Decades of negotiation to extend the GATT/WTO system to address subsidies have never produced the sort of uniform, scheduled rules that apply to tariffs or even services. Instead, WTO members have developed rules to demarcate permissible and impermissible subsidies. In this paper, I argue that the WTO approach is now hampered by shifts in the share of global trade away from geopolitically aligned, wealthy states and the growth of global supply chains. These pressures were magnified by the accession of China, with its centrality to global trade and recurrent geopolitical tensions with the United States. The challenges in facing cooperation over subsidies suggest limits to the ability for a ‘rules based’ approach to handle substantial changes in the global trading system.

Unlike for many other respiratory infections, the seasonality of pertussis is not well understood. While evidence of seasonal fluctuations in pertussis incidence has been noted in some countries, there have been conflicting findings including in the context of Australia. We investigated this issue by analysing the seasonality of pertussis notifications in Australia using monthly data from January 1991 to December 2016. Data were made available for all states and territories in Australia except for the Australian Capital Territory and were stratified into age groups. Using a time-series decomposition approach, we formulated a generalised additive model where seasonality is expressed using cosinor terms to estimate the amplitude and peak timing of pertussis notifications in Australia. We also compared these characteristics across different jurisdictions and age groups. We found evidence that pertussis notifications exhibit seasonality, with peaks observed during the spring and summer months (November–January) in Australia and across different states and territories. During peak months, notifications are expected to increase by about 15% compared with the yearly average. Peak notifications for children <5 years occurred 1–2 months later than the general population, which provides support to the theory that older household members remain an important source of pertussis infection for younger children. In addition, our results provide a more comprehensive spatial picture of seasonality in Australia, a feature lacking in previous studies. Finally, our findings suggest that seasonal forcing may be useful to consider in future population transmission models of pertussis.

This text presents the first systematic quantitative descriptive and explanatory account of World Trade Organization (WTO) member states’ compliance with their one-time and regular notification obligations. The system of around 170 notifications, through which states are obliged to provide to the WTO relevant information on their policies, constitutes a key mechanism of transparency in the global trade regime. Based on data for the one-time and regular obligations from the years 1995–2014, we seek to map and explain the variation in the degree to which states comply with these obligations. Descriptively, we identify enormous differences in the compliance values of states, ranging from compliance well above 80% to below 20%. To explain those differences, we test five theoretical explanations that concentrate on the trade policy preferences of states and on their institutional characteristics. The empirical findings support four of the tested explanations. In particular, they highlight the relevance of states’ administrative capacities and membership in international organizations (IOs). In addition, the empirical analysis shows that compliance levels are strongly positively connected with the economic size of the members.

Pertussis morbidity is highest in infants too young to be fully protected by routine vaccination schedules. Alternate vaccine strategies are required to maximise protection in this age-group. To understand baseline pertussis epidemiology prior to the introduction of the maternal pertussis vaccination program in 2014, we conducted a retrospective case series analyses of 53 901 notifications and temporal trends from 1997 to 2014. Notifications were highest in infants younger than 4 months of age and highest annual notification rates in infants younger than 1 month of age (308/100 000 per year). Amongst Aboriginal and Torres Strait Islander infants aged younger than 1 month, this rate was 576/100 000 per year. Notification rates were 40% higher amongst women 15–44 years, 62·4/100 000 population compared with men (44·5/100 000) and 90% higher in Aboriginal and Torres Strait Islander women of the same age (38·2/100 000) compared with men (19·7/100 000). Six infant deaths were identified, all younger than 2 months of age. Monitoring epidemiology in at-risk groups – infants too young to be vaccinated, women of childbearing age and Aboriginal and Torres Strait Islander peoples – following implementation of the maternal pertussis vaccination program will be important to assess its impact and safety.

Meningococcal disease is a rare, rapidly progressing condition which may be difficult to diagnose, disproportionally affects children, and has high morbidity and mortality. Accurate incidence estimates are needed to monitor the effectiveness of vaccination and treatment. We used linked notification, hospital, mortality and birth data for all children of an Australian state (2000–2007) to estimate the incidence of meningococcal disease. A total of 595 cases were notified, 684 cases had a hospital diagnosis, and 26 cases died from meningococcal disease. All deaths were notified, but only 68% (466/684) of hospitalized cases. Of non-notified hospitalized cases with more than one clinical admission, most (90%, 103/114) did not have meningococcal disease recorded as their final diagnosis, consistent with initial ‘false-positive’ hospital meningococcal disease diagnosis. After adjusting for false-positive rates in hospital data, capture–recapture estimation suggested that up to four cases of meningococcal disease may not have been captured in either notification or hospital records. The estimated incidence of meningococcal disease in NSW-born and -resident children aged 0–14 years was 5·1–5·4 cases/100 000 child-years at risk, comparable to international estimates using similar methods, but lower than estimates based on hospital data.

Although immediate notification of a case is crucial for epidemic control, clinicians may delay notification due to uncertainties in diagnosis, reflecting a trade-off between timeliness and the accuracy of surveillance. We assessed this trade-off for four epidemic-prone diseases that require immediate notification of suspected cases: shigellosis, typhoid fever, paratyphoid fever, and cholera in the Korean National Notifiable Disease Surveillance System data for 2001–2007. Timeliness was measured as the time to registration (TR), being the time interval from symptom onset to notification by the clinician to the local public health centre. We introduced a new index, ‘time-accuracy trade-off ratio’ to indicate time saved by clinical vs. laboratory-based notifications. Clinical notifications comprised 34·4% of total notifications, and these showed a shorter median TR than laboratory-based notifications (1–4 days). The trade-off ratio was greatest for shigellosis (3·3 days), and smallest for typhoid fever (0·6 days). A higher trade-off ratio provides stronger evidence for clinical notification without waiting for laboratory confirmation.

The aim of this study was to demonstrate the epidemiological use of multiple correspondence analysis (MCA), as applied to tuberculosis (TB) data from North East London. Data for TB notifications in North East London primary care trusts (PCTs) between the years 2002 and 2007 were used. TB notification data were entered for MCA allowing display of graphical data output (n=4947); MCA analyses were performed on the whole dataset, by PCT, and by year of notification. Graphical MCA output displayed variance of data categories; clustering of variable categories in MCA output signified association. Clustering patterns in MCA output demonstrated different associations by year of notification, within PCTs and between PCTs. MCA is a useful technique for displaying association of variable categories used in TB epidemiology. Results suggest that MCA could be a useful tool in informing commissioning of TB services.