ABSTRACT
Healthcare system in Korea was found to be very vulnerable to public health emergency preparedness and response as demonstrated in the recent outbreak of Middle East Respiratory Syndrome Coronavirus. We need to redefine the function of and improve the capability of local district public hospital and local health center to cope with potential threats by newly emerging infectious disease in the nearer future. While central government may be responsible for early detection of newly emerging infectious disease transmitted from outside of the country, local government and its district-level public healthcare agencies need to primarily control over spread of the disease among the local residents. Governance setting for rapid response required in public health crisis situation appears to be possible based on strong local public health infrastructure for health promotion and disease prevention at si-gun-gu district level. Proper and sustainable investment is also needed for local public hospital with high standard facilities and skilled healthcare manpower since there seems little economic incentives to maintain such facilities in private hospitals. In conclusion, it would be urgent task to improve prevention activities for infectious disease of local health centers and clinical activities of local public hospital. Especially, role and competencies of public health physicians working at the public health center need to be specified as an essential component of public health infrastructure.