The strengthening of Argentina’s Epidemic Surveillance System has been a government priority for the last fifteen years and, although the public health in the country at large has improved, many more resources need to be devoted to reach a higher level of health, especially regarding epidemic prevention and control. In 2002 the declaration of a health emergency required the adoption of urgent measures to ensure the supply of medicines to the population. Following the outbreak of swine flu in Mexico in April 2009, the government declared a health emergency, taking immediate action to ensure the supply of medicines to the population. The current alert on the Ebola virus outbreak is under strict surveillance by health authorities in the country, who are following the World Health Organization’s international epidemiology protocols.
I. Government Structure
Argentina’s political organization was established by the National Constitution as a Federal Republic consisting of twenty-three provinces and the autonomous city of Buenos Aires. The federal state is headed by a President, who appoints a cabinet and holds the country’s executive power. The legislative power is exercised by a bicameral Congress with a Lower Chamber (Cámara de Diputados) and an Upper Chamber (Cámara de Senadores).
Under the National Constitution, each province has its own provincial constitution, legislation, and resolutions. However, provincial legislation may not violate any of the individual rights protected under the National Constitution. The provinces have delegated to the federal legislature the power to enact laws of national scope governing civil, commercial, and other matters.
Although not stated explicitly, the National Constitution guarantees the right to health as a derivative of the right to life. Several provisions also guarantee the right to health, including the right to a healthy environment, the right of consumers to the protection of their health, and in a broader sense, the right to protect collective rights. The constitutional guarantee of health protection may be defined as the right of all individuals to be protected by the state with regard to the prevention and treatment of diseases and the maintenance of health.
II. Structure of Public Health Crisis Management System
The health system has a decentralized structure where many responsibilities have been transferred to the provinces. The Law on Ministries of 1999, as amended by Decree 355/2002, restructured the Ministry of Health (MH), creating two new subdivisions: the Secretariat for Health and Care and the Secretariat for Health Policy and Regulation. The Secretariat for Health and Care has an office of the Undersecretary of Prevention and Promotion Programs, which comprises the National Directorate of Health Programs and the Directorate of Epidemiology (DE).
Under the Law on Ministries, the MH is assigned the responsibility of assisting the President in all health matters, including
- executing plans, programs, and projects related to health;
- medical aspects of immigration and the defense of borders, ports, airports, and international means of transportation;
- coordinating national, provincial, and municipal health services;
- participating in the control of food safety in coordination with the Ministry of Production;
- intervening in the assignment and control of subsidies to solve health emergencies, either unforeseen or not covered by the system in place;
- preparing health statistics and ensuring access to health information for the population;
- developing epidemiology research studies to improve the efficiency and quality of health services;
- managing international health relations, not only with other countries, but also with international health organizations;
- planning health campaigns to eradicate endemic diseases, rehabilitate the ill, and detect and prevent nontransmissible diseases;
- epidemic control and surveillance, including the management of the disease notification system;
- planning national vaccination and immunization programs; and
- establishing integrated programs to cover specific pathologies affecting groups determined to be at risk because of their geographic location.
In the provinces, health services are provided by a network of provincial primary and secondary care services and by the private sector. The MH establishes basic regulations for the delivery of health services and the operation of health facilities, but most provinces also have an extensive set of regulations. The MH is represented in each province through a Federal Health Council, which constitutes the link between the national MH and the provinces in all health-related matters.
The Federal Health Plan 2010–2016, released by the MH, provides for general guidelines on public health in the country. However, the guidelines are only indicators, since provinces have autonomy in setting their own health policies for the protection of their population. The Federal Health Council, which is made up of the ministers of health of all the provinces and municipalities in the country, facilitates the coordination of health policies and services between the National Health Authority and the provinces. 
In 2011, the MH and the Ministry of Planning signed an agreement to integrate hospitals, primary health care centers, integrated community centers, and other health care centers throughout the country into the National Fiber Optics Network, which became operative in August 2014.
III. Powers of Public Health Authorities
The DE and its National Epidemiological Surveillance System are responsible for the registration of diseases subject to obligatory reporting, as established by Law 15465. The Law includes a list of diseases that is updated periodically as needed. The reporting is required not only in confirmed cases but also in suspected cases. Physicians and veterinarians and, when applicable, laboratory technicians and pathologists, dentists, OB/GYNs, and kinesiologists, are all under obligation to report the listed diseases. Noncompliance with this obligation is punishable by a fine and temporary suspension of the professional license to practice for one to three months. The sanctions are determined by the MH or its provincial counterparts when the offense falls under their jurisdiction.
The Advisory Commission on Epidemic Surveillance was also created within the jurisdiction of the DE to provide guidance on procedural and operational aspects of epidemic surveillance actions. The Advisory Commission on Epidemic Surveillance provides technical advice to the provinces contributing to the organization and development of the National Epidemiological Surveillance System, of which it is a part.
The DE also promotes the control of transmissible and nontransmissible diseases and health risks and regulates all activities related to environmental health, including training, research, and control in situ upon request of the different jurisdictions. This system is organized by levels and is comprised of the DE at the national level and epidemiology directorates, departments, and units within ministries of health at the provincial level. The system compiles information on reportable diseases and laboratory data weekly.
The provincial Federal Health Department is in charge of controlling epidemic diseases; this includes diseases subject to quarantine and those that, by their character, danger, or scope, may become a national threat. To this end, the Federal Health Department reports the presence of any such diseases by means of a uniform national procedure and, together with the provincial authorities, carries out epidemic research related to these diseases. Such reporting and communication are confidential. The manner in which the information is reported allows the Federal Health Department to identify and locate the individuals affected and the source of infection. However, the National Health Authority is the only government body with the power to report on this subject abroad.
Once the National Health Authority receives the required information or report, it provides all the means necessary to perform clinical and laboratory tests, provide assistance to the sick, and protect public health, including ordering quarantines and other preventive measures.
The Comisión Nacional de Actividades Espaciales (National Commission on Space Activities) concluded an agreement with France’s Nationale d’études Spatiales (National Space Studies Center) to develop a panoramic epidemiology system, which allows the prediction and early warning of diseases through the cross-referencing of a combination of satellite-gathered data on such things as vegetation, clouds, rain, rivers, and forests, with traditional data. 
Through the Directorate of Health Emergencies, the MH manages catastrophic and emergency situations and provides necessary medical supplies and health assistance throughout the country. The Directorate of Health Emergencies has a permanent communications unit on call for emergencies in coordination with the Federal Emergency System. However, it has been reported that the Federal Emergency System has not been efficiently used in spite of the considerable amount of funds assigned for its operational budget. Since its creation in 1972, the Directorate of Health Emergencies has assisted both in Argentina and abroad in a number of disasters and health emergencies, providing medicine, medical assistance, and transportation when the seriousness of the situation required treatment in a more sophisticated medical facility. The Directorate of Health Emergencies coordinates with theNational Directorate for Trauma, Emergencies, and Disasters within the jurisdiction of the Undersecretary of Prevention and Promotion Programs to implement assistance at the national, provincial, and municipal level in cases of emergencies or disasters requiring federal intervention. The National Directorate for Trauma, Emergencies, and Disasters is the authority in charge of the evacuation and reception of victims and the referral of patients, whether individually or in mass, in cases of natural, technological, or other disasters.
The Border Health Program is in charge of maintaining health and epidemic control at the borders and in the international transportation terminals, according to international standards and in compliance with the International Health Regulation.
As a result of the 2003 worldwide SARS alert, the MH took a number of measures to prevent and eventually control the disease. The Secretariat for Health Policy and Regulation of the MH ordered the strict control over any vessel and its crew entering the country.
The Criminal Code sanctions with imprisonment of three to fifteen years anyone who knowingly propagates a dangerous and contagious illness to human beings. If the propagation is due to negligence or violation of the public authorities’ regulations or directives but does not result in the death or infection of someone else, a fine may be imposed. If the propagation does result in death or infection, the offender is subject to imprisonment for six months to five years. Anyone who violates the measures adopted by the designated authorities to prevent the introduction or containment of an epidemic is subject to imprisonment for six months to two years. This crime is punishable even when an epidemic does not occur. If the wrongdoer is a public officer or professional, the sanction will include a special disqualification from his/her post for a period double the length of the penalty.
IV. Transparency of Public Health Crisis Management System
The Statistics and Health Information Directorate is the agency in charge of the collection and analysis of health data on a permanent basis. Its objectives include the identification of health factors that allow the early detection of diseases to prevent their spread and alert the population.
The DE publishes an epidemiological bulletin entitled Boletín Epidemiológico Periódico, which is available on the MH webpage. This weekly report includes the latest news on health issues, the current situation on specific illnesses threatening the population, outbreaks of new diseases in the country and abroad, and the epidemic surveillance data provided by the provinces.
V. Management of Health Emergencies
In September 2002, the MH, together with its provincial counterparts, implemented a surveillance system called unidades centinela (health watch units) to closely monitor specific health threats like pneumonia. Since 2001, the National Health Statistics Program has been equipped with the proper hardware and software to make the health information collected accessible to all in a timely manner.
In March 2002, the President declared a National Health Emergency as part of an overall public, social, economic, financial, and monetary emergency declared by Law 25561. The social and economic situation in the country was so serious that the provision of medicine and other health and medical supplies, especially those imported, was undermined, causing a genuine crisis and collapse of the national health system. The critical situation of the health sector constituted an exceptional circumstance, rendering it impossible to provide health services according to regular procedures. Under the National Health Emergency, the MH was empowered to take all necessary measures to guarantee the provision of medicine to the population, and to establish the procedures and priorities for its distribution. The MH instituted exceptional procedures to acquire such medicine, authorized special funding for its acquisition, and imposed price controls to avoid excessive price increases. The MH also developed a system that prioritized medical attention during the emergency.
On April 29, 2009, as part of the measures taken by the Argentine government to control the swine flu outbreak that originated in Mexico, all flights incoming from Mexico were suspended until May 5, 2009. At the same time health control points were set up at all points of entry to the country, and sensors to detect fever among the travelers were set up in international airports. Flights from Mexico resumed on May 15, 2009, but measures to check the body temperature of arriving passengers at international airports remained in effect for some time.
VI. Current Crisis
On August 7, 2014, the MH issued an epidemiological warning (alerta epidemiológica) in the country because of the Ebola virus outbreak in Africa. The warning provides specific instructions and a health protocol to follow in suspicious and confirmed Ebola cases. It further provides information about symptoms to the population at large and specific information for travelers entering the country. On August 20, 2014, the MH published a comprehensive update on the evolution of the Ebola virus in the world, providing an update of the reinforcement prevention, notification and detection measures in compliance with WHO standards.
On September 10, 2014, Argentina announced that the Malbrán Institute of Health in Buenos Aires had developed a biological molecular method for detecting the Ebola virus in less than twenty-four hours.> The Minister of Health announced that Argentina was the first country in Latin America that had a diagnosis method for Ebola that had been validated by the WHO. Health authorities have been working in training health staff, acquiring equipment for patients’ isolation, and developing and updating a protocol for handling Ebola cases. Currently there are three hospitals in the country already selected and ready to treat Ebola patients.
Prepared by Graciela Rodriguez-Ferrand
Senior Foreign Law Specialist
 Constitución de la Nación Argentina, Dec 15, 1994, http://infoleg.mecon. gov.ar/infolegInternet/anexos/0-4999/804/norma.htm.
 Id. arts. 121–129.
 Daniel Sabsay & Pablo Manili, Constitución de la Nación Argentina y Normas Complementaria, Análisis Doctrinal y Jurisprudencial 1234 (2009).
 Constitución de la Nación Argentina art. 41, para. 1.
 Id. art. 42, para. 1.
 Id. art. 43, para. 2.
 Sabsay and Manili, supra note 3, at 1235.
 Law 25233, Law of Ministries, Dec. 10, 1999, http://www.infoleg.gob.ar/infolegInternet/anexos/60000- 64999/61394/norma.htm (in Spanish).
 Decree 355/2002, amending Law 25,233, Law of Ministries, Feb. 21, 2002, http://www.infoleg.gob.ar/infoleg Internet/anexos/70000-74999/72483/texact.htm (in Spanish).
 Id. art. 23 ter.
 Pan American Health Organization [PAHO], Argentina, in II Salud en las Americas, 2007: Países 53, http://www.paho.org/hia/archivosvol2/paisesesp/Argentina%20Spanish.pdf.
 PAHO, Argentina, in Salud en las Americas, Edición de 2012, at 35–36, http://www.paho.org/saludenlas americas/index.php?option=com_docman&task=doc_view&gid=186&Itemid.
 Id. at 37.
 Manzur y DeVido Pusieron en Marcha la red federal de Infraestructura Cibersalud, Ministerio de Salud, Aug. 5, 2014, http://www.msal.gov.ar/prensa/index.php/noticias/noticias-de-la-semana/2150-manzur-y-de-vido-pusieron-en-marcha-la-red-federal-de-infraestructura-cibersalud.
 Law 15465, on Required Reporting of Diseases, Sept. 29, 1960, http://www.infoleg.gob.ar/infolegInternet/anexos/ 195000-199999/195093/norma.htm, regulated by Decree 3640/64, May 19, 1964,http://www.infoleg.gob.ar/ infolegInternet/anexos/195000-199999/195289/norma.htm (in Spanish).
 Decree 2771/79, Nov. 1, 1979, art. 2,available on the Legisalud website, at http://test.e-legis-ar.msal.gov.ar/ leisref/public/showAct.php?id=4140&word (in Spanish).
 Id.art. 3.
 Id. art. 5.
 Id. art. 4.
 Law 15465, art. 16.
 Id. art. 18.
 Ministry of Health, Manual de Normas y Procedimientos de Vigilancia y Control de Enfermedades de Notificación Obligatoria (rev. ed. 2007), http://www.snvs.msal.gov.ar/descargas/Manual%20de%20Normas %20y%20Procedimientos%202007.pdf.
 Dirección de Epidemiología: Acciones, Ministerio de Salud, http://www.msal.gov.ar/index.php/component/ content/article/43-funciones/28-funciones (last visited Oct. 23, 2014).
 Ministry of Health, supra note 22, at 6–8.
 Decree-Law 4143/58, Health Assistance, Apr. 2, 1958, arts. 2 & 7, Boletín Oficial, Apr. 16, 1958.
 Law 15465, on Required Reporting of Diseases, Sept. 29, 1960, arts. 7, 8.
 Id. art. 11.
 Id. art. 14.
 Nora Bär, La Argentina Desarrolla una Red de Vigilancia Epidemiológica Satelital, LaNación (July 14, 2003), http://www.lanacion.com.ar/nota.asp?nota_id=511256.
 Daniel Gallo, El Sistema Federal de Emergencias No se Utiliza, La Nación (Apr. 7, 2013), http://www.lanacion. com.ar/1570410-el-sistema-federal-de-emergencias-no-se-utiliza.
 For historical data on emergencies in Argentina and abroad covered by the Directorate of Health Emergencies, see Historia, DINESA (June 13, 2011), http://www.msal.gov.ar/dinesa/index.php/sobre-dinesa/historia.
 Servicios, DINESA (June 13, 2011), http://www.msal.gov.ar/dinesa/index.php/actividades/servicios.
 Decree 1106/2000 of the Ministry of Health, Nov. 27, 2000, Annex II, http://www.infoleg.gob.ar/infolegInternet/ anexos/65000-69999/65187/norma.htm; DP’12 – Documento Pais 2012: Riesgo de Desastres en la Argentina 183–84, http://www.msal.gov.ar/salud-y-desastres/images/stories/4-biblio-recursos/pdf/2014-04_documento-pais.pdf.
 Decree 1343/2007, Oct. 4, 2007, sched. annexed to art. 2, Secretaria de Politicas Regulaciónes e Institutos, Objetivos 6; Subsecretaria de Politicas, Regulación y Fiscalización, Objetivos 14; Dirección Nacional de Registro, Fiscalización y Sanidad de Fronteras, Acciones 5, 9, 11, http://www.infoleg.gob.ar/infolegInternet/anexos/130000-134999/133099/texact.htm.
 See Ministerio de Salud, Plan de Contingencia Nacional – Síndrome Respiratorio Agudo Grave (SRAG) (Apr. 2003), availableon the Federación Médica de la Provincia de Buenos Aires website, at http://www. femeba.org.ar/fundacion/quienessomos/Novedades/sragministerioabril.pdf.
 Id. annex D.1.A, at 21.
 Código Penal de la Nación Argentina, as amended (1984 revised text), art. 202, http://www.infoleg.gov.ar/ infolegInternet/anexos/15000-19999/16546/texact.htm#22.
 Id. art. 203.
 Id. arts. 205, 207.
 Dirección de Estadísticas e Información de Salud, Sistema de Información de Salud 9 (rev. ed. Sept. 2004), http://www.deis.gov.ar/publicaciones/Archivos/sis2005.pdf.
 Boletín Epidemiológico Periódico, http://www.msal.gov.ar/saladesituacion/epidemiologia_ boletines.php.
 Boletín del Programa Nacional de Estadísticas en Salud, http://www.deis.gov.ar/Publicaciones/ arbol_tematico.asp (last visited Oct. 29, 2014; click on “Boletín del Programa Nacional de Estadísticas en Salud” under “Búsqueda Avanzada”).
 Decree 486/02 on National Health Emergency of March 12, 2002, http://infoleg.mecon.gov.ar/infoleg Internet/anexos/70000-74999/72887/texact.htm (in Spanish).
 Law 25561 on National Emergency of Jan. 6, 2002, http://www.infoleg.gob.ar/infolegInternet/verNorma.do; jsessionid=A917C3C78C096E7D9B12CFD246CC3D4A?id=71477 (in Spanish).
 Id., intro.
 Id. arts. 2, 3.
 Id. art. 9.
 Id. art. 10.
 Id. arts. 18–20.
 Resolution 201/2009 of the Secretaría de Transporte, Apr. 29, 2009, http://www.infoleg.gov.ar/infolegInternet/ anexos/150000-154999/152904/norma.htm; Resolution 214/2009 of May 4, 2009, http://www.infoleg.gov.ar/ infolegInternet/anexos/150000-154999/152973/norma.htm.
 Por la Gripe Porcina, el Gobierno suspende los vuelos con México, Clarín.com (Apr. 28, 2009), http://www. clarin.com/diario/2009/04/28/um/m-01907438.htm.
 Mariano Obarrio, Se reanudan hoy los vuelos a México, LaNacion (May 15, 2009), http://www.lanacion.com. ar/nota.asp?nota_id=1128307.
 Dirección de Epidemiología, Ministerio de Salud de la Nación, Semana Epidemiológica 32 (Aug. 7, 2014), http://www.msal.gov.ar/images/stories/epidemiologia/inmunizaciones/11-08-2014-alerta-6-enfermedad-virus_ebola-.pdf.
 Id. at 2, 3.
 Información sobre la Enfermedad del Virus del ébola, Ministerio de Salud, http://www.msal.gov.ar/index. php/component/content/article/47-epidemiologia/448-informacion-sobre-ebola (last visited Nov. 14, 2014).
 Subsecretaría de Política, Regulación y Fiscalización, Ministerio de Salud de la Nación, Refuerzo de los Planes de Contingencia de Salud Pública ante el Riesgo de Ébola: Puntos de Entrada Argentinos (Aug. 20, 2014), http://www.msal.gov.ar/images/stories/epidemiologia/ebola/pdf/10-11-2014-plan-contingencia-puertos-entrada.pdf.
 Argentina Desarrolló un Método para Diagnosticar Casos de Ebola, Telam (Sept. 10, 2014), http://www.telam. com.ar/notas/201410/81135-argentina-metodo-diagnostico-ebola.html.
Last Updated: 06/09/2015