Abstract Slow outbreak reporting by states is a key challenge to effectively responding to global health emergencies like Zika, Ebola, and H1N1. Current policy focuses on improving domestic outbreak surveillance capacity globally in order to reduce reporting lags. However, governments also face economic and political incentives to conceal outbreaks, and these incentives largely are ignored in policy discussions. In spite of the policy implications for outbreak response, the “capacity” and “will” explanations have not been systematically examined. Analysis of a dataset coding the timeliness of outbreak reporting from 1996–2014 finds evidence that states’ unwillingness to report—rather than just their inability—leads to delayed reporting. The findings suggest that though building surveillance capacity is critical, doing so may not be sufficient to reduce reporting lags. Policy aimed at encouraging rapid reporting must also mitigate the associated economic and political costs.

中文翻译：

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隐藏疾病：贸易和旅行障碍以及疫情报告的及时性


摘要 各国疫情报告速度缓慢是有效应对寨卡、埃博拉和 H1N1 等全球突发卫生事件的关键挑战。当前政策的重点是提高全球国内疫情监测能力，以减少报告滞后。然而，政府也面临着隐瞒疫情的经济和政治动机，而这些动机在政策讨论中很大程度上被忽视了。尽管对疫情应对有政策影响，但“能力”和“意愿”的解释尚未得到系统检验。对 1996 年至 2014 年疫情报告及时性的数据集进行分析发现，有证据表明，各州不愿意报告（而不仅仅是无能力）导致报告延迟。研究结果表明，尽管建立监测能力至关重要，但这样做可能不足以减少报告滞后。旨在鼓励快速报告的政策还必须减轻相关的经济和政治成本。