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“Emerging Threats: Emerging Infectious Disease Surveillance in Cambodia and Indonesia,” U.S.-Pakistan Strategic Partnership: A Track-Two Dialogue for Long-Term Security Cooperation, Grand Hyatt Hotel, Singapore, 7-8 October 2010.
“Emerging Threats: Emerging Infectious Disease Surveillance in Cambodia and Indonesia,” U.S.-Pakistan Strategic Partnership: A Track-Two Dialogue for Long-Term Security Cooperation, Grand Hyatt Hotel, Singapore, 7-8 October 2010.
“Emerging Threats: Emerging Infectious Disease Surveillance in Cambodia and Indonesia,” U.S.-Pakistan Strategic Partnership: A Track-Two Dialogue for Long-Term Security Cooperation, Grand Hyatt Hotel, Singapore, 7-8 October 2010.
and Disease Surveillance Prof. Sophal Ear, Department of National Security Affairs, NPS Emerging Infectious Disease Surveillance in Cambodia and Indonesia Prof. Zafar Jaspal, Department of International Relations, QAU, Bio-security: How real is the threat? Air Commodore Khalid Banuri on National response and future steps. Emerging Threats: Emerging Infectious Disease Surveillance in Cambodia and Indonesia Sophal Ear, Ph.D. Assistant Professor Naval Postgraduate School 8 October 2010 Disclaimer: Material contained herein is made available for the purpose of peer review and discussion and does not necessarily reflect the views of the Department of the Navy or the Department of Defense. From booby-trapped nuclear coffee cups To we dont want to let the technology drive the politics, but we want to let the politics drive the technology To Surrender to the tyranny of the technicians 'Infrared Fever Screening System' April 18, 2003 at Singapore's Changi Airport in Singapore September 2, 2010...10:41 am Concerns over disease raised in Pakistan flood aftermath Before After August 24, 2010: Disease Outbreaks Threaten Pakistan Flood Victims Diarrhea and cholera wreaking havoc in many of Pakistans flooded areas Contents 1. The Problems 2. Timeline Context 3. Indonesia Case Study 4. Cambodia Case Study 5. H1N1 (hitting closer to home) 6. Conclusion: The End or the Beginning? Myriad Problems Poor to non-existent surveillance Poor diagnostic laboratory capability Disincentive to report (bad publicity, bad for business) Viral sovereignty (in Indonesias case) Page 213: In 2006, Indonesia claimed viral sovereignty over samples of H5N1 collected within its borders and announced that it would not share them until the WHO and developed countries established an equitable means of sharing the benefits (e.g., vaccine) that could derive from such viruses. Page 3: in the poorest countries per capita expenditure on all aspects of health care [is] 3% expenditure in high-income countries staff in over 90% not familiar with quality assurance principles more than 60% of laboratory equipment is outdated or not functioning August 2001: the more things change 2010 Director of Laboratory Systems Development at a major American university with whom the GAOs description was shared for insights wrote the following from my own experiences in countries (Southern Caucuses, Central Asia, Southeast Asia, India, Sub-Saharan Africa) I believe the status has not changed much from the date of the report. TimelineContext Human Pandemic Flu Timeline Spanish (H1N1) HK flu H3N2 HPAI H5N1 H7N2 H7N3 H10N7 Downside of Globalization: Global Reach of Diseases Quality of Health Care, 2002 H5N1: Highly Pathogenic Avian Influenza Avian influenza situation in China 8 June 2010 -- 22-year-old pregnant woman died on 3 June exposed to sick and dead poultry. Of the 39 cases confirmed to date in China, 26 have been fatal: mortality rate of 66%! http://www.youtube.com/watch?v=X6vFaMy0w0 0 Indonesia Case Study After FOUR decades, the Naval Area Medical Research Unit- 2 (Namru-2) is kicked-out of Indonesia And all because of one woman? Maybe not. Issues Raised in Indonesia 0% 10% 20% 30% 40% 50% 60% Cambodia Case Study Lucky guy, thanks to Namru-2... H5N1 Animal Outbreaks 04-08 2008 2007 2006 2005 2004 2007 2006 2005 2008 H5N1 Human Victims 05-08 Issues Raised in Cambodia 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Low Staff Compensation Donor Dependence Pathologies Poor staff management/HR Patronage networks detrimental to work environments No compensation for culling Differing host and donor priorities Goal: reduce pandemic potential that could strike donor countries themselves But lets end where we started, with Indonesia and Cambodia Dateline: 11 April 2010 Namru-2 Jakarta is shutting down. I have been very sad. Not only because I am losing my job, but more than that, Indonesia will loss [sic] an established laboratory research coz [sic] of political reasons --Senior Indonesian scientist Scientists Technology should be on tap, but not on top. Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning. --Churchill The end or the beginning? 25 June 2010: Director of Namru-2 Phnom Penh steps down Former Namru-2 Jakarta Commanding Officer to head Namru-2 Phnom Penh Lessons learned from Indonesia should be applied to Cambodia Thank you. Prof. Zafar Jaspal, Department of International Relations, QAU, Bio-security: How real is the threat? Air Commodore Khalid Banuri on National response and future steps.