This article has been written by Ms. Pooja Padmanabhan, a 3rd year student of VIT, University Chennai.
ABSTRACT
Global Health Emergency is a very crucial aspect that in its own way has a great impact in shaping international relations. International Law, also has contributed jurisprudence in regulating the functioning of countries at times of such pandemics. A health emergency or a bio-war, is not a new concern that the world is facing. However, the COVID-19 pandemic has exemplified the need to take a strategic response towards the same. Moreover, after encountering such a brutal health disaster, which locked down countries at a standstill position for months, any nation would choose to be prepared to tackle such scenarios for a future date. One of the major drawbacks of international law is that it is not binding on all the existent nations, but only to those which ratify on the same. With all this put together, the dynamics of the real world also contribute to the chaos of geopolitics. Thus this article titled, Strategies for Enhancing the Global Health Emergency: Preparedness and Response, analyses the way in which previous epidemics or pandemics have been tackled how WHO has provided a framework, and how the same shall continue for the time to come.
Keywords: health, nation-state, preparedness, public, nationalism, priority, international law, response, welfare
INTRODUCTION
Health emergency is indeed a major concern in this post-COVID world. Though the recent pandemic was not the first of its kind, still it has made countries and organizations alert enough to take the necessary precautions for the future. Moreover, such health crises emerge and re-emerge, and this impacts the world particularly, those living in fragile, conflict-affected, and vulnerable settings are at the highest risk. WHO’s HEPR or the Health Emergency Preparedness, prevention, response, and Resilience is a strategic framework that aids by guiding, informing, and resourcing collective efforts to strengthen the key interlinked national, regional, and global multisectoral capacities and capabilities that sit at the intersection of health security, primary health care, and health promotion.
NATIONALISM/GLOBAL WELFARE?
When reference is placed on preparedness, it refers to the preparedness of the countries the inter-governmental organizations, and other forms of organizations governing the world. Likewise, the response here refers to that of the nation-states. But even if such a strategy is implemented, one weak point regarding Public International Law is the lack of obligation on the part of member states to obey the governing body. Moreover, the enforceability of the same can be looked upon only to the boundaries of the member states, thus enhancing the freedom of action of the non-member states at the UN. It is always during a sort of emergency that the nations prefer to choose their self-interest as a priority when compared to the common interest of the world. The vaccine nationalism that the countries tried to practice during the COVID-19 pandemic, is an example of how nations may choose themselves over the greater good.
The dynamic nature of geopolitics also adds to this, thus making it difficult to ensure that the anticipated response of an instant nation and its actual response align. The essence of global health equity is the idea that something so precious as health might be viewed as a right. Thus, putting together, collaborative efforts from all the nations is indeed a cumbersome process.
HOW TO STRENGTHEN THE RESPONSE TO A HEALTH EMERGENCY?
International Health Regulations( hereinafter referred to as “IHR”) is a legal guideline that specifies the obligations of the countries in handling the public health occurrences and emergencies that cross the borders. This instrument of international law is binding on 196 countries which comprises 194 member states of the WHO. This in itself came through the response to one of the deadliest epidemics in Europe. The need to strengthen the response has arisen also because of the probing questions that IHR faced and the parallel programs launched by countries with very common aims.
One of the most important aspects of preparedness is the early detection of health threats, as this helps nations combat biodefense. However, the COVID-19 pandemic aids in reflecting on the consequences of failure in the preparedness strategies. Moreover, a standing committee on Health Emergency Preparedness and Response was established by the WHO in May 2022, to prepare and respond to health emergencies.
These strategies should aim at solving the larger problem and should give a long-term solution. Not all diseases have an end to themselves. Some recur, in a seasonal manner. Thus there is a necessity attached to conducting continuous research on the diseases and the pattern they adopt when the deflect is of utmost priority. Equitable access to combat the disease is the main way to put an end to the disease. This can be best understood through the polio incident. The year of 1988, polio was reported across the globe and many countries lacked access to the vaccine. With assistance from Rotary International and the Centers for Disease Control and Prevention, UNICEF, WHO, and a group of other international financial partners, equitable access to the polio vaccine especially for children across the world has been established.
So far, we have been analyzing strategies to combat the pandemic, mainly through the lens of the disease impacting the lives of citizens, but if the illness spreads amongst the health workers, the same can increase the intensity at which the outbreak spreads.
Though the efforts taken at an international level, comes across to be passive, the COVID-19 pandemic, is indeed a great example of the efforts and impulsive strategies adopted by all the nation-states and organizations that have indeed been revolutionizing the state of policy framework. The Pandemic Fund’s November 2022 launch is expected to be a game-changer in the endeavor to improve national HEPR capacities. The Fund has quickly assembled its Technical Advisory Panel and Governing Board, and it has already raised more than US$ 1.6 billion in donations to support HEPR in low- and middle-income nations.
One of the best ways to create new strategies is to analyze past responses and the associated counter-responses of the relevant stakeholders. The influenza pandemic of 2009–2010 tested the IHR. After consulting with Mexico and the United States, the WHO declared the first-ever PHEIC. When it became apparent that the virus was not highly pathogenic (despite still causing more than 200,000 deaths globally), the WHO was criticized for inciting public fear.22 The criticism, however, was mainly directed at the WHO’s definition of the pandemic influenza phases at the time, which was outside the IHR framework. The WHO’s temporary advice against trade and travel restrictions was also ignored by several state parties; some states outlawed the import of pork, while others imposed advisories and limits on travel.
A well-trained and equipped health workforce, comprising physicians, nurses, community health workers, lab technicians, infection control practitioners, and public health experts, is essential to an efficient response, as the Ebola outbreak revealed. The health system will be unable to contain outbreaks if there is a shortage of medical workers and their numbers are further reduced due to infection. One of the key components of global health security is the education, training, support, and protection of health professionals.
In a public health emergency, even well-trained personnel might not be able to handle things. In such instances, the WHO must make provision for a surge in human resources, such as through the Global Outbreak Alert and Response Network (GOARN). A Global Health Reserve Workforce was supported by the 2015 WHA, but funding was not ensured.
When a population’s needs for physical and human resources change significantly and there are significant human costs associated with not meeting those needs, a situation is declared an “emergency.” Redistributing, creating, and mobilizing resources in accordance with the population’s evolving demands is necessary for emergency management. In India, the demand for several medications increased significantly during the second wave of COVID-19. In order to reallocate, develop, and mobilize resources, a public leader must accurately assess the changing demands of the populace and reorganize the current administrative procedures. To help them get ready for a spike in demand, the public leader must also consistently and clearly present the “state of demand and supply” to civil society, healthcare providers, and producers and distributors of medical supplies.
Every nation where SARS was being locally transmitted decided how to stop the disease’s spread. In order to identify clusters of SARS, every SARS patient in Hong Kong had their details, including name and contact information, entered into a police database that is often used to identify crime clusters. In order to stop those people from travelling overseas, immigration officials were also given access to the names that were placed into the database. In addition, Hong Kong mandated that each traveller provide a health statement and employed remote screening to identify fever in all passengers. Fever-stricken passengers were not allowed to travel domestically or abroad.
On May 2, the World Health Organisation declared that one Hong Kong apartment block had experienced environmental SARS transmission. (It was eventually discovered that a number of coincidental events led to this tragedy.) This discovery raised serious concerns that the virus was now making its way outside of constrained settings like hospitals and into the general public, especially in light of other SARS cases that could not be linked to contact with an infected individual. The World Health Organisation issued a warning to foreign visitors to areas where SARS infections are occurring, citing this risk. The places where the virus was found had to bear a significant financial burden as a result of these recommendations, which were shared on the Internet. Airlines virtually stopped operating to the impacted areas. The Asian Development Bank has estimated that losses in Asia have exceeded $30 billion.
Countries and other stakeholders in health emergencies need to make a strategic shift towards an ecosystem approach to health emergency prevention, preparedness, and response in order to effectively address the ever-growing scope of health emergencies, particularly in fragile, conflict-affected, and vulnerable settings. Five essential components of a health emergency should be strengthened by this change in emphasis:
- collaborative surveillance;
- community protection;
- safe and scalable care;
- access to countermeasures; and
- emergency coordination.
In order to maximize our combined strengths in health emergency planning, prevention, and response, WHO will keep establishing new channels of communication and coordination with partners. We will pay special emphasis to assisting fragile, conflict-affected, and vulnerable nations and situations. In order to avoid, prepare for, identify, and respond to health emergencies, more efficiently across governments and broader societal boundaries is required at the national level. This entails improving and streamlining systems for prevention, readiness, detection, and response at the regional and global levels. These systems must be based on mutual respect, accountability, and collaboration among governments and other global health stakeholders, such as UN agencies, regional public health institutes, and other foreign partner organizations.
CONCLUSION
Preparedness towards health emergencies never ends until the globe faces it. Collaboration of resources can go a long way for countries to pool research on demographics and other aspects. It is evident when thinking about pandemics that the specific forms and characteristics of the upcoming influenza pandemic will differ significantly from those of previous ones. However, this evolution throughout time has a benefit. To be more precise, this is practically the first pandemic in human history for which we will have had some kind of advance notice, allowing us to make preparations. In a similar vein, there is exciting hope that we may use advancements in virology, surveillance, fast communications, contemporary computing, and epidemic modelling to quickly mitigate, if not completely avoid, a pandemic.
REFERENCES
This article was originally published on the WHO website. The link for the same is herein. https://www.who.int/health-topics/international-health-regulations#tab=tab_1
This article was originally published on the WHO website. The link for the same is herein. https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_10-en.pdf
This article was originally written by MG Dente and others, and published on the National Centre for Biotechnology Information website. The link for the same is herein. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171516/#bb0190
This article was originally published on the National Centre for Biotechnology Information website. The link for the same is herein. https://www.ncbi.nlm.nih.gov/books/NBK54171/
This article was originally written by LAWRENCE O. GOSTIN and REBECCA KATZ and published on the JSTOR website. The link for the same is herein. https://www.jstor.org/stable/24869171
This article was originally written by Mohit Choube and published on the IQVIA website. The link for the same is herein. https://www.iqvia.com/locations/india/blogs/2021/12/strategic-leadership-for-public-health-emergencies
This article was originally written by Annelies Wilder-Smith and Sarah Osman and published on the National Centre for Biotechnology Information website. The link for the same is herein. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798963/