A surveillance sector review applied to infectious diseases at a country level

<p>Abstract</p> <p>Background</p> <p>The new International Health Regulations (IHR) require World Health Organization (WHO) member states to assess their core capacity for surveillance. Such reviews also have the potential to identify important surveillance gaps, improve the organisation of disparate surveillance systems and to focus attention on <it>upstream </it>hazards, determinants and interventions.</p> <p>Methods</p> <p>We developed a <it>surveillance sector review </it>method for evaluating all of the surveillance systems and related activities across a sector, in this case those concerned with infectious diseases in New Zealand. The first stage was a systematic description of these surveillance systems using a newly developed framework and classification system. Key informant interviews were conducted to validate the available information on the systems identified.</p> <p>Results</p> <p>We identified 91 surveillance systems and related activities in the 12 coherent categories of infectious diseases examined. The majority (n = 40 or 44%) of these were disease surveillance systems. They covered all categories, particularly for more severe outcomes including those resulting in death or hospitalisations. Except for some notifiable diseases and influenza, surveillance of less severe, but important infectious diseases occurring in the community was largely absent. There were 31 systems (34%) for surveillance of <it>upstream </it>infectious disease hazards, including risk and protective factors. This area tended to have many potential gaps and lack integration, partly because such systems were operated by a range of different agencies, often outside the health sector. There were fewer surveillance systems for determinants, including population size and characteristics (n = 9), and interventions (n = 11).</p> <p>Conclusions</p> <p>It was possible to create and populate a workable framework for describing all the infectious diseases surveillance systems and related activities in a single developed country and to identify potential surveillance sector gaps. This is the first stage in a review process that will lead to identification of priorities for surveillance sector development.</p

Biosecure citizenship: politicising symbiotic associations and the construction of biological threat

Biosecurity politics in New Zealand is implicated in the constitution of a new dimension of citizenship, a biosecure citizenship. This form is distinct in that the political determinants of citizenship do not fully rest on the individual body, but on the body’s connections to other entities, the inter- and intra-active symbiotic condition of human-non-human ‘living together’. Through its constitutive role in enabling the ‘dangerous’ mobility of pathogens, viruses and invasive species, symbiotic individuality has become politicised as a matter for state determination and control. Contemporary articulations of biosecure citizenship emphasise a variety of contractual and non-contractual responsibilities, which augment the national coordinates of citizenship, reconstitute symbiotic individuality, and justify the state penetration of the private sphere. Drawing on biosecurity legislation, public education campaigns and research with community weed removal projects, I chart the reinforcement and practice of this biosecure citizenship. I argue that there is an urgent need to democratise decisionmaking about the construction of biological threat, about where and how to make cuts in our symbiotic associations with different species, and between species and spaces. By articulating biosecure citizenship not only as a discourse of ecological responsibility but of rights, biosecurity could be reinvigorated as ‘bios-security’, the inclusive politics of continually questioning the ecological good life