The work provided by the EMLab (a technical partner of the WHO Emerging and Dangerous Pathogens Laboratory) and the GOARN
was conducted in the context of the projects EVIDENT (Ebola virus disease: correlates of protection, determinants of outcome, and clinical management) and REACTION
GOARN was established in April 2000 as a mechanism for coordinating international responses to infectious disease outbreaks.
As a form of global network governance, GOARN is a relative success story.
The earliest cases of SARS were picked up in media reports in February 2003 by two GOARN partners, the Global Public Health Intelligence Network and the US Global Emerging Infections Surveillance and Response System, which then placed another GOARN partner, the WHO Global Influenza Surveillance Network, on alert.
This record of activity makes GOARN an attractive case for examining both the potential and the limits of global network governance.
The shaded areas in the figure point to the mechanisms and linkages that the GOARN case particularly illuminates.
This was Montgomery's first experience with GOARN
, so before she left the USA, she was apprehensive about working with a virus as contagious as Marburg.
It might, for example, tap into the information provided by GOARN
and act as a clearing house by assisting member states in identifying, from the wealth of information provided by GOARN
, suspicious outbreaks of disease.
One of the partners in GOARN is the WHO Global Influenza Surveillance Network, which was established in 1947 to guide the annual composition of vaccines and provide an early alert to variants that might signal the start of a pandemic of rapidly evolving influenza viruses.
Although information is incomplete, retrospective case identification by Chinese and GOARN epidemiologists since May 2003 suggests that two respiratory disease outbreaks occurred in Guangdong Province in late November 2002: influenza and what now appears to have been a first wave of SARS cases--an atypical pneumonia that was characterized by small, seemingly unrelated clusters of cases scattered over several municipalities in Guangdong, with low-level transmission to healthcare workers (6).
Concurrently, GOARN response teams in Vietnam and Hong Kong began collecting clinical and epidemiologic information about the patient and a growing number of others with similar symptoms.
In two resolutions, they called for increased national capacity development for surveillance and response and endorsed the ways in which GOARN obtained information about SARS and supported containment efforts (15,16).