Avian and pandemic influenza: progress and problems with global health governance.

Globalization has intensified the health risks posed by pandemic influenza. Effective governance to prepare for, and respond to, a pandemic depends on four key functions: surveillance, protection, response, and communication. Although the global nature of the threat posed is recognized, efforts to strengthen cooperation have only made limited progress. Disease surveillance and communication have benefited from new technologies and harnessing the capacities of both state and non-state actors. The protection and response functions, however, remain focused on domestic populations and are characterized by uncoordinated and, at times, competitive strategies. Global governance of influenza requires strengthening in order to prevent actions that undermine the need to protect the health of all populations.