The United States Department of Defense and the International Health Regulations (2005): perceptions, pitfalls and progress towards implementation.

The Department of Defense ofthe United States of America (USA) has been conducting respiratory disease surveillance among United States military personnel around the world since the mid-1970s.' The Department's Global Emerging Infections System began in 1997^ and currently includes nearly 500 sites with partners in 75 countries. The primary focus of the network is the early detection and rapid response to emerging or newly identified viruses of public health concern.' The World Health Organization's ( W H O ' S ) International Health Regulations (IHR) (2005) form the central guiding framework for both reporting of public health threats and potential public health emergencies of international concern. In recent years, the Department of Defense network has established disease surveillance in collaboration with host countries and has built a core capacity within each host country for sustained monitoring of respiratory disease activity within their borders. This network has demonstrated the ability to identify and respond quickly to public health emergencies of international concern, as illustrated in the influenza pandemic of 2009-10, and has also provided multiple viral-strain contributions to influenza vaccines over the past decade.'