Implementation System of a Biosurveillance System in the Republic of Korea and Its Legal Ramifications

Kim, Amanda J.; Tak, Sangwoo

T he 2015 Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (ROK) was the second largest outbreak of its kind, with 186 confirmed cases and 38 deaths. 1 In addition, increasing international travel and infectious disease outbreaks in recent decades have prompted further calls to strengthen national surveillance systems. 2 During the MERS outbreak in 2015, national legislation pertaining to infectious diseases did not include guidelines on MERS. Because of the lack of guidelines and previous experience with MERS, the Korea Centers for Disease Control and Prevention (KCDC) failed to provide a timely response. 3 Given that outbreaks of disease occur beyond predictions and jurisdictional boundaries, the ROK government initiated intergovernmental programs. One such program is the big data-based Food Poisoning Prediction Model, developed in 2015. 4 The model was developed by several government departments to prevent and control outbreaks of foodborne illness. In 2019, the intergovernmental Joint Response to Antimicrobial-Resistant Bacteria project was initiated. This was based on the understanding that combating antimicrobial resistance requires an integrated approach focused on humans, animals, and the environment. 5 Despite these intergovernmental programs to strengthen surveillance systems, a framework to ensure sustained coordination among government departments has yet to be established. Coordination among departments for temporary programs often is not sustained over the long term. To facilitate rapid detection and response to public health threats, systematic coordination of departments is vital. The United States has led implementation of biosurveillance systems involving coordination among multiple agencies, and other countries are rapidly following suit. 6, 7 In the ROK, infectious disease surveillance is carried out by the KCDC under the Ministry of Health and Welfare. Infectious disease surveillance involves the continuous collection and analysis of data, mostly from reports of medical personnel. 8 Traditional infectious disease surveillance, including the existing system in the ROK, focuses on human diseases and does not incorporate the concept that disease outbreaks can be spread by nonhuman vectors. 9 To address these limitations of the current infectious disease surveillance system of the ROK, means of strengthening the current system should be explored in the context of biosurveillance. Unlike infectious disease surveillance, which tends to target only identified cases, biosurveillance requires the integration of dispersed data on human and animal health.