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Eaneff S, Graeden E, McClelland A, Katz R. Investing in global health security: Estimating cost requirements for country-level capacity building. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000880. [PMID: 36962802 PMCID: PMC10021513 DOI: 10.1371/journal.pgph.0000880] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic has highlighted critical gaps in global capacity to prevent, detect, and respond to infectious diseases. To effectively allocate investments that address these gaps, it is first necessary to quantify the extent of the need, evaluate the types of resources and activities that require additional support, and engage the global community in ongoing assessment, planning, and implementation. Which investments are needed, where, to strengthen health security? This work aims to estimate costs to strengthen country-level health security, globally and identify associated cost drivers. The cost of building public health capacity is estimated based on investments needed, per country, to progress towards the benchmarks identified by the World Health Organization's Joint External Evaluation (JEE). For each country, costs are estimated to progress to a score of "demonstrated capacity" (4) across indicators. Over five years, an estimated US$124 billion is needed to reach "demonstrated capacity" on each indicator of the JEE for each of the 196 States Parties to the International Health Regulations (IHR). Personnel costs, including skilled health, public health, and animal health workers, are the single most influential cost driver, comprising 66% of total costs. These findings, and the data generated by this effort, provide cost estimates to inform ongoing health security financing discussions at the global level. The results highlight the significant need for sustainable financing mechanisms for both workforce development and ongoing support for the health and public health workforce.
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Affiliation(s)
- Stephanie Eaneff
- Georgetown University Center for Health Science and Security, Washington, D.C., United States of America
| | - Ellie Graeden
- Georgetown University Center for Health Science and Security, Washington, D.C., United States of America
| | | | - Rebecca Katz
- Georgetown University Center for Health Science and Security, Washington, D.C., United States of America
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Lee CT, Katz R, Eaneff S, Mahar M, Ojo O. Action-Based Costing for National Action Plans for Health Security: Accelerating Progress Toward the International Health Regulations (2005). Health Secur 2020; 18:S53-S63. [PMID: 32004126 DOI: 10.1089/hs.2019.0063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Multiple costing tools have been developed to understand the resources required to build and sustain implementation of the International Health Regulations (IHR), including a detailed costing tool developed by WHO ("WHO Costing Tool") and 2 action-based costing tools, Georgetown University's IHR Costing Tool and CDC's Priority Actions Costing Tool (PACT). The relative performance of these tools is unknown. Nigeria costed its National Action Plan for Health Security (NAPHS) using the WHO Costing Tool. We conducted a desktop review, using the other tools to compare the cost estimates generated using different costing approaches. Technical working groups developed activity plans and estimated component costs using the WHO Costing Tool during a weeklong workshop with approximately 60 participants from various ministries, departments, and federal agencies. We retrospectively applied the IHR Costing Tool and PACT to generate rapid cost estimates required to achieve a Joint External Evaluation (JEE) score of "demonstrated capacity" (level 4). The tools generated similar activities for implementation. Cost estimates varied based on the anticipated procurement and human resources requirements and by the level of implementation (eg, health facility-level versus local government area-level procurement). The desktop IHR Costing Tool and PACT tools required approximately 2 and 8 person-hours to complete, respectively. A strategic costing approach, wherein governments select from a menu of recommended and costed actions following the JEE to develop a NAPHS, could accelerate implementation of plans. Major cost drivers, including procurement and human resources, should be prioritized based on anticipated resource availability and countries' priorities.
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Affiliation(s)
- Christopher T Lee
- Christopher T. Lee, MD, MSc, MPH, is Senior Technical Advisor-Prevent Epidemics, Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY. Rebecca Katz, PhD, MPH, is Professor and Director, Center for Global Health Science and Security, Georgetown University, Washington, DC. Stephanie Eaneff, MSP, is Senior Researcher, Talus Analytics, Boulder, CO. Michael Mahar, PhD, is Public Health Advisor, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Olubunmi Ojo is with the Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Rebecca Katz
- Christopher T. Lee, MD, MSc, MPH, is Senior Technical Advisor-Prevent Epidemics, Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY. Rebecca Katz, PhD, MPH, is Professor and Director, Center for Global Health Science and Security, Georgetown University, Washington, DC. Stephanie Eaneff, MSP, is Senior Researcher, Talus Analytics, Boulder, CO. Michael Mahar, PhD, is Public Health Advisor, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Olubunmi Ojo is with the Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Stephanie Eaneff
- Christopher T. Lee, MD, MSc, MPH, is Senior Technical Advisor-Prevent Epidemics, Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY. Rebecca Katz, PhD, MPH, is Professor and Director, Center for Global Health Science and Security, Georgetown University, Washington, DC. Stephanie Eaneff, MSP, is Senior Researcher, Talus Analytics, Boulder, CO. Michael Mahar, PhD, is Public Health Advisor, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Olubunmi Ojo is with the Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Michael Mahar
- Christopher T. Lee, MD, MSc, MPH, is Senior Technical Advisor-Prevent Epidemics, Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY. Rebecca Katz, PhD, MPH, is Professor and Director, Center for Global Health Science and Security, Georgetown University, Washington, DC. Stephanie Eaneff, MSP, is Senior Researcher, Talus Analytics, Boulder, CO. Michael Mahar, PhD, is Public Health Advisor, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Olubunmi Ojo is with the Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Olubunmi Ojo
- Christopher T. Lee, MD, MSc, MPH, is Senior Technical Advisor-Prevent Epidemics, Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY. Rebecca Katz, PhD, MPH, is Professor and Director, Center for Global Health Science and Security, Georgetown University, Washington, DC. Stephanie Eaneff, MSP, is Senior Researcher, Talus Analytics, Boulder, CO. Michael Mahar, PhD, is Public Health Advisor, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Olubunmi Ojo is with the Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
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Boyce MR, Katz R. Rapid urban health security assessment tool: a new resource for evaluating local-level public health preparedness. BMJ Glob Health 2020; 5:bmjgh-2020-002606. [PMID: 32546588 PMCID: PMC7299020 DOI: 10.1136/bmjgh-2020-002606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 12/21/2022] Open
Abstract
Urbanisation will be one of the defining demographic trends of the 21st century-creating unique opportunities for sustainable capacity development, as well as substantial risks and challenges for managing public health and health emergencies. Plans and policies for responding to public health emergencies are generally framed at higher levels of governance, but developing, improving and sustaining the capacities necessary for implementing these policies is a direct function of local-level authorities. Evaluating local-level public health capacities is an important process for identifying strengths and weaknesses that can impact the preparedness for, detection of and response to health security threats. However, while various evaluations and assessments exist for evaluating capacities at other levels, currently, there are no readily available health security assessments for the local-level. In this paper, we describe a tool-the Rapid Urban Health Security Assessment (RUHSA) Tool-that is based on a variety of other relevant assessments and guidance documents. Assessing capacities allow for local-level authorities to identify the strengths and weaknesses of their local health security systems, create multiyear action plans and prioritise opportunities for improving capacities, effectively engage with development partners to target resources effectively and develop compelling narratives and a legacy of leadership. While the RUHSA Tool was not designed to be used in the midst of a public health emergency, such as the ongoing COVID-19 pandemic, it may also be adapted to inform a checklist for prioritising what capacities and activities a city needs to rapidly develop or to help focus requests for assistance.
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Affiliation(s)
- Matthew R Boyce
- Center for Global Health Science & Security, Georgetown University, Washington, District of Columbia, USA
| | - Rebecca Katz
- Center for Global Health Science & Security, Georgetown University, Washington, District of Columbia, USA
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