WHO Library Cataloguing-in-Publication Data The world health report 2007: a safer future global public health security in the 21st century. 1. World health-trends. 2. Disease outbreaks- prevention and controL. 3. Legislation, Health. 4. International cooperation. 5.Environmental health. ITitle. ILTItle: A safer future: global public health security in the 21st cer BN978924156344 NLM classification: WA530.1) e World Health Organization 2007 Requests we Appia, 1211 Geneva 27, Switzerland (tel : +41 22 791 3264: fax: +41 22 4857 roduce or translate WHO publications- whether for sale or for be addressed to WHO Press, at the abowe address (fax +41 22 791 4806; e-mail: permi border lines for which there may not full agreement. orld Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions the names of proprietary products are distinguished by initial capital letters All reasonable precautions have been tai al isI the world Health Organization to verify responsibility for the interpretation and use of the material lies wit der. In no event shall the World Health Organia. The able for damages arising from its use Information conceming this publication can be obtained from World Health Organization 1211 Geneva 27. Switzerland mail: whr @ who int Copies of this publication can be ordered from: bookorders@who in his report was produced under the leadership of Director-General, Margaret Chan. David Heymann, Assistant Director-General for Communicable Diseases, was Editor-in-Chief. The main writers were Thomson Prentice and Lina Tucker Reinders of the world Health Report Advice and support were gratefully received from all Assistant Directors-General, Regional Directors, numerous WHO technical units, and many ers who reviewed and cont the text athers, Angela Merianos, Francois-Xavier Meslin, Michael Nathan, Maria Neira, Paul Nunn, Kevin O Reilly, Andree Rodier, Oliver Rosenbauer, Cathy Roth, Mike Ryan, Jorgen Schlundt, George Schmid, lan Smith, Claudia Stein and Leo Vita-Finzi. The report was edited by Diana Hopkins, assisted by Barbara Campanini Figures, tables and other illustrations were d by gael Kernen, who also produced the web site version and other electronic media. Vreni schoenenberger assisted in historical research. Administrative support to the world Health Report team was prowided by Saba Amdeselassie. The index was prepared by June Morrison. 30): United States National Library of Medicine(NLM)(p. 47) WHO/Olivier Asselin (pp wi, 16: WHO/Christopher Black(pp. vi, xiv, xvi, i, Xx, xXii, 1, 16, 34, 44, 56, 64: WHO/Christopher Black, Chris de Bode, Umit Kartoglu, Marko Kokic and Jean Mohr (cover) WHO/Chris de Bode (p. 19 WHO/Marko Kokic (pp 20, 21): WHO/Jean Mohr(pp. vili, 1) ns: The Plague Doctor, unknown artist, Wellcome Library, London(p. 2); Death's Dispensary, George Pinwell, 1866(p. 4); Edward enner Performing the First Vaccination against Smallpox in 1796, Gaston Melingue, 1879, Bibliotheque de l'Ac and Reda sad ki on: Raphael CrettazWHO Library Cataloguing-in-Publication Data World Health Organization. The world health report 2007 : a safer future : global public health security in the 21st century. 1.World health – trends. 2.Disease outbreaks – prevention and control. 3.Legislation, Health. 4.International cooperation. 5.Environmental health. I.Title. II.Title: A safer future: global public health security in the 21st century. ISBN 978 92 4 156344 4 (NLM classification: WA 530.1) ISSN 1020-3311 © World Health Organization 2007 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Information concerning this publication can be obtained from: World Health Report World Health Organization 1211 Geneva 27, Switzerland E-mail: whr@who.int Copies of this publication can be ordered from: bookorders@who.int This report was produced under the leadership of Director-General, Margaret Chan. David Heymann, Assistant Director-General for Communicable Diseases, was Editor-in-Chief. The main writers were Thomson Prentice and Lina Tucker Reinders of the World Health Report team. Advice and support were gratefully received from all Assistant Directors-General, Regional Directors, numerous WHO technical units, and many others who reviewed and contributed to the text. Special thanks for their contributions are due to Tomas Allen, Penelope Andrea, Bruce Aylward, Anand Balachandran, Sona Bari, Diarmid Campbell-Lendrum, Amina Chaieb, Claire Lise Chaignat, May Chu, Albert Concha-Eastman, Ottorino Cosivi, Alvaro Cruz, Kevin De Cock,Sophia Desillas, Pat Drury, Pierre Formenty, Keiji Fukuda, Fernando Gonzalez–Martin, Pascal Haefliger, Max Hardiman, Mary Kay Kindhauser, Colin Mathers, Angela Merianos, Francois-Xavier Meslin, Michael Nathan, Maria Neira, Paul Nunn, Kevin O’Reilly, Andrée Pinard-Clark, Guenael Rodier, Oliver Rosenbauer, Cathy Roth, Mike Ryan, Jorgen Schlundt, George Schmid, Ian Smith, Claudia Stein and Leo Vita-Finzi. The report was edited by Diana Hopkins, assisted by Barbara Campanini. Figures, tables and other illustrations were provided by Gael Kernen, who also produced the web site version and other electronic media. Vreni Schoenenberger assisted in historical research. Administrative support to the World Health Report team was provided by Saba Amdeselassie. The index was prepared by June Morrison. Photo credits: Agence France-Presse/Paula Bronstein (pp. viii, 34); International Federation of the Red Cross and Red Crescent Societies (IFRC)/ Christopher Black (p. 25); IFRC/Marko Kokic (p. 22); United Nations Integrated Regional Information Networks (IRIN) (p. 41); Jean-Pierre Revel (p. 30); United States National Library of Medicine (NLM) (p. 47); WHO/Olivier Asselin (pp. viii, 16); WHO/Christopher Black (pp. viii, xiv, xvi, xviii, xx, xxii, 1, 16, 34, 44, 56, 64); WHO/Christopher Black, Chris de Bode, Umit Kartoglu, Marko Kokic and Jean Mohr (cover); WHO/Chris de Bode (p. 19); WHO/Marko Kokic (pp. 20, 21); WHO/Jean Mohr (pp. viii, 1). Illustrations: The Plague Doctor, unknown artist, Wellcome Library, London (p. 2); Death’s Dispensary, George Pinwell, 1866 (p. 4); Edward Jenner Performing the First Vaccination against Smallpox in 1796, Gaston Melingue, 1879, Bibliothèque de l’Académie nationale de Médecine, Paris (p. 5). Design: Reda Sadki Layout: Steve Ewart and Reda Sadki Figures: Christophe Grangier Printing Coordination: Raphaël Crettaz Printed in France