world health report 2007 xiv global public health security in the 21st century CHAPTER SUMMARIES Evolution of public health security Chapter Chapter 1 begins by tracing some of the first steps, historically, that led to the intro- duction of IHR (1969)-landmarks in public health starting with quarantine, a term coined in the 14th century and employed as a protection against "foreign"diseases such as plague; improvements in sanitation that were effective in controlling cholera outbreaks in the 19th century; and the advent of vaccination which led to the eradica- tion of smallpox and the control of many other infectious diseases in the 20th century Understanding the history of international health cooperation- its successes and its failures- is essential in appreciating its new relevance and potential Numerous international conferences on disease control in the late 19th and early 20th centuries led to the foundation of wHo in 1948. In 1951. WHO Member states adopted the International Sanitary Regulations, which were replaced and renamed the International Health Regulations in 1969. Starting in 1995, the Regulations were revised through an intergovernmental process which took into account new epidemiological understanding and accumulated experience, and which responded to the changing world and the related increased threats to global public health security. It was agreed that a code of conduct was required that could not only prevent and control such threats, but could also provide a public health response to them while avoiding unnecessary interference with international trade and traffic. The revision process was comple in 2005 and the Regulations are now referred to as IHR (2005) Chapter 1 describes how the basis of an effective global system of epidemic alert and response was initiated by WHO in 1996 and how it has been widely expanded since then It was built essentially on a concept of international partnership with many other agencies and technical institutions. Called the Global Outbreak Alert and Response RN), this partnership provides an operational to access expertise and skill, and to keep the international community constantly alert the threat of outbreaks and ready to respond. Coordinated by WHO, the network is made up of over 140 technical partners from more than 60 countries In addition, the unique, large-scale active surveillance network developed by the Global Polio Eradication Initiative is being used to support surveillance of many other vaccine-preventable diseases, such as measles, meningitis, neonatal tetanus and yel low fever. This network is also regularly supporting outbreak surveillance and response activities for other health emergencies and outbreaks described in the report. In 2002, WHO established the Chemical Incident Alert and Response System to operate along similar lines to goarN. This was extended in 2006 to cover other environment health emergencies, including those related to the disruption of environmental health services, such as water supply and sanitation, as well as radiological events and emergencies.Chapter summaries Evolution of public health security Chapter 1 begins by tracing some of the first steps, historically, that led to the intro￾duction of IHR (1969) – landmarks in public health starting with quarantine, a term coined in the 14th century and employed as a protection against “foreign” diseases such as plague; improvements in sanitation that were effective in controlling cholera outbreaks in the 19th century; and the advent of vaccination which led to the eradica￾tion of smallpox and the control of many other infectious diseases in the 20th century. Understanding the history of international health cooperation – its successes and its failures – is essential in appreciating its new relevance and potential. Numerous international conferences on disease control in the late 19th and early 20th centuries led to the foundation of WHO in 1948. In 1951, WHO Member States adopted the International Sanitary Regulations, which were replaced and renamed the International Health Regulations in 1969. Starting in 1995, the Regulations were revised through an intergovernmental process which took into account new epidemiological understanding and accumulated experience, and which responded to the changing world and the related increased threats to global public health security. It was agreed that a code of conduct was required that could not only prevent and control such threats, but could also provide a public health response to them while avoiding unnecessary interference with international trade and traffic. The revision process was completed in 2005 and the Regulations are now referred to as IHR (2005). Chapter 1 describes how the basis of an effective global system of epidemic alert and response was initiated by WHO in 1996 and how it has been widely expanded since then. It was built essentially on a concept of international partnership with many other agencies and technical institutions. Called the Global Outbreak Alert and Response Network (GOARN), this partnership provides an operational and coordination framework to access expertise and skill, and to keep the international community constantly alert to the threat of outbreaks and ready to respond. Coordinated by WHO, the network is made up of over 140 technical partners from more than 60 countries. In addition, the unique, large-scale active surveillance network developed by the Global Polio Eradication Initiative is being used to support surveillance of many other vaccine-preventable diseases, such as measles, meningitis, neonatal tetanus and yel￾low fever. This network is also regularly supporting outbreak surveillance and response activities for other health emergencies and outbreaks described in the report. In 2002, WHO established the Chemical Incident Alert and Response System to operate along similar lines to GOARN. This was extended in 2006 to cover other environmental health emergencies, including those related to the disruption of environmental health services, such as water supply and sanitation, as well as radiological events and emergencies. 1 chapter xiv global public health security world health report 2007 in the 21st century