No Global Health Security without Global Health Solidarity

CRDF Global is proud to partner with Management Sciences for Health (MSH) for No More Epidemics, a global campaign calling on governments to close critical gaps in our defenses against infectious diseases by investing in health systems, especially in the low and middle income countries. As we prepare to support No More Epidemics in 2017, we, along with MSH, call on the G20 to do more to increase global health security. The following statement is published with permission from MSH. Read the original version, here.
The No More Epidemics campaign urges G20 leaders to do more to address global health security by supporting the poorest and most vulnerable countries and people to be better protected from infectious diseases outbreaks of epidemic potential. It requires a concerted collective effort to ensure the International Health Regulations are adhered to through a renewed approach to health as a human right and a shared global obligation to building universal health coverage (UHC) in low and middle-income countries.
As the world’s wealthiest and most populous nations, the G20 has a critical role to play in improving global health security. The G20 nations represent around 66 per cent of the world’s population, 86 per cent of the world economy and 78 per cent of global trade. The global interconnectedness of trade and travel increasingly means that an infectious health risk anywhere is a health threat everywhere. Once a pathogen enters the human population, people everywhere are at risk. When an outbreak occurs in a lower income country, weak health systems can become overwhelmed, as was seen in West Africa with Ebola. The global spread of diseases means outbreaks have the potential to impact people everywhere, as we saw with Ebola in Dallas, MERS in Seoul, Yellow Fever in Shanghai, and SARS in Toronto.
Recognizing this growing risk, governments around the world updated and recommitted to the International Health Regulations (IHR), in 2005 to ensure global health security. The regulations came into effect in 2007 and are legally binding. Unfortunately, compliance rates have been low despite various deadlines. In February 2014, the Global Health Security Agenda (GHSA) was launched to increase political support and accelerate compliance with the IHRs. The GHSA created a collaborative process among national and international experts to assess a country’s capacity for IHR compliance. This process was adopted by the WHO in 2015 and formalised as the Joint External Evaluation Tool (JEET). Since then, a growing number of countries have used this tool to identify national level gaps in their capacity to prevent, detect and respond to infectious disease threats. Countries then develop five year roadmaps that set out how gaps will be addressed to ensure IHR compliance.
What is often missing from the global health security debate is a focus on the capacity of the health systems to respond to the health needs of the population. Effective health systems are essential to prevent outbreaks, detect them early and respond effectively. If an outbreak does occur, health systems need to be able to respond with minimum disruption to other life-saving services. Surge capacity is therefore essential. People need to be able to rely on local primary care services and trust their ability to respond to their routine health needs. This will enable better early detection and build up the necessary relations of trust in health services to act in people’s best interests during an outbreak (which was not always the case in West Africa during the Ebola crisis).
There are great concerns that the sense of collective global responsibility for the right to health is breaking down. Aid is stagnating and donors continue to prefer to fund their own priority projects than to support comprehensive national health systems. Despite the rhetoric of the Sustainable Development Goals (SDGs) about leaving no one behind and a universal shared responsibility, the global solidarity that is required to prevent epidemics and achieve the SDGs often seems to be lacking. The No More Epidemics campaign believes that extending the right to health for all is necessary to achieve global health security. By investing in health systems and extending health coverage for all (UHC) as agreed in the Sustainable Development Goals, the G20 will ensure the poorest countries are able to comply with the IHR in a sustainable manner. The most effective way to ensure people anywhere in the world are safe from the threat of epidemics is to ensure that people everywhere in the world have adequate health coverage.