IF EVER THERE WAS an argument for international cooperation and collaboration, the rapidly moving epidemic of SARS -- severe acute respiratory syndrome -- is it. A hundred years ago this kind of disease might well have caused a local epidemic but nothing more. Thanks to modern ventilation systems, however, it has spread rapidly through buildings and hospitals, affecting more than 200 people in one Hong Kong apartment complex. Worse, thanks to airlines, the disease has spread around the world: More than 1,800 people have now contracted it, and more than 60 have died. Cases have been reported in a handful of Asian countries, Australia, Belgium, Canada and the United States. All the North American victims were people who had recently traveled from Asia or had been in contact with such travelers. SARS, in other words, is very much a disease linked to the technology of this particular historical moment.
The international response has been better than many expected, reflecting a number of positive changes within the World Health Organization over the past decade. In the past, the WHO was often accused of squandering its prestige on public relations projects and public health campaigns of questionable value, while its responses to other mystery illnesses, most notably the Ebola virus, were weak. In recent years, however, the organization rededicated itself to its original mission -- providing information about infectious diseases and putting together the international response -- and the results are visible. As the spread of SARS became known, the WHO swiftly issued an unprecedented worldwide travel warning and facilitated an unusual degree of international cooperation among the normally competitive laboratories studying the disease, as well as among teams of epidemiological investigators. Within the first week of cooperation, the labs had produced a preliminary diagnostic test. They now say they are close to identifying the virus. The true value of the WHO, in other words, lies in its unique ability to coordinate the work of others, and not, as some have thought in the past, in its carrying out original research. It is also worth noting that much of the organization's epidemic response system was built with the help of private donations and charities. The WHO now needs more support from its member countries to expand and develop its response capacity for the future. SARS, it seems, is a naturally occurring disease. The next epidemic may not be.
But the swift spread of SARS also carries a lesson about the importance of public health information disclosure. SARS first appeared in China, where authorities were, in the beginning, less than fully forthcoming. The Chinese and the WHO are negotiating over whether to allow an outside team to investigate the source of the disease in Guangdong province; the situation within the country remains murky. Julie Gerberding, director of the Centers for Disease Control and Prevention, has said that public health officials are "desperate to learn more about the scope and magnitude of the problem there." Once again, the closed nature of Chinese society is proving a problem, not just for the Chinese themselves but for the world. If greater political openness leads to greater openness about public health, that's one more reason for the United States to continue to advocate the former, as well as the latter, within the WHO and elsewhere.