As numbers of international large-scale events, such as music concerts, sports events, religious pilgrimage and state funerals increase in frequency and scale, they pose substantial risks to the general public.
The Lancet Infectious Diseases is launching a series of six papers on Mass Gatherings (MGs) health that address risks in terms of global health security, including the rapid spread of infectious diseases, and complex public health challenges, such as violence, stampedes or terrorist attacks, which require specialist expertise outside the borders of traditional medicine and event planning.
The first paper addresses the lessons learnt from decades of safety management and maintaining the wellbeing of millions of pilgrims at the annual Hajj to Mecca in Saudi Arabia. The knowledge obtained over the years could help in the prevention of global disease outbreaks and overcome other complex public health challenges at MGs. For instance, the Olympic Games and G20 summits.
Ziad Memish, from the Ministry of Health in Saudi Arabia and his team, have outlined the history and diversity of MGs and have illustrated the emergence of the new science-based discipline of MG health.
They point out that after decades of hosting the Hajj, the world's largest annual MG, which attracts over 2.5 million pilgrims from all around the world, Saudi Arabia is a leading expert in the management of MGs, and could assist other communities and countries to improve their preparations and better respond to such challenges.
"The public health implications of the Hajj are huge - nearly 200 000 pilgrims arrive from low-income countries, many will have had little, if any, pre-Hajj health care, added to which are the extremes of climate and crowding, rugged terrain, mingling of populations from around the world, and migration to the country of livestock, butchers, and abattoir workers," they explain.
Saudi Arabia has made considerable progress in response to these health hazards to ensure the wellbeing of pilgrims by taking various precautions that include improved disease surveillance, regulations about food and water security, regularly updated immunization recommendations, regulation of barbers as well as building a separate terminal at Jeddah's International Airport for pilgrims that contains various facilities, such as its own health-screening systems, medical clinics, customs, and immigration security.
The WHO and Saudi authorities implemented a successful improved screening and surveillance strategy in response to the 2003 SARS outbreak and the H1N1 influenza pandemic in 2009, through the issue of travel restrictions for visitors from SARS-affected countries, rapid testing and quarantine, which helped to prevent large outbreaks from arising at the Hajj.
Memish and his team declare:
"MGs pose complex challenges that require a broad expertise and Saudi Arabia has the experience and infrastructure to provide unique expertise with respect to MGs." The preparations for Barack Obama's Presidential Inauguration and crowd management for example were based on experiences from the Hajj.
Furthermore, they add that the Muslim world has become an important contributor to global health diplomacy by working in collaboration on this scale, saying: "Saudi Arabia's experience of Hajj medicine contains rapidly developing public health solutions to several global challenges. Multi-agency and multinational approaches to public health challenges are likely to become major factors in the specialty of global health diplomacy, engaging societies globally, and drawing the west a little closer to the east."
Written by Petra Rattue