1. RFP : 한국형 Bio-surveillance 감시망 구축

2. 해당분과 : 1-1 과제

3. 과제명 : 감염병 공중보건 위기의 범정부 공동대응을 위한 한국 생물감시체계 플랫폼 구축

4. 연구책임자 : 탁상우(서울대학교)

[Abstract]

Laws are fundamental tools that regulate and manage various issues to protect the rights of the people in a society. Legislation on disease surveillance enables agencies to regulate and manage public health, including preventing the spread of infectious diseases. We assessed the Infectious Disease Prevention and Control Act of Korea (IDPCA) through the lens of biosurveillance to understand its effectiveness in protecting public health. In addition, the relevant legislation and regulations of the United States and the World Health Organization were examined. The evaluation concludes that the current IDPCA is limited in terms of providing guidance for early detection of and response to hazards using integrated data and an information-sharing system. Further revision of the laws is needed to enable early detection and warning of potential threats to public health.

The authors assessed the Infectious Disease Prevention and Control Act of Korea (IDPCA) through the lens of biosurveillance to understand its effectiveness in protecting public health. The relevant legislation and regulations of the United States and the World Health Organization also were examined. They concluded that the current IDPCA is limited in terms of providing guidance for early detection of and response to hazards using integrated data and an information-sharing system.

The 2015 Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (ROK) was the second largest outbreak of its kind, with 186 confirmed cases and 38 deaths.1 In addition, increasing international travel and infectious disease outbreaks in recent decades have prompted further calls to strengthen national surveillance systems.2 During the MERS outbreak in 2015, national legislation pertaining to infectious diseases did not include guidelines on MERS. Because of the lack of guidelines and previous experience with MERS, the Korea Centers for Disease Control and Prevention (KCDC) failed to provide a timely response.3 Given that outbreaks of disease occur beyond predictions and jurisdictional boundaries, the ROK government initiated intergovernmental programs. One such program is the big data–based Food Poisoning Prediction Model, developed in 2015.4 The model was developed by several government departments to prevent and control outbreaks of foodborne illness. In 2019, the intergovernmental Joint Response to Antimicrobial-Resistant Bacteria project was initiated. This was based on the understanding that combating antimicrobial resistance requires an integrated approach focused on humans, animals, and the environment.5

Despite these intergovernmental programs to strengthen surveillance systems, a framework to ensure sustained coordination among government departments has yet to be established. Coordination among departments for temporary programs often is not sustained over the long term. To facilitate rapid detection and response to public health threats, systematic coordination of departments is vital. The United States has led implementation of biosurveillance systems involving coordination among multiple agencies, and other countries are rapidly following suit.6,7

In the ROK, infectious disease surveillance is carried out by the KCDC under the Ministry of Health and Welfare. Infectious disease surveillance involves the continuous collection and analysis of data, mostly from reports of medical personnel.8 Traditional infectious disease surveillance, including the existing system in the ROK, focuses on human diseases and does not incorporate the concept that disease outbreaks can be spread by nonhuman vectors.9 To address these limitations of the current infectious disease surveillance system of the ROK, means of strengthening the current system should be explored in the context of biosurveillance. Unlike infectious disease surveillance, which tends to target only identified cases, biosurveillance requires the integration of dispersed data on human and animal health.

Such integration requires coordination among various stakeholders to achieve early detection and mount a response to any biological threat. Because the concept of biosurveillance is relatively new to the public health disciplines, it is often misunderstood as a massive compilation of data available in various government agencies. Rather, it is recommended that the regulations mandating jurisdictional collaboration be examined to enable integration of relevant information in different agencies, if not across the government.

Examination of legislation provides insight into how a nation ensures public health and safety.5 Assessing existing legislation also enables understanding of the current status of surveillance systems and their limitations, allowing legal tools to be used to strengthen the public health system.8 In this study, we assessed the Infectious Disease Prevention and Control Act of Korea (IDCPA) to understand the current infectious disease surveillance system of the ROK in terms of its utility for biosurveillance. In addition, to learn from previous experience, we examined the relevant US and World Health Organization (WHO) regulations.