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Global solidarity is required to establish an ethically preferable global pandemic response regime, whether by revising the IHR or creating a new treaty.
At this critical juncture in the evolution of global health governance, we believe that both the sense of preparedness prior to an outbreak and the sense of urgency when one occurs stem from the fact that we are and will continue to be in this together. These two senses are what we refer to as global solidarity for emerging disease outbreaks, and without them, institutional redesign may fail. The belief in global solidarity, shared by global citizens and the nation-states they form domestically, encompasses both self-interest and the global public good. The former stems from the expectation of the boomerang effect of sharing, whereas the latter derives primary and secondary benefits from sharing burden and effort (Lee & Yeh, 2022).
Solving these complex issues requires a focus on equity and solidarity. Expanding the definition of security to encompass multiple dimensions highlights the need for holistic and multidisciplinary solutions to enhance security, such as strengthening health systems, achieving universal health coverage, and eliminating poverty (2021).
Kindly share your views on the importance and need for Global Solidarity.
References:
- Lee, P. H., & Yeh, M. J. (2022). From security to solidarity: The normative foundation of a global pandemic treaty. Journal of global health, 12, 03025. //doi.org/10.7189/jogh.12.03025
- From security to Solidarity: (n.d.-a). //globalhealth.org/wp-content/uploads/2021/11/Security-to-Solidarity-Paper.pdf
Posted : March 25, 2024 5:03 pm
Global Solidarity for Health Security is a concept that emphasizes the importance of international cooperation and the collective well-being of all nations in the face of health crises. It moves beyond the traditional focus on national security and disease containment to prioritize the health of individuals and communities worldwide.
Equity and Inclusivity: Global Solidarity for Health Security advocates for equitable access to health resources and services across all countries, regardless of their economic status. It stresses the need for inclusive health policies that serve not just the wealthy nations but also the underprivileged and vulnerable populations.
Shared Knowledge and Resources: The approach calls for the voluntary pooling of knowledge, intellectual property, and data necessary for combating health emergencies like COVID-19. This collective sharing can accelerate the development of treatments and vaccines and ensure their fair distribution.
Sustainable Health Systems: Building resilient health systems that can withstand future health threats is a cornerstone of Global Solidarity. This involves investing in healthcare infrastructure, workforce, and research capabilities in all countries to create a robust global health network.
Human Rights and Values: Respect for human rights and values such as solidarity should underpin national and international health security agendas. This includes ensuring that responses to health emergencies do not infringe on individual freedoms and rights.
Policy Coordination and Cooperation: Effective global health security requires timely and transparent international policy coordination based on science and evidence. This coordination must align with universal human rights and aim to mitigate the socio-economic effects of public health threats.
References:
1. Global Health Security — Harvard University Press. (2021). Harvard University Press. //www.hup.harvard.edu/books/9780674976610
2. U.S. Government Global Health Security Strategy 2024. Available at: //www.whitehouse.gov/wp-content/uploads/2024/04/Global-Health
Security-Strategy-2024-1.pdf.
Posted : June 12, 2024 3:42 pm
The WHO defines global health security (GHS) as efforts to prevent, detect, and respond to international public health threats. The International Health Regulations (IHR), binding for 194 WHO member states and two additional countries, aim to coordinate responses to significant health threats without overly disrupting international travel or trade. The COVID-19 pandemic showed that greater adherence to the IHR correlated with lower disease incidence and mortality. However, the IHR and the GHS Index, which rank compliance, lack an explicit ethics framework for decision-making. While the IHR references ethical principles like respect for persons, dignity, and human rights, it does not provide detailed ethical guidance for public health emergencies. Existing ethical frameworks for public health, research, and healthcare delivery are not integrated within the IHR, assuming individual actors will manage their own ethical decisions. Each outbreak or pandemic requires specific ethical guidelines. Therefore, a comprehensive framework is needed to balance competing ethical considerations, along with an implementation guide and a mechanism for continuous review and revision.
During the 2014 Ebola outbreaks, the international community showed a limited capacity to prevent or mitigate the public health emergency, a problem only compounded by failures of transparency and community engagement. A similar pattern of failure was repeated during COVID-19, revealing divisions between national and regional resources as well as between communities and individuals that prevented proper protections and impeded access to needed healthcare interventions. Privileged persons and communities may resist even limited personal inconveniences to protect public health, and less privileged persons and groups may be put in life-threatening danger by measures to protect the preferences of larger or more affluent communities. Some public health measures, such as shelter-in-place orders, may excessively burden vulnerable persons while other protective measures, such as social distancing, may not be effectively implemented for certain groups (e.g., those living in detention centers, prisons, multigenerational housing, or refugee camps). As shown during COVID-19, a hasty response, however robust, once an emerging infectious agent is detected does not resolve underlying public health issues. Hasty responses may even exacerbate preexisting inequities in access to healthcare and likely will not overcome a lack of capacity for early public health surveillance. Any community lacking adequate investment in healthcare endangers GHS, reinforcing a moral argument against deprioritizing the protection and care of any region or group (Kebede et al., 2024).
References:
Kebede, S., DeTora, L. M., Perihan Elif Ekmekci, Wassie, T. A., Baer, C., Addiss, D., Crawley, F. P., & Bierer, B. E. (2024). Ethics and global health security. Elsevier EBooks, 19–36. //doi.org/10.1016/b978-0-323-90945-7.00018-x
To read more:
Posted : June 15, 2024 4:40 pm
The concept of global health security underpins the current framework for global preparedness and response to emerging infectious diseases. The Global Health Security Agenda--a collaboration between governments--was launched in 2014, aiming to make our interconnected world safe from infectious disease threats. The governments involved in the Global Health Security Agenda focus on strengthening their countries' capacities for detection, response and prevention. In the context of public health emergencies, the Agenda has received financial and political support from international organizations and almost 50 countries. However, there is tension between the aims of global health security and governments' mandate to ensure national security. The 1994 United Nations Development Programme's Human Development Report first introduced the concept of human security, referring to security of citizens as individuals rather than that of the states in which they live. We posit that the use of the term global health security can have a negative unintended effect on the ultimate goal of improving health for all. There are three reasons why this term potentially privileges the security of the state rather than the security of individuals. First, global health security, in its current use, is largely focused on protecting high-income countries against public health threats coming from low- and middle-income countries. Ebola virus, Marburg, Zika virus, dengue, chikungunya, Riff Valley and Lassa fevers, originated in low--and middle-income countries. If the Agenda is used to prioritize global health risk depending on the origin of infections, resource allocation may become even more skewed towards high-income settings. To ensure that a health security agenda is an integral part of national and foreign policy of each country, political attention and coordination between national ministries is needed as well as support from the national security budget. Second, global health security tends to emphasize disease containment to protect national security rather than the prevention of future local outbreaks. Disease containment is common practice in the control of emerging infectious diseases. A national security perspective often results in unilateral, neo-colonial and/or short-term solutions designed to protect national borders. For example, many countries and airline companies imposed travel restrictions during the 2013-2016 Ebola virus disease outbreak in western Africa, contrary to World Health Organization recommendations. Third, we argue that respect for human rights and values such as equity and solidarity should underlie each national security agenda. Such values are consistent with the motives of many people who provide health services in public health emergencies. Health security agendas should aim to build resilience to future outbreaks of infectious diseases, and require a long-term systems approach based on surveillance and national health system strengthening. Protecting the world from infectious disease threats requires that national governments share the responsibility of serving those most in need, wherever they live. We believe that the concept of global health security should be expanded to include solidarity and sustainability.
References:
Flahault, A., Wernli, D., Zylberman, P., & Tanner, M. (2016). From global health security to global health solidarity, security and sustainability. Bulletin of the World Health Organization, 94(12), 863. //doi.org/10.2471/blt.16.171488
Posted : June 17, 2024 10:33 pm
The Global Health Security Agenda -
Designed to help countries meet their commitments under the International Health regulations, the Global Health security Agenda(GHSA) is a worldwide effort to strengthen countries’ public health capacity to prevent, detect, and respond to infectious disease threats. Today, CDC is partnering with 31 countries around the world to reach the goals of the GHSA.
In a world where diseases can spread faster and more unpredictablythan ever before, GHSA sets out clear, attainable, and measurable targetsfor countries to improve their public health systems and better prepare against outbreaks.
To measure country's progress towards meeting GHSA goals, CDC and its partners developed the Joint External Evaluation(JEE). The JEE is a voluntary evaluation process that gives countries a starting point for improving their health security by identifying their strengths and pointing out the most urgent needs within their health systems. This transparent, external evaluation process encourages countries to share vital information with each other and work together towards a safer, healthier world.
The Joint External Evaluation (JEE) and National Action Plan for Health Security (NAPHS) processes are parts of a voluntary whole-of-government approach to identify gaps in health security across 19 technical areas and implement activities to address them.
References -
//www.cdc.gov/globalhealth/healthprotection/ghs/about.html
//www.cdc.gov/globalhealth/healthprotection/resources/fact-sheets/naphs.html?_cid=about-ghs
Posted : July 1, 2024 1:17 am
The aftermath of COVID-19 pandemic has revealed the inefficient healthcare systems and highlighted the flaws in the preparedness, thus emphasising upon the need to strengthen the healthcare ecosystem and health security in developing and underdeveloped countries. A research published in The Lancet also highlighted the importance of international co-operation to mitigate the impact of pandemic. The international health regulations framework serves as a foundation for global collaboration.
A review highlighted the initiatives like COVAX which united the global efforts to address challenges of low and middle income countries. The importance of global solidarity aids in enhancing resilience in health systems by sharing data, and innovative approaches and building robust healthcare systems. Literature reveals the pandemic treaty negotiations aims to improve the systems and prepare the countries for future pandemics with setting equity metrics and by holding countries accountable resulting in alignment of global health security.
Henceforth, highlighting the significance of achieving health equity, protecting health security so that the countries are capable and prepared to manage health crises.
Ref:
- The Lancet COVID-19 Commission. (2020). Lancet COVID-19 Commission statement on the occasion of the 75th session of the UN General Assembly. The Lancet
- Global Health Governance Journal. (2021). Equity in global health security: A call for greater solidarity and commitment. Global Health Governance. Retrieved from Global Health Governance Journal
- World Health Organization, GAVI, CEPI. (2021). COVAX: Ensuring global equitable access to COVID-19 vaccines. World Health Organization. Retrieved from WHO COVAX
- Binagwaho, A., Mathewos, K., Davis, S., & Bermejo, R. (2023). Building resilience in the pandemic treaty: A global health equity framework to ensure equity and accountability. Health Promotion Perspectives, 14(9), 1-9. //www.ncbi.nlm.nih.gov/pmc/articles/PMC11016140/pdf/hpp-14-9.pdf
Posted : July 12, 2024 9:38 pm