In 2008, we reported on a survey of national public health institutes (NPHIs) – governmental focal points for science-based public health leadership, problem identification, and response.1, 2 We summarized information about the budgets, numbers of staff, and activities from members of the International Association of National Public Health Institutes (IANPHI), which had been chartered in 2006 to strengthen NPHIs and create linkages among them.1

By the end of 2008, 61 NPHIs were members of IANPHI, representing nearly one-third of the countries of the world. We conducted a survey in August 2008, similar to the one conducted in 2007.1 Although survey results are not directly comparable because of changes in IANPHI membership, the 2008 data indicate that NPHIs continue to have broad responsibilities for core functions of public health (see www.ianphi.org for survey results).

Public health faces two challenges that we believe may have significant impacts on the missions and structures of NPHIs. The first is the continued threat of infectious diseases pandemics, as illustrated by this year's outbreak of H1N1 influenza. The outbreak of severe acute respiratory syndrome in 2003 and threats of avian influenza resulted in consolidation of public health functions in NPHIs of many countries, such as in Canada. Continued infectious diseases threats may lead to additional restructuring to ensure close linkages among governmental components responsible for disease detection and response. The revised International Health Regulations framework continues to be an important driver for strengthening national public health capacity.2

The second major challenge is the growing need to respond to non-communicable conditions in developing countries. Chronic, non-communicable diseases, such as heart disease, stroke, type 2 diabetes, contribute to 60 per cent of deaths worldwide and are projected in the coming decades to rise particularly rapidly in developing countries.3

NPHIs in developing countries are more likely to focus on infectious diseases than non-communicable conditions. Among the IANPHI members from Africa who responded to the survey (the response rate from members in the Africa region was 67 per cent), all conduct infectious disease surveillance and only 50 per cent conduct non-communicable condition surveillance. While 83 per cent conduct epidemiologic investigations for infectious diseases, 67 per cent conduct investigations for non-communicable conditions. NPHIs conducting health promotion and prevention programs in the Africa region tend to focus on infectious diseases (67 per cent) rather than non-communicable conditions (33 per cent).

IANPHI will continue to encourage member NPHIs to become more comprehensive and to link with other agencies to ensure that their countries can mount robust efforts to protect and improve their publics’ health. IANPHI will also continue to work to expand its membership and foster communication among NPHIs. We believe that an integrated global network of strong and capable NPHIs will help the countries of the world to respond effectively to the public health challenges of today and tomorrow.