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dc.contributor.authorEar, Sophal
dc.date.accessioned2016-02-09T17:24:27Z
dc.date.available2016-02-09T17:24:27Z
dc.date.issued2012-01-22
dc.identifier.citationAsia Health Policy Program working paper #27, January 22, 2012en_US
dc.identifier.urihttp://hdl.handle.net/10945/47750
dc.descriptionWorking paper series on health and demographic change in the Asia-Pacificen_US
dc.description.abstractEmerging infectious diseases (EIDs) pose international security threats because of their potential to inflict harm upon humans, crops, livestock, health infrastructure, and economies. The following questions stimulated the research described in this paper: What infrastructure is necessary to enable EID surveillance in developing countries? What cultural, political, and economic challenges stand in the way of setting up such infrastructure? And are there general principles that might guide engagement with developing countries and support EID surveillance infrastructure? Using the U.S. Naval Area Medical Research Unit No. 2 as common denominator, this paper compares barriers to EID surveillance in Cambodia and Indonesia and presents key factors—uncovered through extensive interviews—that constrain disease surveillance systems. In Cambodia, the key factors that emerged were low salaries, poor staff and human resources management, the effect of patronage networks, a culture of donor dependence, contrasting priorities between the government and international donors, and a lack of compensation for animal culling. The Cambodian military has also played a part. The government ceased a merit-based salary supplement scheme for civil servants after the military is alleged to have demanded similar pay incentives that donors had no interest in funding. In Indonesia the key issues emerging as barriers to effective surveillance include poor host-donor relationships, including differing host-donor priorities and a misunderstanding of NAMRU-2 by Indonesian authorities; low salaries; a decline in the qualifications of personnel in the Ministry of Health; poor compensation for animal culling; and difficulties incentivizing local-level reporting in an era of decentralization. As the interviews with in-country practitioners revealed, low levels of development in general are the main impediments to building EID surveillance infrastructure and are perhaps beyond the scope of health and scientific agencies at this point. Nevertheless, promoting greater understanding of these issues is a critical first step in mitigating negative outcomes.en_US
dc.format.extent33 p.en_US
dc.publisherStanford University, Walter H. Shorenstein Asia-Pacific Research Center, Asia Health Policy Programen_US
dc.rightsThis publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.en_US
dc.titleEmerging infectious disease surveillance in Southeast Asia: Cambodia, Indonesia, and the Naval Area Medical Research Unit 2en_US
dc.typeArticleen_US
dc.contributor.corporateNaval Postgraduate School (U.S.)en_US
dc.contributor.departmentNational Security Affairsen_US


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