This article has been written by Ms. Aninditha Gandhe, a 2nd year student of Symbiosis Law School, Hyderabad.
Abstract
This legal research paper explores the critical intersections between health systems and global health security, emphasizing the imperative for a comprehensive and interconnected approach in light of the COVID-19 pandemic. The paper underscores the universal concern for optimal health and well-being, recognizing the intrinsic value of good health beyond individual benefits to encompass broader social and economic advantages. The pandemic has exposed health, social, economic, and political vulnerabilities, necessitating a One Health approach and concerted global efforts.
Global health security is a multifaceted framework encompassing proactive and reactive measures against public health threats, acknowledging the interdependence of health, economic stability, and national security. The research outlines key pillars such as Prevention and Detection, Health Emergency Preparedness, Outbreak Response and Coordination, and Global Health Partnerships as essential components of global health security.
The paper delves into specific priorities within global health security, including pandemic preparedness, infectious disease response, antimicrobial resistance, sustainable financing, legal preparedness, and biosafety initiatives. It highlights the significance of multilateral partnerships such as the International Health Regulations (IHR), the Global Health Security Agenda (GHSA), and the Global Health Security Initiative (GHSI) in addressing global health challenges through collaborative efforts.
Examining the intricate connections between health systems and health security reveals the heightened importance of robust and resilient public health systems. The research emphasizes the need for a Health System Strengthening (HSS) approach, integrating routine service delivery, epidemic response, and emergency preparedness to achieve Universal Health Coverage (UHC) and global health security objectives.
The active role of the Bureau of Global Health Security and Diplomacy (GHSD) and USAID in international collaborations underscores a commitment to mitigating infectious disease threats. The paper concludes by stressing the necessity for sustained efforts in preventing, detecting, and responding to health crises, contributing to a resilient global health landscape.
Introduction
Promoting optimal health and well-being is a universal concern, as individuals aspire to lead lives marked by physical and mental strength. Attaining this objective necessitates access to first-rate healthcare services whenever required, with a paramount emphasis on feeling assured, secure, and respected during their utilization. The intrinsic value of good health extends beyond individual well-being, encompassing broader social and economic advantages.
The COVID-19 pandemic has unequivocally underscored the imperative of investing in global health, as it has ramifications that extend beyond public health concerns and significantly impact the global economy. The world found itself ill-equipped to handle the pandemic, and its reverberations have exacted a profound toll on the progress achieved in various realms of economic, human, and social development. Crucial indicators in these domains have not only stagnated but are regrettably reversing due to the strains placed on existing systems.
This crisis has laid bare the vulnerability of health, social, economic, and political systems, demonstrating their susceptibility to disruption. Furthermore, it has brought to light the intricate interconnectedness of people, animals, and the planet, underscoring the necessity for adopting One Health approaches. Even before the pandemic, progress toward the Sustainable Development Goals (SDGs) was already faltering. Attaining these goals now poses an even more formidable challenge, amplifying the urgency for concerted global efforts to address the multifaceted implications of the pandemic and fortify our collective resilience against future crises.
Global Health Security
Global health security encompasses proactive and reactive measures to mitigate the risks and consequences of acute public health events that threaten individuals’ well-being across geographical regions and international borders. Global health security encompasses a complex framework beyond conventional disease control endeavours. It acknowledges the interdependence of health, economic stability, and national security. In the contemporary globalized landscape, a health emergency originating in one geographic region can swiftly disseminate, yielding extensive repercussions. Consequently, the scope of global health security encompasses addressing diverse threats, including infectious diseases, pandemics, antimicrobial resistance, and the health implications of climate change.
- Global Health Security at glance
In pursuing global health security, the focus spans key pillars to fortify the world against potential health threats. These pillars encompass Prevention and Detection, Health Emergency Preparedness, Outbreak Response and Coordination, and Global Health Partnerships.
- Prevention and Detection:
It advocates for enhancing robust health systems capable of foreseeing and averting potential outbreaks. This is achieved through synchronized and collaborative surveillance efforts, bolstering diagnostic capabilities on a global scale, and reinforcing worldwide biological security and biosafety measures.
- Health Emergency Preparedness:
Their commitment extends to driving policies and strategies that fortify preparedness for effective responses to potential health emergencies. This involves advocating for sustainable financing mechanisms to ensure preparedness remains a cornerstone of global health security.
- Outbreak Response and Coordination:
It collaborates with domestic and international partners in the face of emerging health threats. This includes governments, academia, and various global health organizations.
- Global Health Partnerships:
Acknowledging that achieving global health security is a collective endeavour, it actively collaborates with various domestic and global stakeholders. This collaborative approach is integral to our mission of strengthening global health security through joint efforts and shared responsibilities.
- Global Health Security Priorities
- Pandemic Preparedness for Influenza and Emerging Pathogens
Ensuring global health security necessitates the establishment of comprehensive pandemic preparedness plans and systems. Its focus is developing and supporting policies and initiatives to combat seasonal and pandemic influenza, respiratory diseases, and emerging zoonotic diseases such as viral hemorrhagic fevers and vector-borne infectious diseases.
- Effective Response to Infectious Disease Outbreaks
Collaboration with national and international partners is paramount at the intersection of domestic and international realms.
- Addressing Antimicrobial Resistance (AMR)
To counter the escalating threat of AMR, it focuses on promoting the responsible use of antibiotics, fostering the development of new antimicrobial products, and advocating for global action to mitigate the emergence and impact of drug-resistant pathogens.
- Sustainable Financing for Preparedness
The achievement of global health security hinges on robust and sustained financing. Its collaborative initiatives aim to enhance the resilience of health systems and effectively prevent, detect, and respond to health threats.
- Legal Preparedness for Rapid Response
Legal preparedness is critical to global health security to enable rapid and effective action when responding to health crises.
- Strengthening Global Biological Security & Biosafety
Their commitment extends to supporting policies and initiatives and engaging with international partners to safeguard against accidental release, theft, or illicit use of dangerous pathogens.
- Multidisciplinary and Multisectoral Approach to Enhancing Global Health Security
- International Health Regulations (IHR): A Framework for Global Health Security
The International Health Regulations (IHR) are a paramount international legal framework for averting international health emergencies. This framework strengthens global health security by establishing a worldwide surveillance system that facilitates rapid information exchange among nations.
- Global Health Security Agenda (GHSA): Driving Multisectoral Action
The Global Health Security Agenda (GHSA) is a pivotal partnership comprising over 70 countries, international organizations, non-governmental entities, and private sector collaborators. This coalition operates at both technical and political levels, aiming to achieve global health security and fortify the implementation of the IHR.
- Global Health Security Initiative (GHSI): Strengthening Global Preparedness
The Global Health Security Initiative (GHSI) is an informal international partnership dedicated to enhancing global public health preparedness and response to threats such as chemical, biological, radiological, and nuclear terrorism (CBRN) and pandemic influenza.
- North American Plan for Animal and Human Influenza (NAPAPI): Trilateral Preparedness Framework
The North American Plan for Animal and Human Influenza (NAPAPI) represents a cross-sectoral trilateral framework involving Canada, Mexico, and the United States. This collaborative initiative is geared towards preparing for and responding to animal and human influenza pandemic outbreaks.
- Partnership for Influenza Vaccine Introduction (PIVI): Strengthening Vaccine Delivery
The Partnership for Influenza Vaccine Introduction (PIVI) is a public-private program that collaborates with countries to enhance their capacity to deliver vaccines reliably and expeditiously, ultimately saving lives.
- Biological Weapons Convention (BWC): Multilateral Treaty for Prevention
The Biological Weapons Convention (BWC) is a multilateral treaty facilitated by the United Nations. It prohibits the development, stockpiling, production, or transfer of biological agents and toxins for the countries that have signed the treaty. This legally binding agreement involves 184 state parties committed to its principles.
The delicate balance of the microbial world is being disturbed by factors such as population growth, rapid urbanization, environmental degradation, and the inappropriate use of antimicrobials. This disruption is giving rise to new diseases, like emergence of COVID-19, leading to significant disruptions in both health and socio-economic spheres. The extensive air travel undertaken by billions of passengers annually further amplifies the potential for the swift international dissemination of infectious agents and their vectors.
The World Health Organization (WHO) is pivotal in spearheading global public health initiatives, particularly in acute health-security events, even those involving the deliberate use of biological materials and chemicals for harmful purposes. WHO collaborates with various sectors, including partners in the security sector, as part of its overarching public health mission and mandate. This collaboration aims to diligently prepare for and effectively respond to global health security threats, irrespective of origin.
Strengthening Health Systems
There have historically been concrete connections between health systems and health security; however, there hasn’t been enough research done on the conceptual connections between these domains, especially when it comes to building health systems. In light of the COVID-19 pandemic, which highlighted the critical interdependency between strong health system capacity and an effective health security response, it is even more crucial to rectify this shortcoming. Global health security (GHS) entails robust and resilient public health systems capable of averting, identifying, and managing emerging infectious disease threats, regardless of their global location. Since the onset of the 21st century, the severity and frequency of infectious disease outbreaks and epidemics have escalated. Notably, 75% of these emerging infectious diseases stem from animals, a trend exacerbated by the escalating human-animal proximity driven by deforestation, land use alterations, and climate change.
This has profoundly impacted millions of lives and livelihoods worldwide, underscoring the urgent need for enhanced global capacity to prevent, detect, and respond to threats like COVID-19 and other emerging infectious diseases. Before the onset of the COVID-19 pandemic, a significant portion of the global population, estimated at around half, lacked access to essential health services. Additionally, approximately 100 million individuals were annually pushed into extreme poverty due to the financial burden of out-of-pocket spending on healthcare. The emergence of COVID-19 further exacerbated this predicament, as the demand for acute care surged among individuals facing financial constraints resulting from income loss and diminished health insurance coverage.
In response to the pandemic, countries grappled with balancing immediate COVID-19-related demands while sustaining ongoing strategic planning and coordinated efforts to uphold the delivery of essential health services. This delicate equilibrium aimed to prevent system collapse and fortify defences against future crises. Noteworthy weaknesses in health systems, including inadequate infrastructure and supplies (e.g., limited beds, ventilators, and testing equipment), along with severe staff shortages exacerbated by increased illnesses and deaths due to insufficient personal protective equipment and inadequate infection prevention control, further compromised the overall quality of healthcare. This situation forced healthcare professionals to decide who would receive care and who would not. The global insecurity stemming from these events emphasizes that effective responses and risk mitigation hinge on the strength of healthcare systems.
Global Health Security (GHS) plays a vital role in any healthcare framework and is intricately connected to the achievement of Universal Health Coverage (UHC) objectives. The primary objective of Universal Health Coverage (UHC) is to ensure that every individual and community has access to essential health, nutrition, and Water, Sanitation, and Hygiene (WaSH) services without facing financial burdens. UHC entails comprehensive and high-quality essential services, spanning health promotion, prevention, treatment, rehabilitation, and palliative care, encompassing end-of-life support. Effective subnational risk mitigation demands robust infrastructure and capabilities, including well-equipped health facilities and a skilled workforce. This ensures not only routine health service delivery for Universal Health Coverage (UHC) but also the capacity to combat epidemics, swiftly respond to outbreaks, and safeguard against public health emergencies. The significance of high-quality service statistics cannot be overstated, as they not only describe disease burden and epidemiology but are also crucial for distributing skilled human resources and funding. Achieving UHC and Global Health Security (GHS) objectives necessitates an integrated Health System Strengthening (HSS) approach, fostering sustained improvements in health system performance to deliver enduring results.
The Bureau of Global Health Security and Diplomacy (GHSD) endeavours to enhance global health security by urging foreign governments, the private sector, and civil society to undertake tangible measures to thwart the dissemination of infectious diseases and orchestrate effective responses to outbreaks. Our commitment to advancing these imperatives is manifested through active engagement in various multilateral organizations, notably the World Health Organization (WHO).
Conclusion
In conclusion, the COVID-19 pandemic highlights the need for a comprehensive, interconnected approach to bolster health systems and global health security. The interdependence of health, social, economic, and political systems emphasizes the urgency for collaborative efforts and a One Health approach. The pillars of global health security, including prevention, detection, preparedness, outbreak response, and partnerships, provide a robust framework for addressing diverse threats.
Key priorities such as pandemic preparedness, infectious disease response, antimicrobial resistance, sustainable financing, legal preparedness, and biosafety initiatives are crucial in fortifying global health security. Multilateral partnerships, like the International Health Regulations (IHR), Global Health Security Agenda (GHSA), and Global Health Security Initiative (GHSI), exemplify collective commitment to addressing global health challenges.
The COVID-19 crisis reveals global health system vulnerabilities, stressing the essential link between health system capacity and effective security responses. Achieving Universal Health Coverage (UHC) and global health security necessitates a holistic Health System Strengthening (HSS) approach, integrating routine service delivery, epidemic response, and emergency preparedness.
The active involvement of the Bureau of Global Health Security and Diplomacy (GHSD) and USAID in international collaborations reflects the commitment to mitigating infectious disease threats. Amid challenges posed by emerging infectious diseases, sustained efforts are imperative to prevent, detect, and respond to health crises, fostering a resilient global health landscape.
References
This was published on the WHO website. The link for the same is herein. https://www.who.int/activities/strengthening-the-global-health-security-interface
This was published on the WHO website. The link for the same is herein. https://www.who.int/health-topics/health-security#tab=tab_1
This article was originally written by Wendy Morton MP published on Foreign, Commonwealth and Development Office. The link for the same is herein. https://assets.publishing.service.gov.uk/media/61b093eae90e0704423dc07c/Health-Systems-Strengthening-Position-Paper.pdf
This article was originally written by Martin Alilio et al. published on PubMed Central. The link for the same is herein. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9053150/
This article was originally written by Antony J. Blinken et al. published on JAMA Network. The link for the same is herein. https://jamanetwork.com/journals/jama/fullarticle/2783866
This article was originally written by Garrett Wallace et al. published on PubMed Central. The link for the same is herein. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107590/
This article was originally published on CDC. The link for the same is herein. https://www.cdc.gov/globalhealth/healthprotection/ghs/about.html
This was originally published on US Department of State. The link for the same is herein. https://www.state.gov/strengthening-global-health-security/
This article was originally published on Gray Group International. The link for the same is herein. https://www.graygroupintl.com/blog/global-health-security
This article was originally written by Debbie Hillier published on Oxford Policy Management. The link for the same is herein. https://www.opml.co.uk/blog/how-global-health-systems-strengthened-respond-shocks-covid
This article was originally published on USAID. The link for the same is herein. https://www.usaid.gov/global-health/health-areas/global-health-security
This article was originally published on U.S. Department of Health and Human services. The link for the same is herein. https://www.hhs.gov/about/agencies/oga/global-health-security/index.html