Implications of the International Health Regulations (2005) for communicable disease surveillance systems: Tunisia's experience.
BACKGROUND
In May 2005, the revised International Health Regulations, known as IHR (2005), were adopted in response to the evolving nature of communicable diseases (CD) and the rapid increase in global trade and travel. CD surveillance is an integral part of a country's core requirements under the regulations.


METHODS
The implications of these requirements were assessed as part of a review of the national CD surveillance system of Tunisia using a qualitative methodology of strengths, weaknesses, opportunities and threats (SWOT).


RESULTS
Tunisia is some way towards meeting the requirements of IHR (2005) while some specific areas that need to be addressed are highlighted for improvement: standardization of surveillance documents, strengthening the role of the laboratory in surveillance, increased human resources and training.


CONCLUSIONS
Tunisia's experience can offer some lessons to other countries in this process. While meeting the capacity obligations of IHR (2005) requires investment and commitment, this investment will enable countries to better protect themselves against public health emergencies arising within their borders and threatening from elsewhere in the world.
Lyons
S
S
European Programme for Intervention Epidemiology Training, Department of Epidemic and Pandemic Alert & Response, World Health Organization, 1211 Geneva 27, Switzerland. lyonssu@who.int
Zidouh
A
A
Ali Bejaoui
M
M
Ben Abdallah
M
M
Amine
S
S
Garbouj
M
M
Fitzner
J
J
D003140:Communicable Disease Control / Q000379:methods* / Q000592:standards*; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D011159:Population Surveillance / Q000379:methods*; D014416:Tunisia / Q000453:epidemiology