Development and Application of a Framework for Emerging Infectious Disease Intelligence in Lower Resource Settings

In 2005, World Health Organization member countries agreed to the revised International Health Regulations which require countries to detect, report, and respond to any event that may represent a public health emergency of international concern. Forecasting the risk posed by hazards, including incidents in animal populations, requires an intelligence-based approach. We propose an emerging infectious disease intelligence framework informed by literature from the fields of surveillance, epidemic intelligence, and military intelligence. This framework highlights the need for situational awareness and can be used to assess emerging infectious disease intelligence capacity in lower resource settings. To illustrate the utility of this framework we applied it to the Infectious Disease Surveillance and Analysis System, a mobile phone-based surveillance pilot project supplementing diagnostic laboratory-based surveillance in Sri Lanka. Application of the framework was feasible and useful in illuminating the strengths and deficits in the current surveillance infrastructure in Sri Lanka for emerging infectious disease early warning. The approach also demonstrated how a mobile phoned-based system could improve Sri Lanka’s emerging infectious disease intelligence capabilities. Finally, the framework allowed us to recommend steps to take in order to strengthen Sri Lanka’s emerging infectious disease early warning capacity, enabling more timely and complete identification of events in the animal population that could pose a human health risk.