Acknowledgements
CAREC Regional Communicable Disease Surveillance System
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- Major Changes in the Regional Communicable Disease Surveillance System
- Legal Basis
- Strategic and Operational Plans
- Reporting Chain
CAREC Regional Communicable Disease Surveillance SystemIn 2000-2001, CAREC and its member countries recognised that many attributes of the system, such as timeliness, accuracy and usefulness, needed to be improved. The need for revision of the regional communicable disease surveillance system was further recognised as the process of revision of the International Health Regulations (currently taking place) progressed. In 2002, the CAREC Scientific Advisory Committee (SAC)1 supported the desire of member countries and CAREC to provide accurate and timely reports on health threats and diseases in the region. Realising that this process will likely identify further areas for rationalisation and improvement, SAC recommended that CAREC and national programmes exchange information as needed on a country-by-country basis. SAC also recommended that CAREC prepare to provide additional training and capacity building both at the national level and CAREC level to initiate agreed-upon changes. In 1986, heads of government in English-speaking Caribbean countries approved a CCH initiative, a mechanism for health development through increasing collaboration and promoting technical cooperation among countries in the Caribbean. Communicable diseases were identified as one of the eight priority areas in this initiative. As such, effective communicable disease surveillance is necessary in order to achieve the goals of the CCH initiative and to monitor the CCH indicators in this area. Most of CAREC’s member countries will soon be part of the CARICOM Single Market and Economy (CSME), which will allow free movement of CARICOM goods, services, people and capital throughout the Caribbean community and facilitate more homogenous economic performance across CARICOM member states. Effective communicable disease surveillance, which promotes disease prevention and control, will support the implementation of CSME. Major Changes in the Regional Communicable Disease Surveillance System
Legal BasisAll CAREC member countries are WHO member states and, as such, are signatory to the International Health Regulations (currently under revision), which will require all member states to report all potential public health emergencies of international concern to WHO. Regional surveillance is mandated under the multilateral agreement between CAREC and its member countries and is implemented through the annual meetings of Chief Medical Officers, Caribbean National Epidemiologists, Laboratory Directors and Programme Managers, who agree upon surveillance systems and contribute to revisions and amendments. This supports the CCH initiative for the prevention and control of communicable diseases. The multilateral agreement also mandates that surveillance activities shall be co-ordinated with the surveillance programmes of PAHO/WHO. Legal Basis, continuedAll member countries have legislation and/or regulations governing the reporting of communicable diseases, which state the conditions that are nationally reportable by law. However, legislation is outdated in many countries and needs to be revised. Strategic and Operational PlansA national policy on communicable disease surveillance is critical for guiding planning and implementation activities and supports the sustainability of the system. At both the national and regional level, there should be strategic and operational plans for communicable disease surveillance. These plans must address all components of the system (as indicated in Figure 3.2), namely:
Reporting ChainIn-country healthcare providers, such as health centres, hospitals, laboratories and private physicians (as identified by each country) are responsible for the transmission of communicable disease data to the national level. In some countries, healthcare providers report data directly to the national level. In others, they report to an intermediary regional/district/parish level that reports to the national level. At the national level, the office of the National Epidemiologist is responsible for the transmission of data, information and public health emergencies (as outlined in International Health Regulations) to CAREC. The office of the National Epidemiologist, in collaboration with the national surveillance and response team, is also responsible for the dissemination of information within each country. At the regional level, CAREC is responsible for the dissemination of data and information to PAHO/WHO and other stakeholders and partners, including member countries. The conceptual framework of surveillance and response systems for communicable diseases is presented in Figure 3.2 on the next page. Reporting Chain, continued Figure 3.2. Conceptual framework of surveillance and response systems. 
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