1. Case study: infectious disease Professor Anne Johnson FMedSci Head, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London

2. Background Globally: infections cause over a fifth of all deaths a million children die each year from diseases preventable through vaccination In the UK, infectious diseases account for: over 10% of deaths one in three GP consultations New infectious diseases: one per year

3. Public health measures relating to infectious disease 1)Prevention through vaccination 2)Surveillance 3)Control strategies

4. Prevention through vaccination Aims of vaccination: –to protect individuals –to protect vulnerable or at-risk individuals –to achieve ‘population immunity’ Concerns about safety of vaccines ‘Free riders’

5. Prevention through vaccination Three broad approaches to vaccination policy: –voluntary –incentivised –quasi-mandatory Conclusions: –No justification for moving beyond voluntary system in UK for childhood vaccination

6. Surveillance Population surveillance using anonymised data –Conclusion: acceptable for predicting trends Notifiable disease surveillance using identifying data –Conclusion: acceptable for avoiding harm to others if invasion of privacy is minimised

7. Surveillance Global surveillance of infectious diseases is vital Problems if countries do not have capacity or do not cooperate Conclusions: –UK should enhance surveillance capacities of developing countries –WHO should explore virus isolates as ‘public good’ –WHO should impress social responsibilities on pharmaceutical companies

8. Control Quarantine and isolation are at the top of the intervention ladder Conclusion: ethical justification involves weighing the harm principle with consent and avoiding intrusive interventions

9. Information and communication Effective communication is crucial Risks should not be downplayed or overstated Conclusions: –Government should ensure the timely provision of information about outbreaks –Those who report research have a duty to communicate findings in a responsible manner