of failing to gather and share information about the outbreak, and the Gulf state has complained that a patent filed by Dutch researchers who first identified the virus is making it harder for the Saudis to develop a diagnostic test for the disease.2 3

It is hardly a shining example of international cooperation in the face of a global health threat.

Yet in 2007, the international system for preventing emerging infectious diseases turning into pandemics was completely overhauled to reflect the fact that in an era of globalisation, over two million people cross borders every day so a new pathogen, even in the remotest corners of the earth, can rapidly become a global threat. In 2003 severe acute respiratory syndrome (SARS) had spread from Hong Kong to 35 countries in the space of only a few weeks, forcing the World Health Organization to impose global travel restrictions that caused huge economic damage through interrupted global trade and traffic.4

In an extraordinary signal of global consensus, all 194 countries that are members of WHO signed up to the International Health Regulations (IHR),5 agreeing to report any potential global health threat instantly to WHO , which coordinates an international, 24 hour early warning and rapid response system. The whole process is based on the world helping any individual country to detect and control a new disease before it spreads.

“When we …

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