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Fehross A, Pahlman K, Silva DS. Ethics and Health Security in the Australian COVID-19 Context: A Critical Interpretive Literature Review. JOURNAL OF BIOETHICAL INQUIRY 2024; 21:131-150. [PMID: 37938499 PMCID: PMC11052779 DOI: 10.1007/s11673-023-10255-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/03/2023] [Indexed: 11/09/2023]
Abstract
Background The concept of "health security" is often used to motivate public health responses, yet the ethical values that underpin this concept remain largely unexamined. The recent Australian responses to COVID-19 serve as an important case study by which we can analyse the pre-existing literature to see what ethical values shaped, and continue to shape, Australia's response. Methods We conducted a critical interpretive literature review of academic and grey literatures within key databases, resulting in 2,220 sources. After screening for duplicates and relevance, we analysed ninety-six sources. Results First, risk and uncertainty are a leading focus, with a heavy concentration on risks to life and health. Second, free movement, safety, and security were recurringly emphasized, albeit narrowly focused upon the safety of the population. Third, legitimacy was a recurring theme, and it is here that discussions of "health security" figured highly. Conclusion Discussions of harm from government and associated official bodies fail to adequately distinguish between various senses of harm. Moreover, while the literature often discusses the balancing of rights, the steps involved in the weighing of these rights is rarely adequately explained and defended. We suggest that decision-makers should endeavour to clearly identify and defend the values undergirding their decisions in the public sphere.
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Affiliation(s)
- Anson Fehross
- Sydney Health Ethics, University of Sydney, Edward Ford Building, A27 Fisher Rd, Sydney, NSW, 2006, Australia
| | - Kari Pahlman
- Sydney Health Ethics, University of Sydney, Edward Ford Building, A27 Fisher Rd, Sydney, NSW, 2006, Australia
| | - Diego S Silva
- Sydney Health Ethics, University of Sydney, Edward Ford Building, A27 Fisher Rd, Sydney, NSW, 2006, Australia.
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Zhu J, Wu Q, Zhang S, Song B, Wang W. Cracking the code of health security: unveiling the balanced indices through rank-ordered effect analysis. BMC Health Serv Res 2024; 24:27. [PMID: 38178218 PMCID: PMC10768473 DOI: 10.1186/s12913-023-10503-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Health security is a critical issue which involves multiple dimensions. It has received increasing attention in recent years, especially in China. In order to improve the national health level, China has made many efforts, such as the "Healthy China 2030" plan proposed several years ago. However, due to the complexity of its national conditions and the difficulty of index design, the results of these efforts are not significant. Therefore, it is necessary to construct a new measurement index system. METHODS Based on the questionnaire of "Health China 2030", we have collected a total of 3,000 participants from all 31 provinces, autonomous regions, and municipalities in China. We used statistical methods such as multiple correspondence analysis and rank-ordered effect analysis to process the data. The balance index is constructed by a series of actions such as weight division, order calculation and ranking. RESULTS Through multiple correspondence analysis, we can find that there was a close relation in the correspondence space between the satisfaction degrees 1, 2, and 3, while a far distance from satisfaction degrees 4 and 5. There were four positive and four negative indices separately based on the average expected level and four clusters after ordinal rank cluster analysis. Generally speaking, there are no prominent discrepancies across gender and residential areas. CONCLUSIONS We created and examined balanced indicators for health security in China based on the "Health China 2030" questionnaire. The findings of this study give insight into the overall situation of health security in China and indicate opportunities for improvement.
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Affiliation(s)
- Jianping Zhu
- School of Management, Xiamen University, Xiamen, China
- Data-Mining Research Center, Xiamen University, Xiamen, China
| | - Qi Wu
- School of Management, Xiamen University, Xiamen, China
- Data-Mining Research Center, Xiamen University, Xiamen, China
| | - Shiqi Zhang
- School of Management, Xiamen University, Xiamen, China
| | - Boliang Song
- School of Management, Xiamen University, Xiamen, China
| | - Weiwei Wang
- The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
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Almugti HS, Aldeghalbey AA, Swaif KA, Alrashdi HH, Mahdi EM, Alharbi MB, Alsaidi AS, Algathradi NY, Alanazi SM, Alsalameh NS, Kariri A, Alasmari EA, Alqarni KA, Asiri EJ, Alhasan JH. Saudi Health System and Health Security Structure: A Scope Review Study Addressing the National Need for Governing the Health Security. Cureus 2023; 15:e47376. [PMID: 38021861 PMCID: PMC10659570 DOI: 10.7759/cureus.47376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Health security has gained significant attention at the national and global levels, "security" is not a simple term; instead, it is "essentially contested" - that is, it induces debates about what it means and how to use it. This study aimed to define three terms frequently used in health security discussions. These terms are national health security, Global Health Security, and public health. The research method was a scoping review performed in three stages. The first stage was electronic searching based on selection criteria among multiple sources at various time points during the year 2023. These sources included online literature searches, websites of non-governmental organizations (NGOs), and other governmental health agencies. The second stage involved determining the relevance of the selected papers to the study's objectives; the selected papers had moderate to high relevance to the study's objectives. The third stage was to evaluate the methodological quality of a study; we selected peer-reviewed published papers and websites recognized as trustworthy sources of information. The search yielded 143 articles; five met the inclusion criteria and were subjected to the definition of health security. Despite proposed definitions, agreement has yet to be reached on the content and scope of health security. Another main finding is that health security requires more state and international collaboration efforts to reach Global Health Security. To the best of our knowledge, no known government body or organization is responsible for governing health security in Saudi Arabia. However, the current study presents a definition of health security and differentiates it from the public health approach, in addition to emphasizing the importance of governing the related health sectors within each country in order to improve health security and have a positive impact on overall Global Health Security.
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Affiliation(s)
- Hani S Almugti
- Primary Health Care, Ministry of National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdul-Aziz University for Health Sciences, Jeddah, SAU
| | | | - Khadijah A Swaif
- Prehospitalisation Department, Hospital Dhahran Eye Specialist Hospital, Dhahran, SAU
| | - Hind H Alrashdi
- Molecular Biology Department, Jeddah Regional Laboratory, Jeddah, SAU
| | | | | | - Abrar S Alsaidi
- Laboratory Medicine, Jeddah Regional Laboratory, Jeddah, SAU
| | | | - Salwa M Alanazi
- Family Medicine, Aldefea Primary Health Care Center, Al-Madinah al-Munawwarah, SAU
| | | | - Atyaf Kariri
- Medicine, College of Medicine, Jazan University, Jazan, SAU
| | - Enas A Alasmari
- Research and Studies Department, Directorate of Health Affairs, Jeddah, SAU
| | - Khalid A Alqarni
- Emergency Department, Thuryban General Hospital, Al Qunfudhah, SAU
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McCoy D, Roberts S, Daoudi S, Kennedy J. Global health security and the health-security nexus: principles, politics and praxis. BMJ Glob Health 2023; 8:e013067. [PMID: 37748796 PMCID: PMC10537961 DOI: 10.1136/bmjgh-2023-013067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/20/2023] [Indexed: 09/27/2023] Open
Abstract
The past four decades have seen a steady rise of references to 'security' by health academics, policy-makers and practitioners, particularly in relation to threats posed by infectious disease pandemics. Yet, despite an increasingly dominant health security discourse, the many different ways in which health and security issues and actors intersect have remained largely unassessed and unpacked in current critical global health scholarship. This paper discusses the emerging and growing health-security nexus in the wake of COVID-19 and the international focus on global health security. In recognising the contested and fluid concept of health security, this paper presents two contrasting approaches to health security: neocolonial health security and universal health security. Building from this analysis, we present a novel heuristic that delineates the multiple intersections and entanglements between health and security actors and agendas to broaden our conceptualisation of global health security configurations and practices and to highlight the potential for harmful unintended consequences, the erosion of global health norms and values, and the risk of health actors being co-opted by the security sector.
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Affiliation(s)
- David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Stephen Roberts
- Institute for Global Health, University College London, London, UK
| | - Salma Daoudi
- Department of Politics and International Relations, University of Oxford, Oxford, UK
| | - Jonathan Kennedy
- Wolfson Institute for Population Health, Queen Mary University London, London, UK
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5
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Manji K, Perera S, Hanefeld J, Vearey J, Olivier J, Gilson L, Walls H. An analysis of migration and implications for health in government policy of South Africa. Int J Equity Health 2023; 22:82. [PMID: 37158907 PMCID: PMC10165765 DOI: 10.1186/s12939-023-01862-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/15/2023] [Indexed: 05/10/2023] Open
Abstract
For over a decade, the global health community has advanced policy engagement with migration and health, as reflected in multiple global-led initiatives. These initiatives have called on governments to provide universal health coverage to all people, regardless of their migratory and/or legal status. South Africa is a middle-income country that experiences high levels of cross-border and internal migration, with the right to health enshrined in its Constitution. A National Health Insurance Bill also commits the South African public health system to universal health coverage, including for migrant and mobile groups. We conducted a study of government policy documents (from the health sector and other sectors) that in our view should be relevant to issues of migration and health, at national and subnational levels in South Africa. We did so to explore how migration is framed by key government decision makers, and to understand whether positions present in the documents support a migrant-aware and migrant-inclusive approach, in line with South Africa's policy commitments. This study was conducted between 2019 and 2021, and included analysis of 227 documents, from 2002-2019. Fewer than half the documents identified (101) engaged directly with migration as an issue, indicating a lack of prioritisation in the policy discourse. Across these documents, we found that the language or discourse across government levels and sectors focused mainly on the potential negative aspects of migration, including in policies that explicitly refer to health. The discourse often emphasised the prevalence of cross-border migration and diseases, the relationship between immigration and security risks, and the burden of migration on health systems and other government resources. These positions attribute blame to migrant groups, potentially fuelling nationalist and anti-migrant sentiment and largely obscuring the issue of internal mobility, all of which could also undermine the constructive engagement necessary to support effective responses to migration and health. We provide suggestions on how to advance engagement with issues of migration and health in order for South Africa and countries of a similar context in regard to migration to meet the goal of inclusion and equity for migrant and mobile groups.
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Grants
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
- Grant number: MR/S013601/1 Health Systems Research Initiative (HSRI) in the UK, a collaboration between the UK MRC, ERSC, DFID, and the Wellcome Trust
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Affiliation(s)
- Karima Manji
- London School of Hygiene & Tropical Medicine (LSHTM), Faculty of Public Health and Policy, Department of Global Health and Development, London, UK
| | - Shehani Perera
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Johanna Hanefeld
- London School of Hygiene & Tropical Medicine (LSHTM), Faculty of Public Health and Policy, Department of Global Health and Development, London, UK
| | - Jo Vearey
- The African Centre for Migration & Society (ACMS), University of the Witwatersrand, Johannesburg, South Africa
| | - Jill Olivier
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lucy Gilson
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Helen Walls
- London School of Hygiene & Tropical Medicine (LSHTM), Faculty of Public Health and Policy, Department of Global Health and Development, London, UK.
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Holst J, van de Pas R. The biomedical securitization of global health. Global Health 2023; 19:15. [PMID: 36871029 PMCID: PMC9985490 DOI: 10.1186/s12992-023-00915-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND The COVID-19 outbreak has shifted the course in the global health debate further towards health security and biomedical issues. Even though global health had already played a growing role in the international policy agenda, the pandemic strongly reinforced the interest of the media, the general public and the community in cross-border infectious diseases. This led to a strengthening of the already dominant biomedical understanding of global health and the securitization of health in foreign policy. METHODS This paper critically provides a narrative, iterative review of the health security literature available to date, with a special focus on the development of the currently prevailing concept of health security and the dual trend towards the securitization and biomedicalization of global health. FINDINGS In a world increasingly determined by power asymmetries, unequal distribution of opportunities and resources, and inadequate governance structures, securitizing health has become a key feature of global governance. Health security is predominantly based on a concept that neglects the global burden of disease determined by non-communicable conditions rather than by infectious diseases. Moreover, it exhibits a trend towards biomedical solutions and neglects root causes of global health crises. CONCLUSIONS As important as health security is, the underlying concept driven by biomedical and technocratic reductionism falls short. It widely neglects the social, economic, political, commercial and environmental determination of health. Beyond improved health care and prevention, health-in-all policies are ultimately required for ensuring health security and reducing one of its main challenges, health inequalities within and between countries. Global health security must first and foremost seek to guarantee the universal right to health and therefore emphasise the social, economic, commercial and political determination of health.
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Affiliation(s)
- Jens Holst
- Department of Health Sciences, Fulda University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
| | - Remco van de Pas
- Department of Public Health, Lecturer Global Health Policy, Institute of Tropical Medicine, Antwerp, Nationalestraat 155, B-2000, Antwerp, Belgium.,Centre for Planetary Health Policy, German Alliance Climate Change and Health, Berlin, Germany
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7
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Hamisi NM, Dai B, Ibrahim M. Global Health Security amid COVID-19: Tanzanian government's response to the COVID-19 Pandemic. BMC Public Health 2023; 23:205. [PMID: 36721158 PMCID: PMC9887238 DOI: 10.1186/s12889-023-14991-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/05/2023] [Indexed: 02/02/2023] Open
Abstract
Several stakeholders assumed different responsibilities for global health security and safety during the COVID-19 pandemic. This study aims to highlight how the Tanzanian government, in collaboration with the international government, non-governmental organizations (NGOs), donor agencies, and stakeholders responded to the pandemic to improve health security and community well-being. This article analyzed secondary data sources from the World Health Organization's (WHO) country report and published reports from Tanzania's government to evaluate vaccine availability and health security. Findings from the data gathered indicate that the initial response from the Tanzanian government concerning the fight against the COVID-19 pandemic was rather abysmal due to the posture of the late President John Pombe Magufuli who at first downplayed the severity and seriousness of the COVID-19 pandemic. However, with the swearing-in of the new President, Samia Suluhu, there was a new approach and strategy instituted to deal with the pandemic which has resulted in the country making headway in containing the pandemic. Data gathered thus, indicate that, as of 11th February 2022, the total number of fully vaccinated individuals in the country as of 12th April 2022 stood at 3,435,513 from the total number of 2,205,815 reported on 11th February 2022. This study thus, concludes that there is a need for a strong stakeholder engagement with high-level political, community, and religious leaders and increased access to COVID-19 vaccination as well as a mass campaign to scale up vaccination activities with adequate resource mobilization and plan.
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Affiliation(s)
- Nyaso Malilo Hamisi
- grid.440785.a0000 0001 0743 511XSchool of Management Jiangsu University, Zhenjiang, China
| | - Baozhen Dai
- School of Public Health, Southeast University, Nanjing, China.
| | - Masud Ibrahim
- Department of Management Studies, AAMUSTED, Kumasi, Ghana
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8
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Karačić Zanetti J, Brown M, Viđak M, Marušić A. Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study. Front Public Health 2023; 11:1164940. [PMID: 37124832 PMCID: PMC10136764 DOI: 10.3389/fpubh.2023.1164940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/16/2023] [Indexed: 05/02/2023] Open
Abstract
Background Global health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights. Methods In a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes. Findings We contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic. Interpretation The role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.
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Affiliation(s)
- Jasna Karačić Zanetti
- International Council of the Patient Ombudsman, Health Diplomacy Unit, Bruxelles, Belgium
- University of Zagreb, Zagreb, Croatia
- *Correspondence: Jasna Karačić Zanetti
| | - Matthew Brown
- Global Health Policy Institute, University of California, San Diego, San Diego, CA, United States
| | - Marin Viđak
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
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9
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Sazgarnejad S, Takian A. The Universal Triangle to Ensure Health Security. Int J Public Health 2022; 67:1605443. [PMID: 36339658 PMCID: PMC9626511 DOI: 10.3389/ijph.2022.1605443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Saharnaz Sazgarnejad
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran,*Correspondence: Amirhossein Takian,
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10
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Augustynowicz A, Opolski J, Waszkiewicz M. Health Security: Definition Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10009. [PMID: 36011643 PMCID: PMC9408279 DOI: 10.3390/ijerph191610009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
The link between security and health is not a discovery. Despite the widespread recognition of the social importance of health security, there is no single common definition of this concept. The study's objective was to search, analyse and evaluate possible original propositions to define the concept of "health security" in Polish professional literature published from 10 January 2017 to 31 March 2022. The research method was a scoping review performed in five stages according to H. Arksey and L. O'Malley. Ultimately, the study criteria were met by four studies. The proposed definition of health security in these papers failed to solve this problem and raised further questions and doubts. It is urgent to start a discourse on the meaning of the concept of "health security" with the broadest possible participation of representatives of various scientific disciplines, but taking into account the knowledge and practice of public health. It seems that it will be impossible to avoid the following questions: what is health security nowadays? What is health security as a personal issue? What are the necessary steps to achieve the consensus? Is it worthwhile to consider it on the international level?
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Affiliation(s)
- Anna Augustynowicz
- Department of Economics of Health and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
- School of Public Health Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
| | - Janusz Opolski
- Faculty of Engineering and Management, University of Ecology and Management in Warsaw, 00-792 Warsaw, Poland
| | - Michał Waszkiewicz
- School of Public Health Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
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11
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Osewe PL, Peters MA. Prioritizing Global Public Health Investments for COVID-19 Response in Real Time: Results from a Delphi Exercise. Health Secur 2022; 20:137-146. [PMID: 35420445 PMCID: PMC9081018 DOI: 10.1089/hs.2021.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In the first months of the COVID-19 pandemic, there was a lack of guidance on how to channel the unprecedented amount of health financing toward the pandemic response. We employed a multistep, interactive Delphi process to reach consensus on a “menu” of priority COVID-19 response interventions. In all, 27 health security experts—representing national governments, bilateral and multilateral organizations, academia, technical agencies, and nongovernmental organizations—participated in the exercise. The experts rated 11 technical investment areas and 37 interventions on a 5-point scale in terms of their importance to COVID-19 response. Initial findings were discussed at a virtual meeting where experts suggested modifications. A group of 19 experts then rated a revised list of 11 technical areas and 39 interventions. Consensus was defined as at least 80% of experts agreeing on the importance of a technical area or intervention; stability of scores across the rounds was identified using Wilcoxon matched-pairs and unpaired signed rank tests. Between the initial and final menu, 3 technical areas and 7 interventions were slightly modified, 3 interventions were added, and 1 intervention was removed. Consensus was reached on all 11 technical areas and 35 of the final 39 interventions, and between 34 and 37 interventions were stable across rounds depending on the test used. In this exercise, the health security experts agreed that COVID-19 response financing should prioritize interventions that enhance a country's capacity to test, trace, and treat high-risk populations. Simultaneously, supportive systems (eg, risk communication, community engagement, public health infrastructure, information systems, policy and coordination, workforce capacity, other social protections) should be developed to ensure that nonpharmaceutical and medical interventions can maximize the effectiveness of these systems.
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Affiliation(s)
- Patrick L Osewe
- Patrick L. Osewe, MD, MPH, is Chief of Health Sector Group, Asian Development Bank, Manila, Philippines
| | - Michael A Peters
- Michael A. Peters, MSPH, PhD, was a Consultant, Asian Development Bank, Manila, Philippines. He is now Associate Faculty, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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12
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Larsen DA, Collins MB, Du Q, Hill D, Insaf TZ, Kilaru P, Kmush BL, Middleton F, Stamm A, Wilder ML, Zeng T, Green H. Coupling freedom from disease principles and early warning from wastewater surveillance to improve health security. PNAS NEXUS 2022; 1:pgac001. [PMID: 36712792 PMCID: PMC9802328 DOI: 10.1093/pnasnexus/pgac001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/02/2021] [Accepted: 01/06/2022] [Indexed: 02/01/2023]
Abstract
Infectious disease surveillance is vitally important to maintaining health security, but these efforts are challenged by the pace at which new pathogens emerge. Wastewater surveillance can rapidly obtain population-level estimates of disease transmission, and we leverage freedom from disease principles to make use of nondetection of SARS-CoV-2 in wastewater to estimate the probability that a community is free from SARS-CoV-2 transmission. From wastewater surveillance of 24 treatment plants across upstate New York from May through December of 2020, trends in the intensity of SARS-CoV-2 in wastewater correlate with trends in COVID-19 incidence and test positivity (⍴ > 0.5), with the greatest correlation observed for active cases and a 3-day lead time between wastewater sample date and clinical test date. No COVID-19 cases were reported 35% of the time the week of a nondetection of SARS-CoV-2 in wastewater. Compared to the United States Centers for Disease Control and Prevention levels of transmission risk, transmission risk was low (no community spared) 50% of the time following nondetection, and transmission risk was moderate or lower (low community spread) 92% of the time following nondetection. Wastewater surveillance can demonstrate the geographic extent of the transmission of emerging pathogens, confirming that transmission risk is either absent or low and alerting of an increase in transmission. If a statewide wastewater surveillance platform had been in place prior to the onset of the COVID-19 pandemic, policymakers would have been able to complement the representative nature of wastewater samples to individual testing, likely resulting in more precise public health interventions and policies.
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Affiliation(s)
- David A Larsen
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
| | - Mary B Collins
- Department of Environmental Studies, SUNY ESF, Syracuse, NY 13210, USA
| | - Qian Du
- Quadrant Biosciences, Inc, Syracuse, NY 13210, USA
| | - Dustin Hill
- Department of Environmental Studies, SUNY ESF, Syracuse, NY 13210, USA
| | - Tabassum Z Insaf
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, NY 12237, USA
- Department of Epidemiology and Biostatistics, University at Albany, Albany, NY 12222, USA
| | - Pruthvi Kilaru
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
| | - Brittany L Kmush
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
| | - Frank Middleton
- Department of Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Abigail Stamm
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, NY 12237, USA
| | - Maxwell L Wilder
- Department of Environmental Biology, SUNY ESF, Syracuse, NY 13210, USA
| | - Teng Zeng
- Department of Civil and Environmental Engineering, Syracuse University, Syracuse, NY 13244, USA
| | - Hyatt Green
- Department of Environmental Biology, SUNY ESF, Syracuse, NY 13210, USA
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13
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The Mediating Effect of Healthcare Utilization on Livelihood Empowerment against Poverty (LEAP) and Health Security of Older Adults in Ghana: A Case Study on the Ga-West Municipality in Accra, Ghana. Healthcare (Basel) 2022; 10:healthcare10020370. [PMID: 35206984 PMCID: PMC8872544 DOI: 10.3390/healthcare10020370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023] Open
Abstract
The concept of health security has aroused several interpretations because of theoretical technique indifferences or academic methodology. The focus has been on human security, old age health security (OAHS), whereas there remain issues of low healthcare utilization by older people from rural Ghana while there are social assistance programs. The study aimed at investigating the mediating effect of healthcare utilization on Livelihood Empowerment against Poverty (LEAP) and old age health security OAHS. With purposive sampling technique, participants were selected to participate in the study with standardized quantitative questionnaire to measure the variables involved in the study and a regression technique to analyze the data. The result of the mediation analysis showed a partial mediation between LEAP and Healthcare Utilization (HU) was found to have bridged the gap between the LEAP and OAHS. The LEAP policy also caused an increase in Health Utilization and, subsequently, an increase in old age health security (OAHS). The study is essential to help the National Health Insurance Authority NHIA in restructuring health care premiums to incite utilization of health facilities by the aged.
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14
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Rendell N, Sheel M. Expert perspectives on priorities for supporting health security in the Pacific region through health systems strengthening. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000529. [PMID: 36962587 PMCID: PMC10021329 DOI: 10.1371/journal.pgph.0000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/12/2022] [Indexed: 11/19/2022]
Abstract
The COVID-19 pandemic has reiterated the interdependence of health security and health systems, and the need for resilient health systems to prevent large-scale impacts of infectious disease outbreaks and other acute public health events. Three years into the COVID-19 pandemic has led to discussions on how to "build back better", making it important to identify lessons to strengthen health systems and prevent future shocks from health security threats. Limited data exist on effective implementable initiatives, especially for the Pacific region. We explored the perceptions of a selection of experts with field experience in the Pacific region to identify and prioritise areas for future health system investments that strengthen health security. We conducted a qualitative cross-sectional study, collecting data using four focus group discussions. We analysed the data using a content analysis of notes recorded from each of the sessions. There were 24 participants, representing 15 research and academic institutions, nongovernment agencies, UN agencies and government as well as independent consultants. All were health sector stakeholders with field experience in the Pacific region and expertise in either health systems or health security. The analysis revealed four areas to prioritise future efforts, namely workforce development, risk communication, public health surveillance and laboratory capacity. A fifth theme, localisation, was identified as a cross cutting theme that should be applied to implementation of other identified priority areas. These findings provide a starting point to apply in practice this relatively new concept, of targeted health systems strengthening for health security development, in the Pacific. Evaluation of these initiatives will strengthen knowledge on the value of integrating these two concepts.
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Affiliation(s)
- Nicole Rendell
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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15
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Malik SM, Barlow A, Johnson B. Reconceptualising health security in post-COVID-19 world. BMJ Glob Health 2021; 6:bmjgh-2021-006520. [PMID: 34285043 PMCID: PMC8295018 DOI: 10.1136/bmjgh-2021-006520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 11/11/2022] Open
Abstract
While drawing upon the existing literature and policy documents on health security and its practice at the national and global levels, this article shows that the idea of health security has mostly remained rhetoric or at the most conceptualised and operationalised within the narrow Westphalian tradition of protecting nation states from external threats. By undertaking a critical examination of the national security strategies of some powerful G-20 countries, we show that non-traditional threats such as infectious diseases and pandemics are either absent from the list of potential threats or are accorded a weak priority and addressed within the state and military-centric notion of security. This approach has shortcomings that are laid bare by the ongoing pandemic. In this article, we show how national and global health security agendas can be advanced much more productively by mobilising a wider securitisation discourse that is driven by the human security paradigm as advanced by the United Nations in 1994, that considers people rather than states as the primary referent of security and that emphasises collective action rather than competition to address the transnational nature of security threats. We discuss the relevance of this paradigm in broadening the concept of health security in view of the contemporary and future threats to public health.
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Affiliation(s)
| | - Amy Barlow
- Political Science, York University, Toronto, Ontario, Canada
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16
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Noman H, Dureab F, Ahmed I, Al Serouri A, Hussein T, Jahn A. Mind the gap: an analysis of core capacities of the international health regulations (2005) to respond to outbreaks in Yemen. BMC Health Serv Res 2021; 21:477. [PMID: 34016124 PMCID: PMC8134964 DOI: 10.1186/s12913-021-06395-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are essential to public health security. The aim of this study is to assess the implementation of the International Health Regulations (IHR 2005) core capacities under the current ongoing conflict in Yemen. METHODS The study simulated the World Health Organization (WHO) Joint External Evaluation (JEE) tool to assess the IHR core capacities in Yemen. Qualitative research methods were used, including desk reviews, in-depth interviews with key informants and analysis of the pooled data. RESULT Based on the assessment of the three main functions of the IHR framework (prevention, detection, and response), Yemen showed a demonstrated or developed capacity to detect outbreaks, but nevertheless limited or no capacity to prevent and respond to outbreaks. CONCLUSION This study shows that there has been poor implementation of IHR in Yemen. Therefore, urgent interventions are needed to strengthen the implementation of the IHR core capacities in Yemen. The study recommends 1) raising awareness among national and international health staff on the importance of IHR; 2) improving alignment of INGO programs with government health programs and aligning both towards better implementation of the IHR; 3) improving programmatic coordination, planning and implementation among health stakeholders; 4) increasing funding of the global health security agenda at country level; 5) using innovative approaches to analyze and address gaps in the disrupted health system, and; 6) addressing the root cause of the collapse of the health services and overall health system in Yemen by ending the protracted conflict situation.
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Affiliation(s)
- Hanan Noman
- Heidelberg Institute of Global Health, Uniklinikum, Heidelberg, Germany
| | - Fekri Dureab
- Heidelberg Institute of Global Health, Uniklinikum, Heidelberg, Germany.
- Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany.
- IRIA, Akkon-Hochschule für Humanwissenschaften, Berlin, Germany.
| | - Iman Ahmed
- Independent Global Health Expert, Montreal, Canada
| | - Abdulwahed Al Serouri
- Yemen Field Epidemiology Training Program, Ministry of Public Health and Population, Sana'a, Yemen
| | | | - Albrecht Jahn
- Heidelberg Institute of Global Health, Uniklinikum, Heidelberg, Germany
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17
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Vearey J, de Gruchy T, Maple N. Global health (security), immigration governance and Covid-19 in South(ern) Africa: An evolving research agenda. J Migr Health 2021; 3:100040. [PMID: 34405188 PMCID: PMC8352209 DOI: 10.1016/j.jmh.2021.100040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/23/2022] Open
Abstract
The Covid-19 pandemic provides a stark reminder of the political tensions associated with the field of immigration and health, highlighting the central role that nationalism, racism and xenophobia play in determining responses to communicable diseases. The blurring of global health, immigration governance, and the global health security agendas has long been recognised. However, an improved understanding of the politics influencing these entanglements, specifically within the context of the Covid-19 response in low- and middle-income country contexts, is urgently needed. This includes - but is not limited to - the immediate concerns surrounding inclusive social, political and medical responses to Covid-19; vaccine nationalism - at both global and national levels; and calls for 'vaccine passports'. To this end, we draw on the Southern African Development Community (SADC) context - one associated with high levels of diverse population movements and a large burden of communicable diseases - to explore responses to Covid-19. We unpack tensions surrounding the management of migration and the ways in which sovereignty impacts attempts at building regional, coordinated responses to migration and health, and consider how this affects progress towards global health targets. With an initial focus on South Africa, we build on previous work exploring the blurring of global health, immigration governance, and the global health security agendas in SADC, and draw from ongoing research on the governance of migration and health within the region. This includes current and evolving research exploring migration and Covid-19, initiated in March 2020 when the first cases of Covid-19 were identified in Southern Africa. The aim is for these findings to catalyse a new and evolving researh agenda to inform the development and implementation of appropriate pandemic responses in a region associated with some of the highest levels of inequality globally. To this end, an evolving research agenda should be responsive to current needs. We suggest that, in SADC, priority research should focus on improving our understanding of (1) the political factors influencing the (dis)connections between migration and health governance structures in the context of Covid-19, and how to overcome these in the context of a pandemic; and (2) the motivations for and implications of a 'vaccine passport' system on movement within and beyond the SADC region. This requires a reactive, cross-disciplinary, regional research network. In a context where funding for research is increasingly inaccessible, this requires innovative, informal, collaborative engagement.
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Affiliation(s)
- Jo Vearey
- African Centre for Migration & Society (ACMS), Wits University, PO Box 76, WITS, 2050, South Africa
| | - Thea de Gruchy
- African Centre for Migration & Society (ACMS), Wits University, PO Box 76, WITS, 2050, South Africa
| | - Nicholas Maple
- African Centre for Migration & Society (ACMS), Wits University, PO Box 76, WITS, 2050, South Africa
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18
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Assefa Y, Hill PS, Gilks CF, Damme WV, van de Pas R, Woldeyohannes S, Reid S. Global health security and universal health coverage: Understanding convergences and divergences for a synergistic response. PLoS One 2020; 15:e0244555. [PMID: 33378383 PMCID: PMC7773202 DOI: 10.1371/journal.pone.0244555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 12/13/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Global health security (GHS) and universal health coverage (UHC) are key global health agendas which aspire for a healthier and safer world. However, there are tensions between GHS and UHC strategy and implementation. The objective of this study was to assess the relationship between GHS and UHC using two recent quantitative indices. METHODS We conducted a macro-analysis to determine the presence of relationship between GHS index (GHSI) and UHC index (UHCI). We calculated Pearson's correlation coefficient and the coefficient of determination. Analyses were performed using IBM SPSS Statistics Version 25 with a 95% level of confidence. FINDINGS There is a moderate and significant relationship between GHSI and UHCI (r = 0.662, p<0.001) and individual indices of UHCI (maternal and child health and infectious diseases: r = 0.623 (p<0.001) and 0.594 (p<0.001), respectively). However, there is no relationship between GHSI and the non-communicable diseases (NCDs) index (r = 0.063, p>0.05). The risk of GHS threats a significant and negative correlation with the capacity for GHS (r = -0.604, p<0.001) and the capacity for UHC (r = -0.792, p<0.001). CONCLUSION The aspiration for GHS will not be realized without UHC; hence, the tension between these two global health agendas should be transformed into a synergistic solution. We argue that strengthening the health systems, in tandem with the principles of primary health care, and implementing a "One Health" approach will progressively enable countries to achieve both UHC and GHS towards a healthier and safer world that everyone aspires to live in.
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Affiliation(s)
- Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Peter S. Hill
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Charles F. Gilks
- School of Public Health, the University of Queensland, Brisbane, Australia
| | | | | | | | - Simon Reid
- School of Public Health, the University of Queensland, Brisbane, Australia
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19
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Quinn JM, Bencko V, Bongartz AV, Stoeva P, Atanasoska Arsov A, De Porzi S, Bohonek M, Ti R, Taylor J, Mitchell J, Reinhard V, Majovsky P, Kuca J, Kral P, Fazekas L, Bubenik Z. NATO and evidence-based military and disaster medicine: case for Vigorous Warrior Live Exercise Series. Cent Eur J Public Health 2020; 28:325-330. [PMID: 33338371 DOI: 10.21101/cejph.a6045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 09/15/2020] [Indexed: 11/15/2022]
Abstract
The North Atlantic Treaty Organization (NATO) is the premier and only security alliance uniting 30 countries and growing with many partner states in the provision of collective security and against threats posed by conflict and natural disasters. Security of countries and communities is increasingly threatened by a broad spectrum of unconventional types of war and disease threats - from hybrid and asymmetric to multi-domain and peer-to-peer/near-peer conflict. The NATO Centre of Excellence for Military Medicine (MILMED COE) is the centre of gravity for medical best practices and promotion of medical doctrine across the NATO alliance. Disaster medicine is multidisciplinary and in NATO, multinational, requiring best practices that are driven by data and evidence to prevent death on the battlefield and prepare for future conflicts. "Vigorous Warrior" is a live military and disaster medicine exercise series using both civilian and military actors across all sectors of health focused on health security and identifying lessons learned to ready the alliance for future threats. In this brief report, we make the case that the Vigorous Warrior exercise exposes gaps, highlights challenges and generates an evidence base to make NATO military medicine systems more robust, more efficient and in provision of best medical practices. We specifically argue that clinical data capture must be duplicated and continuous across the alliance to ensure evidence-based medicine stays current in NATO military medical doctrine.
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Affiliation(s)
- John M Quinn
- Prague Centre for Global Health, Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladimír Bencko
- Prague Centre for Global Health, Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexander V Bongartz
- Emergency Medical Faculty, Prague Institute of Postgraduate Medical Education, Prague, Czech Republic
| | - Preslava Stoeva
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Adrijana Atanasoska Arsov
- Medical Military Centre Skopje, Army of the Republic of North Macedonia, Skopje, Republic of North Macedonia
| | - Stefano De Porzi
- Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary
| | - Milos Bohonek
- Department of Haematology and Blood Transfusion, Military University Hospital, Prague, Czech Republic.,Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Ronald Ti
- Specialist Technical Advisor, Poland Office, Department of Defence, Canberra, Australia
| | - Jack Taylor
- Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary
| | - John Mitchell
- Secretary of Defence, Operational Medicine Readiness Policy and Oversight, Pentagon, Washington, D.C., USA
| | - Veronika Reinhard
- Estonian Military Academy, Tartu University Hospital, Tartu, Estonia
| | - Petr Majovsky
- Ministry of Defence of the Czech Republic, Prague, Czech Republic
| | - Jozef Kuca
- Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary
| | - Petr Kral
- Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary
| | - Laszlo Fazekas
- Interoperability Branch, NATO Centre of Excellence for Military Medicine, Budapest, Hungary
| | - Zoltan Bubenik
- Ministry of Defence of the Czech Republic, Prague, Czech Republic.,Committee of Chiefs of Military Medical Services in NATO, Brussels, Belgium
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20
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Voo TC, Lederman Z, Kaur S. Patient Isolation during Infectious Disease Outbreaks: Arguments for Physical Family Presence. Public Health Ethics 2020; 13:133-142. [PMID: 33294029 PMCID: PMC7700794 DOI: 10.1093/phe/phaa024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This article argues that outbreak preparedness and response should implement a ‘family presence’ policy for infected patients in isolation that includes the option of physical visits and care within the isolation facility under some conditions. While such a ‘physical family presence’ (PFP) policy could increase infections during an outbreak and may raise moral dilemmas, we argue that it is ethically justified based on the least infringement principle and the need to minimize the harms and burdens of isolation as a restrictive measure. Categorical prohibition of PFP during the course of an outbreak or epidemic is likely to result in unnecessary harms to patients and families, and violate values such as the moral commitments of families to care for each other. Supporting the option of PFP under particular circumstances, on the other hand, will least infringe these moral considerations. An additional reason for a family presence policy is that it may facilitate voluntary cooperation with isolation and other restrictive measures. We provide an analysis of these considerations for supporting modes of family presence during an outbreak emergency, before defending the riskier option of PFP in the isolation facility from plausible objections and concerns.
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Affiliation(s)
- Teck Chuan Voo
- Centre for Biomedical Ethics, National University of Singapore, Yong Loo Lin School of Medicine
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21
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Desempeño del sistema de vigilancia colombiano durante la pandemia de COVID-19: evaluación rápida de los primeros 50 días. ACTA ACUST UNITED AC 2020; 40:96-103. [PMID: 33152193 PMCID: PMC7676837 DOI: 10.7705/biomedica.5582] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 11/21/2022]
Abstract
Introducción. La pandemia de COVID es un desafío para la vigilancia en salud pública y una oportunidad para evaluar sus fortalezas y debilidades en aras de mejorar la respuesta.Objetivo. Evaluar el desempeño del sistema de vigilancia en salud pública colombiano durante los primeros 50 días de la pandemia de COVID-19 en el país.Materiales y métodos. Se analizaron los datos publicados entre el 6 de marzo y el 24 de abril de 2020 por el Instituto Nacional de Salud y la Organización Mundial de Salud (OMS). Se consideraron en la evaluación: i) la calidad de los datos según la ley de Benford y ii) la oportunidad de la información, medida como la diferencia en fechas entre los datos generados en el Instituto Nacional de Salud y los recogidos en el informe situacional de la OMS. La variabilidad en el cumplimiento de la ley de Benford se evaluó con los valores de p en las pruebas de razón del logaritmo de la verosimilitud, ji al cuadrado o exacta de Moreno.Resultados. Hasta el 24 de abril hubo 4.881 casos de COVID-19 en Colombia. En la mayoría de los primeros 50 días se cumplió la ley de Benford, excepto en los primeros días de la epidemia. La diferencia entre los informes del Instituto Nacional de Salud y la OMS ha dependido, en gran medida, de la diferencia en los horarios de cierre de la información.Conclusión. En general, el sistema de vigilancia en salud pública colombiano cumplió con la ley de Benford, lo cual sugiere que hubo calidad en los datos. En futuros estudios que comparen el desempeño de los departamentos y distritos se podrá mejorar el diagnóstico de la vigilancia en salud pública del país.
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22
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Stoeva P. Dimensions of Health Security-A Conceptual Analysis. GLOBAL CHALLENGES (HOBOKEN, NJ) 2020; 4:1700003. [PMID: 33033624 PMCID: PMC7533848 DOI: 10.1002/gch2.201700003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Discussions of the politics and practicalities of confronting health security challenges-from infectious disease outbreaks to antimicrobial resistance and the silent epidemic of noncommunicable diseases-hinge on the conceptualization of health security. There is no consensus among analysts about the specific parameters of health security. This inhibits comparative evaluation and critique, and affects the consistency of advice for policymakers. This article aims to contribute to debates about the meaning and scope of health security by applying Baldwin's (1997) framework for conceptualizing security with a view to propose an alternative framing. Asking Baldwin's concept-defining questions of the health security literature highlights how implicit and explicit assumptions currently place health security squarely within a narrow traditionalist analytical framework. Such framing of health security is inaccurate and constraining, as demonstrated by practice and empirical observations. Alternative approaches to security propose that security politics can also be multiactor, cooperative, and ethical, while being conscious of postcolonial and feminist critique in search of sustainable solutions to existential threats to individuals and communities. A broader conceptualization of health security can transform the politics of health security, improving health outcomes beyond acute crises and contribute to broader security studies' debates.
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Affiliation(s)
- Preslava Stoeva
- Department of Global Health & DevelopmentLondon School of Hygiene and Tropical Medicine15‐17 Tavistock PlaceLondonWC1H 9SHUK
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23
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Berner-Rodoreda A, Rehfuess EA, Klipstein-Grobusch K, Cobelens F, Raviglione M, Flahault A, Casamitjana N, Fröschl G, Skordis-Worral J, Abubakar I, Ashrafian H, Agardh A, Visser L, Schultsz C, Plasència A, Jahn A, Norton R, van Leeuwen R, Hagander L, Bärnighausen T. Where is the 'global' in the European Union's Health Research and Innovation Agenda? BMJ Glob Health 2019; 4:e001559. [PMID: 31646008 PMCID: PMC6781967 DOI: 10.1136/bmjgh-2019-001559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/19/2019] [Accepted: 08/25/2019] [Indexed: 11/26/2022] Open
Abstract
Global Health has not featured as prominently in the European Union (EU) research agenda in recent years as it did in the first decade of the new millennium, and participation of low-income and middle-income countries (LMICs) in EU health research has declined substantially. The Horizon Europe Research and Innovation Framework adopted by the European Parliament in April 2019 for the period 2021-2027 will serve as an important funding instrument for health research, yet the proposed health research budget to be finalised towards the end of 2019 was reduced from 10% in the current framework, Horizon 2020, to 8% in Horizon Europe. Our analysis takes the evolvement of Horizon Europe from the initial framework of June 2018 to the framework agreed on in April 2019 into account. It shows that despite some improvements in terms of Global Health and reference to the Sustainable Development Goals, European industrial competitiveness continues to play a paramount role, with Global Health research needs and relevant health research for LMICs being only partially addressed. We argue that the globally interconnected nature of health and the transdisciplinary nature of health research need to be fully taken into account and acted on in the new European Research and Innovation Framework. A facilitated global research collaboration through Horizon Europe could ensure that Global Health innovations and solutions benefit all parts of the world including EU countries.
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Affiliation(s)
- Astrid Berner-Rodoreda
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Eva Annette Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU München, München, Germany
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Frank Cobelens
- Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Mario Raviglione
- Global Health Centre, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Antoine Flahault
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Núria Casamitjana
- Barcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
| | - Günter Fröschl
- Division of Infectious Diseases and Tropical Medicine, LMU München, München, Germany
| | | | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Hutan Ashrafian
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Anette Agardh
- Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Leo Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Constance Schultsz
- Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Antoni Plasència
- Barcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
| | - Albrecht Jahn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Robyn Norton
- The George Institute for Global Health, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
| | - Remko van Leeuwen
- Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Lars Hagander
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Africa Health Research Institute (AHRI), Somkhele and Durban, KwaZulu-Natal, South Africa
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24
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Towards Resilient Health Systems in Sub-Saharan Africa: A Systematic Review of the English Language Literature on Health Workforce, Surveillance, and Health Governance Issues for Health Systems Strengthening. Ann Glob Health 2019; 85. [PMID: 31418540 PMCID: PMC6696789 DOI: 10.5334/aogh.2514] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Meeting health security capacity in sub-Saharan Africa will require strengthening existing health systems to prevent, detect, and respond to any threats to health. The purpose of this review was to examine the literature on health workforce, surveillance, and health governance issues for health systems strengthening. Methods: We searched PubMed, Science Direct, Cochrane library, CINAHL, Web of Science, EMBASE, EBSCO, Google scholar, and the WHO depository library databases for English-language publications between January 2007 and February 2017. Electronic searches for selected articles were supplemented by manual reference screening. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: Out of 1,548 citations retrieved from the electronic searches, 31 articles were included in the review. Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance. Building novel surveillance systems can improve clinical care and improve health system preparedness for health threats. Effective governance processes build strong partnerships for health and create accountability mechanisms for responding to health emergencies. Conclusions: Overall, policy shifts in African countries’ health systems that prioritize training a cadre of willing and able workforce, invest in robust and cost-effective surveillance capacity, and create financial accountability and good governance are vital in health strengthening efforts.
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Wenham C, Katz R, Birungi C, Boden L, Eccleston-Turner M, Gostin L, Guinto R, Hellowell M, Onarheim KH, Hutton J, Kapilashrami A, Mendenhall E, Phelan A, Tichenor M, Sridhar D. Global health security and universal health coverage: from a marriage of convenience to a strategic, effective partnership. BMJ Glob Health 2019; 4:e001145. [PMID: 30713747 PMCID: PMC6340060 DOI: 10.1136/bmjgh-2018-001145] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/19/2018] [Accepted: 10/28/2018] [Indexed: 11/26/2022] Open
Abstract
Global health security and universal health coverage have been frequently considered as "two sides of the same coin". Yet, greater analysis is required as to whether and where these two ideals converge, and what important differences exist. A consequence of ignoring their individual characteristics is to distort global and local health priorities in an effort to streamline policymaking and funding activities. This paper examines the areas of convergence and divergence between global health security and universal health coverage, both conceptually and empirically. We consider analytical concepts of risk and human rights as fundamental to both goals, but also identify differences in priorities between the two ideals. We support the argument that the process of health system strengthening provides the most promising mechanism of benefiting both goals.
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Affiliation(s)
- Clare Wenham
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Rebecca Katz
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Charles Birungi
- Institute for Global Health, University College London, London, UK
- UNAIDS, Geneva, Switzerland
| | - Lisa Boden
- Global Academy of Agriculture and FoodSecurity, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, UK
| | | | - Lawrence Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University Law Centre, Georgetown University, Washington, District of Columbia, USA
| | - Renzo Guinto
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Mark Hellowell
- Global Health Policy Unit, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Anuj Kapilashrami
- Centre for Global Public Health, Queen Mary University, London, London, UK
| | - Emily Mendenhall
- Georgetown University Edmund A Walsh School of Foreign Service, Washington, District of Columbia, USA
| | - Alexandra Phelan
- Georgetown University O'Neill Institute for National and Global Health Law, Washington, District of Columbia, USA
| | - Marlee Tichenor
- University of Edinburgh Division of Health Sciences, Edinburgh, UK
| | - Devi Sridhar
- University of Edinburgh Division of Health Sciences, Edinburgh, UK
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26
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Saha A, Alleyne G. Recognizing noncommunicable diseases as a global health security threat. Bull World Health Organ 2018; 96:792-793. [PMID: 30455534 PMCID: PMC6239014 DOI: 10.2471/blt.17.205732] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/23/2018] [Accepted: 07/02/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Amrita Saha
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America (USA)
| | - George Alleyne
- Pan American Health Organization, 525 Twenty Third Street NW, Washington, DC, USA
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27
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Wendelboe AM, McCumber M, Erb-Alvarez J, Mould N, Childs RW, Regens JL. Managing emerging transnational public health security threats: lessons learned from the 2014 West African Ebola outbreak. Global Health 2018; 14:75. [PMID: 30053868 PMCID: PMC6064117 DOI: 10.1186/s12992-018-0396-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/11/2018] [Indexed: 11/11/2022] Open
Abstract
Background Pandemics pose significant security/stability risks to nations with fragile infrastructures. We evaluated characteristics of the 2014 West African Ebola outbreak to elucidate lessons learned for managing transnational public health security threats. Methods We used publically available data to compare demographic and outbreak-specific data for Guinea, Sierra Leone, and Liberia, including key indicator data by the World Health Organization. Pearson correlation statistics were calculated to compare country-level infrastructure characteristics with outbreak size and duration. Results Hospital bed density was inversely correlated with longer EVD outbreak duration (r = − 0.99). Country-specific funding amount allocations were more likely associated with number of incident cases than the population at-risk or infrastructure needs. Key indicators demonstrating challenges for Guinea included: number of unsafe burials, percent of EVD-positive samples, and days between symptom onset and case hospitalization. Sierra Leone’s primary key indicator was the number of districts with ≥1 security incident. Liberia controlled their outbreak before much of the key-indicator data were collected. Conclusion Many of the country-level factors, particularly the WHO key indicators were associated with controlling the epidemic. The infrastructure of countries affected by communicable diseases should be assessed by international political and public health leaders.
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Affiliation(s)
- Aaron M Wendelboe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 323, Oklahoma City, OK, 73104, USA.
| | - Micah McCumber
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 NE 13th St., CHB 323, Oklahoma City, OK, 73104, USA
| | - Julie Erb-Alvarez
- Indian Health Service, US Public Health Service, 701 Market Drive, Oklahoma City, OK, 73114, USA.,Division of Intramural Research, Office of the Clinical Director, National Institutes of Health, Bethesda, MD, USA
| | - Nicholas Mould
- Center for Intelligence and National Security, University of Oklahoma, 755 Research parkway, Suite 520, Oklahoma City, OK, 73104, USA
| | - Richard W Childs
- National Heart Lung and Blood Institute, Hematology Branch, Section of Transplantation Immunotherapy, National Institutes of Health, Building 10-CRC, Room 3-5330, Bethesda, MD, 20814, USA
| | - James L Regens
- Center for Intelligence and National Security, University of Oklahoma, 755 Research parkway, Suite 520, Oklahoma City, OK, 73104, USA
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28
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Mackintosh M, Mugwagwa J, Banda G, Tibandebage P, Tunguhole J, Wangwe S, Karimi Njeru M. Health-industry linkages for local health: reframing policies for African health system strengthening. Health Policy Plan 2018; 33:602-610. [PMID: 29562286 PMCID: PMC5894083 DOI: 10.1093/heapol/czy022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2018] [Indexed: 12/15/2022] Open
Abstract
The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013-15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a 'local health' policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health-industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with 'global health' frameworks but poses a challenge to some of its underlying assumptions.
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Affiliation(s)
- Maureen Mackintosh
- Faculty of Arts and Social Sciences, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK
| | - Julius Mugwagwa
- Department of Science, Technology, Engineering and Public Policy, University College London, London W1T 6EY, UK
| | - Geoffrey Banda
- Science, Technology and Innovation Studies, University of Edinburgh, Edinburgh EH1 1LZ, UK
| | | | - Jires Tunguhole
- Economic and Social Research Foundation, Dar es Salaam, Tanzania
| | - Samuel Wangwe
- Economic and Social Research Foundation, Dar es Salaam, Tanzania
| | - Mercy Karimi Njeru
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
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29
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Abstract
Global health security is increasingly reliant on vigilance to provide early warning of transnational health threats. In theory, this approach requires that sentinels, based in communities most affected by new or reemerging infectious diseases, deliver timely alerts of incipient risk. Medicalizing global safety also implies there are particular forms of insecurity that must be remedied to preempt disease spread. I examine vigilance in the context of spreading drug-resistant malaria in Southeast Asian border zones and argue that to act as sentinels, marginal groups vulnerable to infection must be able to articulate what social and behavioral factors prompt proliferating disease risks.
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Affiliation(s)
- Chris Lyttleton
- a Department of Anthropology , Macquarie University , Sydney , NSW , Australia
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30
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Quinn J, Stoeva P, Zelený T, Nanda T, Tomanová A, Bencko V. Public Health Crisis: the Need for Primary Prevention in Failed and Fragile States. Cent Eur J Public Health 2017; 25:171-176. [PMID: 29022674 DOI: 10.21101/cejph.a4671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 08/16/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A new 'normal' in global affairs may be erupting from large global powers to that of non-state actors and proxies committing violence through scaled conflict in a post-Westphalian world generating significant global health policy challenges. Health security of populations are multifactorial and indirectly proportional to war, conflict and disaster. Preventing conflict and avoiding the health vacuum that occurs in war and violence may be best practices for policy makers. This paper considers an approach of applying clinical primary prevention principles to global health policy. METHODS Brief policy review of current standards and practices in health security in fragile and failed states and prevention; and definitions discussion. A short case study series are presented with best practices, with risk and outcome review. RESULTS The global balance of power and order may be shifting through geopolitical transference and inadequate action by major global power brokers. Health security in at risk nation-states may be decreasing as a result. CONCLUSION Small scale conflict with large-scale violence threatens health security and may experience increased incidence and prevalence in fragile and failed states. Preventative policy to resuscitate fragile and failed states and prevent further external and internal shocks may support health and promote a positive feedback loop of further state stability and increased health security. Public health policy shift to mitigate state failure and public health crisis in war and conflict through the basis of primary prevention may provide best practices and maximize health security for at risk populations.
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Affiliation(s)
- John Quinn
- Prague Centre for Global Health, Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Preslava Stoeva
- MSc Global Health Policy (DL), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tomáš Zelený
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Toozy Nanda
- Prague Centre for Global Health, Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alžběta Tomanová
- Prague Centre for Global Health, Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladimír Bencko
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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31
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Ooms G, Flores W, Mulumba M, Sarker M, Van de Pas R, Jahn A. False and real, but avoidable, dichotomies. Lancet 2017; 390:647-648. [PMID: 28816133 DOI: 10.1016/s0140-6736(17)31445-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/03/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Gorik Ooms
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
| | - Walter Flores
- Center for the Study of Equity and Governance in Health Systems, Guatemala City, Guatemala
| | - Moses Mulumba
- Center for Health, Human Rights and Development, Kampala, Uganda
| | - Malabika Sarker
- James P Grant School of Public Health at BRAC University, Dhaka, Bangladesh
| | - Remco Van de Pas
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Albrecht Jahn
- Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany
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32
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Wernli D, Jørgensen PS, Morel CM, Carroll S, Harbarth S, Levrat N, Pittet D. Mapping global policy discourse on antimicrobial resistance. BMJ Glob Health 2017; 2:e000378. [PMID: 29225939 PMCID: PMC5717922 DOI: 10.1136/bmjgh-2017-000378] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/12/2017] [Accepted: 06/17/2017] [Indexed: 12/18/2022] Open
Abstract
The rising importance of antimicrobial resistance (AMR) to the global health agenda is associated with a growing number of parties voicing their concern about the issue. With more recommendations and policies appearing, understanding the policy process requires making sense of the views, values, interests and goals of each participant. Policy frame analysis provides a method to understand both the scientific view and the actions advocated by global health actors to tackle AMR. Here we review and refine policy frame analyses of AMR using a deductive approach. Among several policy frames previously defined in the field of global health, we identify 'AMR as healthcare', 'AMR as development', 'AMR as innovation' and 'AMR as security' as frequent frames used in dealing with AMR. In addition, we found that 'AMR as One Health' constitutes a recent framing of the topic that seeks to provide an integrated understanding between human and animal health. Each frame originates in distinct scientific fields, conceptualises the main causes of AMR and prioritises different interventions and measurements. Better understanding and integration of these frames into an overarching social and ecological framework will support policy progress in tackling AMR.
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Affiliation(s)
- Didier Wernli
- Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Peter S Jørgensen
- Global Economic Dynamics and the Biosphere, Royal Swedish Academy of Sciences, Stockholm, Sweden
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | - Chantal M Morel
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- London School of Economics, London, UK
| | - Scott Carroll
- Department of Entomology and Nematology, University of California, Davis, USA
- Institute for Contemporary Evolution, Davis, USA
| | - Stephan Harbarth
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Nicolas Levrat
- Global Studies Institute, University of Geneva, Geneva, Switzerland
- Faculty of Law, University of Geneva, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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33
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Ooms G, Beiersmann C, Flores W, Hanefeld J, Müller O, Mulumba M, Ottersen T, Sarker M, Jahn A. Synergies and tensions between universal health coverage and global health security: why we need a second 'Maximizing Positive Synergies' initiative. BMJ Glob Health 2017; 2:e000217. [PMID: 28589005 PMCID: PMC5321394 DOI: 10.1136/bmjgh-2016-000217] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gorik Ooms
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Claudia Beiersmann
- Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Walter Flores
- Center for the Study of Equity and Governance in Health Systems, Guatemala, Guatemala
| | - Johanna Hanefeld
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Olaf Müller
- Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Moses Mulumba
- Center for Health, Human Rights and Development, Kampala, Uganda
| | - Trygve Ottersen
- Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and the Centre for Global Health, University of Oslo, Oslo, Norway
| | - Malabika Sarker
- James P. Grant School of Public Health at BRAC University, Dhaka, Bangladesh
| | - Albrecht Jahn
- Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany
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34
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Advocating Global Health Security. GLOBAL INSECURITY 2017. [PMCID: PMC7121127 DOI: 10.1057/978-1-349-95145-1_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
For the last two decades, a recurring strategy employed by health professionals, scientists, and diplomats has been to play the ‘health security card’ to achieve particular trade, diplomatic, strategic, and development goals. The presumption has been that the securitisation of health will harness global political leadership and resources. This marriage of health issues to security logic has been met with a mix of applause, caution, and critique. In particular, there have been growing claims that the successful global health initiatives such as, the Global Fund for AIDS, TB, and Malaria (Global Fund) and the Global Alliance for Vaccine Immunization (GAVI) were achieved without asserting their necessity on security considerations. Thus, what difference does the association of security to health make for the success and longevity of global health initiatives? In this chapter, I answer this question through comparing a case where the security logic was deliberately deployed to frame the ‘health emergency’ (Framework Convention on Tobacco Control), against a case where human rights logic was used to advocate for its creation (the GAVI). I critically explore the conditions under which linking securitisation with an international health initiative captures and maintains political leadership and resources.
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35
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Flahault A, Wernli D, Zylberman P, Tanner M. From global health security to global health solidarity, security and sustainability. Bull World Health Organ 2016; 94:863. [PMID: 27994276 DOI: 10.2471/blt.16.171488] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Antoine Flahault
- Institute of Global Health, University of Geneva, 9 Chemin des Mines,1202 Geneva, Switzerland
| | - Didier Wernli
- Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Patrick Zylberman
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Paris, France
| | - Marcel Tanner
- Swiss Tropical & Public Health Institute, Basel, Switzerland
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36
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Calain P, Abu Sa'Da C. Coincident polio and Ebola crises expose similar fault lines in the current global health regime. Confl Health 2015; 9:29. [PMID: 26380580 PMCID: PMC4572646 DOI: 10.1186/s13031-015-0058-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 09/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine. DISCUSSION The resurgence of polio and the spread of Ebola in 2014 have not only exposed the weaknesses of national health systems, but also the shortcomings of the current global health regime in dealing with transnational epidemic threats. These shortcomings are of three sorts. Firstly, the global health regime is fragmented and dominated by the domestic security priorities of industrialised nations. Secondly, the WHO has been constrained by constitutional country allegiances, crippling reforms and the limited impact of the (2005) International Health Regulations (IHR) framework. Thirdly, the securitization of infectious diseases and the militarization of humanitarian aid undermine the establishment of credible public health surveillance networks and the capacity to control epidemic threats. SUMMARY The securitization of communicable diseases has so far led foreign aid policies to sideline health systems. It has also been the source of ongoing misperceptions over the aims of global health initiatives. With its strict allegiance to Member States, the WHO mandate is problematic, particularly when it comes to controlling epidemic diseases. In this context, humanitarian medical organizations are expected to palliate the absence of public health services in the most destitute areas, particularly in conflict zones. The militarization of humanitarian aid itself threatens this fragile and imperfect equilibrium. None of the reforms announced by the WHO in the wake of the 68(th) World Health Assembly address these fundamental issues.
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Affiliation(s)
- Philippe Calain
- Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, Geneva, 1211 Switzerland
| | - Caroline Abu Sa'Da
- Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, Geneva, 1211 Switzerland
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37
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Riccardo F, Shigematsu M, Chow C, McKnight CJ, Linge J, Doherty B, Dente MG, Declich S, Barker M, Barboza P, Vaillant L, Donachie A, Mawudeku A, Blench M, Arthur R. Interfacing a biosurveillance portal and an international network of institutional analysts to detect biological threats. Biosecur Bioterror 2015; 12:325-36. [PMID: 25470464 DOI: 10.1089/bsp.2014.0031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Early Alerting and Reporting (EAR) project, launched in 2008, is aimed at improving global early alerting and risk assessment and evaluating the feasibility and opportunity of integrating the analysis of biological, chemical, radionuclear (CBRN), and pandemic influenza threats. At a time when no international collaborations existed in the field of event-based surveillance, EAR's innovative approach involved both epidemic intelligence experts and internet-based biosurveillance system providers in the framework of an international collaboration called the Global Health Security Initiative, which involved the ministries of health of the G7 countries and Mexico, the World Health Organization, and the European Commission. The EAR project pooled data from 7 major internet-based biosurveillance systems onto a common portal that was progressively optimized for biological threat detection under the guidance of epidemic intelligence experts from public health institutions in Canada, the European Centre for Disease Prevention and Control, France, Germany, Italy, Japan, the United Kingdom, and the United States. The group became the first end users of the EAR portal, constituting a network of analysts working with a common standard operating procedure and risk assessment tools on a rotation basis to constantly screen and assess public information on the web for events that could suggest an intentional release of biological agents. Following the first 2-year pilot phase, the EAR project was tested in its capacity to monitor biological threats, proving that its working model was feasible and demonstrating the high commitment of the countries and international institutions involved. During the testing period, analysts using the EAR platform did not miss intentional events of a biological nature and did not issue false alarms. Through the findings of this initial assessment, this article provides insights into how the field of epidemic intelligence can advance through an international network and, more specifically, how it was further developed in the EAR project.
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38
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Courtney B, Bond KC, Maher C. Regulatory underpinnings of Global Health security: FDA's roles in preventing, detecting, and responding to global health threats. Biosecur Bioterror 2015; 12:239-46. [PMID: 25254912 DOI: 10.1089/bsp.2014.0046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a range of efforts in support of global health security. This article provides an overview of FDA's global health security roles, focusing on its responsibilities related to the development and use of medical countermeasures (MCMs) for preventing, detecting, and responding to global infectious disease and other public health emergency threats. The article also discusses several areas-antimicrobial resistance, food safety, and supply chain integrity-in which FDA's global health security roles continue to evolve and extend beyond MCMs and, in some cases, beyond traditional infectious disease threats.
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39
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Jappah JV, Smith DT. Global governmentality: Biosecurity in the era of infectious diseases. Glob Public Health 2015; 10:1139-56. [PMID: 25981616 DOI: 10.1080/17441692.2015.1038843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This paper uses Foucault's concept of governmentality to examine relationships between globalisation, the threat of infectious diseases and biosecurity. It draws attention to forms of calculated practices which Foucault notes as technologies of power that aim to foster positive demographic and economic trends in societies through the apparatus of security. These practices are employed at the global level with similar ambitions; hence, we adopt the term global governmentality. We discuss the applications of global governmentality by actors in the global core through the apparatus of security and (neo)liberal economic practices. We then provide examples of resistance/contestation from actors mainly in the global periphery through discussions of viral sovereignty; access to essential medicines, including HIV drugs; and health for all as a human right. We conclude that despite the core-periphery power asymmetry and competing paradigms, these developments tend to complement and/or regulate the phenomenon termed global governmentality, which is made evident by the tremendous successes in global health.
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Affiliation(s)
| | - Danielle Taana Smith
- b Department of Sociology and Anthropology , Rochester Institute of Technology , Rochester , NY , USA
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40
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Abstract
Global health reflects the realities of globalization, including worldwide dissemination of infectious and noninfectious public health risks. Global health architecture is complex and better coordination is needed between multiple organizations. Three overlapping themes determine global health action and prioritization: development, security, and public health. These themes play out against a background of demographic change, socioeconomic development, and urbanization. Infectious diseases remain critical factors, but are no longer the major cause of global illness and death. Traditional indicators of public health, such as maternal and infant mortality rates no longer describe the health status of whole societies; this change highlights the need for investment in vital registration and disease-specific reporting. Noncommunicable diseases, injuries, and mental health will require greater attention from the world in the future. The new global health requires broader engagement by health organizations and all countries for the objectives of health equity, access, and coverage as priorities beyond the Millennium Development Goals are set.
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Affiliation(s)
- Kevin M De Cock
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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41
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De Maio FG, Llovet I, Dinardi G. Chagas disease in non-endemic countries: ‘sick immigrant’ phobia or a public health concern? CRITICAL PUBLIC HEALTH 2013. [DOI: 10.1080/09581596.2013.836589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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42
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Watt NF, Gomez EJ, McKee M. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS. Health Policy Plan 2013; 29:763-73. [DOI: 10.1093/heapol/czt063] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lencucha R. Cosmopolitanism and foreign policy for health: ethics for and beyond the state. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:29. [PMID: 23829176 PMCID: PMC3717113 DOI: 10.1186/1472-698x-13-29] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 07/04/2013] [Indexed: 11/29/2022]
Abstract
Background Foreign policy holds great potential to improve the health of a global citizenship. Our contemporary political order is, in part, characterized by sovereign states acting either in opposition or cooperation with other sovereign states. This order is also characterized by transnational efforts to address transnational issues such as those featured so prominently in the area of global health, such as the spread of infectious disease, health worker migration and the movement of health-harming products. These two features of the current order understandably create tension for truly global initiatives. Discussion National security has become the dominant ethical frame underlying the health-based foreign policy of many states, despite the transnational nature of many contemporary health challenges. This ethical approach engages global health as a means to achieving national security objectives. Implicit in this ethical frame is the version of humanity that dichotomizes between “us” and “them”. What has been left out of this discourse, for the most part, is the role that foreign policy can play in extending the responsibility of states to protect and promote health of the other, for the sake of the other. Summary The principal purpose of this paper is to review arguments for a cosmopolitan ethics of health-based foreign policy. I will argue that health-based foreign policy that is motivated by security interests is lacking both morally and practically to further global health goals. In other words, a cosmopolitan ethic is not only intrinsically superior as a moral ideal, but also has potential to contribute to utilitarian ends. This paper draws on the cosmopolitanism literature to build robust support for foreign policies that contribute to sustainable systems of global health governance.
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Affiliation(s)
- Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Hosmer House, 3630 Promenade Sir William Osler, Montréal, QC H3G 1Y5, Canada.
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Gagnon ML, Labonté R. Understanding how and why health is integrated into foreign policy - a case study of health is global, a UK Government Strategy 2008-2013. Global Health 2013; 9:24. [PMID: 23742130 PMCID: PMC3680218 DOI: 10.1186/1744-8603-9-24] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 05/31/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Over the past decade, global health issues have become more prominent in foreign policies at the national level. The process to develop state level global health strategies is arguably a form of global health diplomacy (GHD). Despite an increase in the volume of secondary research and analysis in this area, little primary research, particularly that which draws directly on the perspectives of those involved in these processes, has been conducted. This study seeks to fill this knowledge gap through an empirical case study of Health is Global: A UK Government Strategy 2008-2013. It aims to build understanding about how and why health is integrated into foreign policy and derive lessons of potential relevance to other nations interested in developing whole-of-government global health strategies. METHODS The major element of the study consisted of an in-depth investigation and analysis of the UK global health strategy. Document analysis and twenty interviews were conducted. Data was organized and described using an adapted version of Walt and Gilson's policy analysis triangle. A general inductive approach was used to identify themes in the data, which were then analysed and interpreted using Fidler's health and foreign policy conceptualizations and Kingdon's multiples streams model of the policymaking process. RESULTS The primary reason that the UK decided to focus more on global health is self-interest - to protect national and international security and economic interests. Investing in global health was also seen as a way to enhance the UK's international reputation. A focus on global health to primarily benefit other nations and improve global health per se was a prevalent through weaker theme. A well organized, credible policy community played a critical role in the process and a policy entrepreneur with expertise in both international relations and health helped catalyze attention and action on global health when the time was right. Support from the Prime Minister and from the Foreign and Commonwealth Office was essential. The process to arrive at a government-wide strategy was complex and time-consuming, but also broke down silos. Significant negotiation and compromise were required from actors with widely varying perspectives on global health and conflicting priorities. CONCLUSIONS As primarily an exploratory study, this research sheds significant light on the global health policymaking process at the level of the state. It provides a useful and important starting point for further hypothesis driven empirical research that focuses on the integration of health in foreign policy, how and why this happens and whether or not it makes an impact on improving global health.
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Affiliation(s)
- Michelle L Gagnon
- Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, Ontario, K1N6N5, Canada
| | - Ronald Labonté
- Canada Research Chair, Globalization / Health Equity, Faculty of Medicine, Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, Ontario, K1N6N5, Canada
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Fourie P. Turning dread into capital: South Africa's AIDS diplomacy. Global Health 2013; 9:8. [PMID: 23497509 PMCID: PMC3599770 DOI: 10.1186/1744-8603-9-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 02/27/2013] [Indexed: 11/18/2022] Open
Abstract
Background In much of the world, President George W. Bush was not admired for his foreign policy and diplomacy. It is therefore ironic that Bush’s single most uncontested foreign policy triumph was an instance of what has now become known as “health diplomacy”. In 2003 Bush launched the President’s Emergency Plan for AIDS Relief, a five-year $15 billion initiative to fight HIV/AIDS, mostly in Africa. The president’s pragmatic health diplomacy may well save his foreign policy legacy. This article argues that a middle power such as South Africa should consider a similar instrumental AIDS diplomatic strategy, to rehabilitate its public health as well as foreign policy images. Discussion This article reflects on the emergence and contemporary practice of health diplomacy. In particular, it explores the potential of niche areas within health diplomacy to become constructive focal points of emerging middle powers’ foreign policies. Middle powers often apply niche diplomacy to maximise their foreign policy impact, particularly by pursuing a multilateral agenda. The literature on middle powers indicates that such foreign policy ambitions and concomitant diplomacy mostly act to affirm the global status quo. Instead, this paper argues that there may well be niches within health diplomacy in particular that can be used to actually challenge the existing global order. Emerging middle powers in particular can use niche areas within health diplomacy in a critical theoretical manner, so that foreign policy and diplomacy become a project of emancipation and transformation, rather than an affirmation of the world as it is. Summary The article first describes the emergence and contemporary practice of health diplomacy; this is followed by a discussion of niche diplomacy, in particular as it applies to the foreign policy agendas of emerging middle powers. It then reviews South African foreign policy and diplomacy, before situating these policies within the context of emerging mechanisms of south-south multilateralism. The article concludes by synthesizing these elements and advocating for a South African AIDS diplomacy, emphasizing its potential to galvanize a global project of emancipation.
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Affiliation(s)
- Pieter Fourie
- Department of Political Science, Stellenbosch University, Private Bag X1, 7602, Matieland, South Africa.
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Hunter A, Wilson L, Stanhope M, Hatcher B, Hattar M, Hilfinger Messias DK, Powell D. Global health diplomacy: an integrative review of the literature and implications for nursing. Nurs Outlook 2013; 61:85-92. [PMID: 22999856 PMCID: PMC7118513 DOI: 10.1016/j.outlook.2012.07.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 06/13/2012] [Accepted: 07/29/2012] [Indexed: 12/02/2022]
Abstract
The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy.
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Affiliation(s)
- Anita Hunter
- Department of Nursing, Dominican University of California, San Rafael, CA, USA.
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Bond KC, Macfarlane SB, Burke C, Ungchusak K, Wibulpolprasert S. The evolution and expansion of regional disease surveillance networks and their role in mitigating the threat of infectious disease outbreaks. EMERGING HEALTH THREATS JOURNAL 2013; 6:19913. [PMID: 23362414 PMCID: PMC3557911 DOI: 10.3402/ehtj.v6i0.19913] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We examine the emergence, development, and value of regional infectious disease surveillance networks that neighboring countries worldwide are organizing to control cross-border outbreaks at their source. The regional perspective represented in the paper is intended to serve as an instructive framework for others who decide to launch such networks as new technologies and emerging threats bring countries even closer together. Distinct from more formal networks in geographic regions designated by the World Health Organization (WHO), these networks usually involve groupings of fewer countries chosen by national governments to optimize surveillance efforts. Sometimes referred to as sub-regional, these "self-organizing" networks complement national and local government recognition with informal relationships across borders among epidemiologists, scientists, ministry officials, health workers, border officers, and community members. Their development over time reflects both incremental learning and growing connections among network actors; and changing disease patterns, with infectious disease threats shifting over time from local to regional to global levels. Not only has this regional disease surveillance network model expanded across the globe, it has also expanded from a mostly practitioner-based network model to one that covers training, capacity-building, and multidisciplinary research. Today, several of these networks are linked through Connecting Organizations for Regional Disease Surveillance (CORDS). We explore how regional disease surveillance networks add value to global disease detection and response by complementing other systems and efforts, by harnessing their power to achieve other goals such as health and human security, and by helping countries adapt to complex challenges via multi-sectoral solutions. We note that governmental commitment and trust among participating individuals are critical to the success of regional infectious disease surveillance networks.
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Affiliation(s)
- Katherine C. Bond
- Former Associate Director for Health, Rockefeller Foundation Southeast Asia and Africa Regional Offices, United States
| | - Sarah B. Macfarlane
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, United States
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Moore M, Bond KC, Gresham L, Rweyemamu M, Chowdhury AMR, Bino S. Promising pathways for regional disease surveillance networks. EMERGING HEALTH THREATS JOURNAL 2013; 6:19961. [PMID: 23362416 PMCID: PMC3557953 DOI: 10.3402/ehtj.v6i0.19961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Bencko V, Quinn V JM. Environmental risk and risk perception management in public health. Health (London) 2013. [DOI: 10.4236/health.2013.53059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Davies SE. The international politics of disease reporting: Towards post-Westphalianism? INTERNATIONAL POLITICS 2012; 49:591-613. [PMCID: PMC7149110 DOI: 10.1057/ip.2012.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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