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[BANGKOK] The next global pandemic is likely to arise in South-East Asia where factors ranging from weak surveillance to the increasing proximity of humans and animals continue to make it vulnerable to emerging infectious diseases, according to experts.

The region's population has soared in the last decade and, together with an increase in livestock production, particularly poultry, has led to people living closer to each other and the animals they rear, said a team writing in The Lancet last week (25 January).

Meanwhile health systems are weak in many parts of the region and little attention has been paid to regional cooperation — even though diseases cross national boundaries, said the review, part of a series of six papers on health in South-East Asia.

The scientists called for research that "practically informs policy and practice", including the development of predictive surveillance. Nations should set their health priorities so that health systems can respond to surges in demand and be more equitable, effective and efficient, the scientists said.

South-East Asia has been the focus of research since 2003 because it is the region where both SARS and avian influenza (bird flu) emerged.

"It is anticipated by many experts that the region would be the hotspot of a new global pandemic," Richard Coker, lead author of the research and head of the communicable diseases policy research group at the London School of Hygiene and Tropical Medicine, United Kingdom, told SciDev.Net.

They concluded South-East Asia is undergoing rapid social, environmental, and demographic change — leading, among many other things, to the emergence of new ecological niches. These allow bugs to jump from animals to humans as their relationship changes.

Governance of infectious disease control is "challenging, with overlapping institutional roles and responsibilities. The region also is politically complex, with some intra-national and international tensions that have the potential to further hinder control."

Although there has been "substantial investment" in surveillance capacity in recent years, "it remains weak in many areas".

"There is a new term, 'one health', which attempts to argue that human and animal health systems are interlinked," said Coker. "We are dependent upon what has emerged in animals. And if we manage our livestock and interactions with animals well, that means we protect ourselves."

He added that research should inform how health systems should be configured to respond to the demands of new diseases and potential pandemics, including planning where resources should be best placed within a country or region, and determining the consequences of shortfalls of resources.

Link to full paper in The Lancet*

Link to series in The Lancet*

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