The SARS story.(LETTERS TO THE EDITOR)(Letter to the editor)

Congratulations on a first-rate global governance issue (December 2007). In "Governing Global Health," David Bloom highlights the experience with severe acute respiratory syndrome (SARS) and reports how "concerted action ... quickly brought it under control," and "agencies put aside their competing interests and coordinated their efforts through the rapid establishment of global epidemiological, clinical, and laboratory networks." This is true, but it necessarily misses out on detail.

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There is a difference between establishing networks and having them actually work. While there was an early sharing of SARS experience and concerted action, only the laboratory network worked optimally, immediately sharing specimens and so discovering the cause of SARS and establishing essential tests. In the epidemiological and climate field, good networks were formed. But the World Health Organization's (WHO) global epidemiological data set was never adequately populated, and the clinical network found it hard to develop a consensus on treatment and could not agree on trials. It was the early sharing of experience by the affected centers under the WHO's leadership as to how the virus was spreading and what control methods worked that was most important--along with the happy coincidence that SARS was controllable by rigorously applying traditional public health and infection control ...