Prior to 2009, the Ministry of Health had no systematic notifiable disease surveillance system for infectious diseases. After 2009 Annual Health Conference, the Ministry of Health entrusted the Public Health Laboratory to institute notifiable disease surveillance system on priority diseases of national concern. In 2010, the Public Health Laboratory developed first edition of national notifiable disease surveillance guideline. However, due to changes in disease pattern and operational problem faced in implementing the previous surveillance guideline, the list of national notifiable disease surveillance guideline has been revised in 2014 to reinforce and strengthen the existing disease surveillance system. The revised guideline also included an event-based surveillance (EBS) to complement and supplement the indicator based notifiable diseases surveillance which is also one of the IHR requirements. Since various acute syndromes were incorporated in the revised list of notifiable diseases and also an even based surveillance, the name of the current revised guideline has been changed to “National Early Warning Alert and Response Surveillance (NEWARS)”.