A paper in BMC Infectious Diseases in February 2024 offers an “in-depth understanding” of data sharing practices through an examination of the MERS epidemic as a model of a zoonotic Emerging Infectious Disease (EID) outbreak. The authors comment on the importance of “timely access” to outbreak related data, which is important to facilitate evidence-based control measures. Through a series of interviews and focus group discussions, the international team behind the paper performed a root-case analysis, mapped enablers to this analysis, and then placed the root causes in the context of “core dilemmas”.
Data sharing is crucial but impeded
Recognising the “inevitable” need for “rapid and open” data sharing during zoonotic EID outbreaks, the authors emphasise that this process is “crucial” to inform public health responses. However, there are a “multitude of interrelated barriers” that “delay or hamper timely data sharing”.
“These barriers can be complex in nature and difficult to circumvent, especially during outbreaks that involve multiple sectors and countries.”
Considering MERS
The Middle East respiratory syndrome (MERS) epidemic was caused by a newly emerging Coronavirus (MERS-CoV) and, as “continuous new introductions” were observed in the human population, it posed a “constant threat for public health”. Thus, in this study the authors use it as a model that offers experience of a “wide array of stakeholders, with competing interests, different priorities, attitudes, and ownership issues” were engaged in the response.
The study: barriers and enablers
The study involved 40 participants who brought expertise across three out of four defined levels of data sharing: global, international, national (regional was excluded). Experts were from Australia, Europe, Qatar, and the US. The root cause analysis identified eight distinct barriers that “hampered or delayed” data sharing during the MERS epidemic and fourteen distinct enablers. The enablers were classified as indisputable, situational/contextual, and tentative. The study investigated the causes of the barriers, finding them “highly interconnected”.
Organisation and alignment
The results of the study suggest that the “current organisation of stakeholders and their institutions” and “alignment of outbreak investigation and response activities across disciplines and sectors” fall short of society’s need for a swift and effective response. Indeed, “significant delays” were identified at the “enhanced level of coordinated and structural multi-stakeholder collaboration, particularly at the human-animal interface”.
“Although the need for integrated One Health collaboration has increasingly been recognised, this study identified in the context of a zoonotic EID outbreak a systemic dilemma on (timeliness of) taking action in the interest of public health, balancing inherent knowledge gaps, and meeting a required threshold of proof to substantiate an involvement of certain animal reservoirs.”
One Health
How can we enable a One Health approach? Two enablers were “perceived to have underscored embracing a One Health approach”. At national level, establishing a “dedicated” One Health Joint field investigation team unifying mandates, activities, etc. among sectors and disciplines. At global level, the tripartite WHO, WOAH, and FAO collaboration. The tripartite, now the Quadripartite, has been working on strengthening global health security.
“While improvements to strengthen outbreak investigation and response at the human-animal interface have been made since the MERS epidemic, the root causes deciphered in this study further indicate areas of improvements.”
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