“Today, the Middle East is threatened with a new plague, one eponymously if not ominously named the Middle East respiratory syndrome (MERS-CoV, or MERS for short),” Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations (CFR), and Maxine Builder, a research associate at CFR, write in a Foreign Policy opinion piece. “Although the numbers — so far — are small, the disease is raising anxiety throughout the region,” they note, adding, “But officials in Saudi Arabia are particularly concerned” as “[t]his fall, millions of devout Muslims will descend upon Mecca, Medina, and Saudi Arabia’s holy sites in one of the largest annual migrations in human history.” They note, “Traditionally, the onus to protect the pilgrimage and prevent disease rests on the shoulders of the Saudi royal family,” but “[t]oday, that responsibility lies with the kingdom’s Ministry of Health, which has deployed all its disease-fighting resources to tracking down MERS.”

“The ministry also must deal with the distinct possibility that pilgrims from abroad could bring other diseases to the kingdom, especially polio,” Garrett and Builder continue, noting, “It has been eliminated in Saudi Arabia, but pilgrims from outside could carry the disease back into the region.” “Despite these risks of disease transmission, neither the [WHO] nor the Saudi government has placed explicit travel guidelines in advance of this influx,” although “Saudi authorities are urging pilgrims to postpone their hajj plans due” to construction work at the Grand Mosque, they state. However, “even if pilgrims postpone their plans for pilgrimage, they are not the only mobile population in the region who could serve as global vectors,” they write, highlighting migrant workers and Syrian refugees. Garrett and Builder highlight issues surrounding the spread of the disease in hospitals, controversy over research patents, and WHO funding for emergencies. They say identifying the virus’s origin, halting human-to-human transmission, quickly identifying new patients, and breaking down “barriers to a transparent international research and information-sharing system” are important challenges to preventing the continued spread of MERS (6/28).