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Value of a Global Health Security Index (World Health Assembly Side-Event)

Organized by Multiple Partners or Sponsors

Save the Date
Breakfast Side-Event: Value of a Global Health Security Index
May 23
7:30 AM – 9:00 AM
Intercontinental Hotel, Ballroom B-C
Geneva, Switzerland

RSVP

NTI-Bio, in partnership with the Johns Hopkins Center for Health Security and The Economist Intelligence Unit, will convene a side event at WHA 2018 to discuss the value of a Global Health Security (GHS) Index in reducing the threat posed by emerging infectious diseases. This event will be co-hosted by the Bill & Melinda Gates Foundation and the World Bank Group and has been supported by the Open Philanthropy Projectthe Bill & Melinda Gates Foundation, and the Robertson Foundation.

For questions, please contact Dr. Beth Cameron, Vice President for Biological Policy and Programs (+1 (202) 296-4810cameron@nti.org).

Featured Speakers:

1) Hon. Dr. Jane Aceng, Minister of Health, Uganda
2) Dr. Scott Dowell, Deputy Director for Surveillance and Epidemiology, Bill and Melinda Gates Foundation
3) Dr. Mukesh Chawla, Adviser for Health, Nutrition and Population, World Bank Group
4) Dr. Wilmot James, Visiting Professor of Pediatrics & International Affairs, Columbia University Medical Center

About the Global Health Security Index Project:

The purpose of a GHS Index is to create a national-level assessment that, can be applied to all countries, drawing on publicly available information, measured by an independent non-governmental entity, and informed by a global panel of experts.  The GHS Index framework was developed in consultation with international experts from 12 countries. The framework’s six categories include indicators that assess country capability to prevent, detect, and respond to infectious disease threats, and take into consideration political and socio-economic risk factors and a country’s broader healthcare system.  The GHS Index also draws from internationally-accepted technical assessments, including the WHO International Health Regulations (IHR) Joint External Evaluation and the OIE Performance of Veterinary Services Pathway.

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Getting Local with Global Health Security: A Path Toward Sustainable Action

Organized by
May 21
4:00 PM – 6:00 PM CEST
Club Suisse de la Press, Route de Ferney 106
Geneva, Switzerland

REGISTRATION

*This event will be webcast live*

Protecting the world from infectious disease threats requires that national governments share the responsibility of serving those most in need, but how do countries prioritize their investments in a rapidly changing world?

On the margins of the 71st World Health Assembly, this event will convene global and national leaders for a discussion on how investments in global health security strengthen public health systems, promote universal health coverage, and drive economic growth and local research and development. This event will outline the best case for investment in health security, explore how to scale up innovative programming at the country level, and provide recommendations on increasing country ownership and domestic buy-in for health security.

Speakers will be as follows:

Moderator: Loyce Pace, President and Executive Director, Global Health Council

Opening Remarks: Dr. Tom Frieden, President and Chief Executive Officer, Vital Strategies.

Keynote Speaker: Peter Sands, Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria

Panelists
1) Dr. Naoko Yamamoto, Assistant Director-General for Universal Health Coverage and Health Systems Cluster, World Health Organization (TBC)
2) Dr. Diane Gashumba, Minister of Health, Rwanda
3) Catharina Boehme, Chief Executive Officer, Foundation for Innovative New Diagnostics (FIND)

Closing Remarks: Marian W. Wentworth, President and Chief Executive Officer, Management Sciences for Health

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Diseases Do Not Respect Borders: A Conversation With CDC’s Dr. Rebecca Martin on The Economic Case for Preventing Disease Outbreaks

This blog was originally posted on the Rabin Martin website. It was written by Tina Flores, VP, External Engagement, Rabin Martin and GHC’s Advisory Council member. Rabin Martin is a strategy consulting firm that helps clients be leaders in improving health and access to global health technologies and is a 2018 Global Health Council member.

Dr. Rebecca Martin, Director of the CDC’s Center for Global Health. Source: CDC

Dr. Rebecca Martin is a fixture in the global health community. As director of the CDC’s Center for Global Health, Dr. Martin’s leadership has been a driving force in engaging the public and private sectors to accelerate progress towards disease prevention, detection and response around the world. Dr. Martin and her colleagues at the CDC are also important partners to the Global Health Security Agenda (GHSA) Private Sector Roundtable (PSRT), a coalition of companies that acts as a central touchpoint for industry to mobilize efforts to protect against, detect and respond to disease threats.

PSRT members generate private sector insights to address specific health and development risks and vulnerabilities, identify opportunities to apply the unique expertise and resources of its members, and facilitate industry engagement to strengthen health systems and outbreak preparedness. The CDC provides technical support to the PSRT to ensure alignment with country priorities.

Tina Flores, who leads the PSRT’s secretariat at Rabin Martin, talks with Dr. Martin about some of CDC’s recent research on the effects of pandemic outbreak on the U.S. economy and the organization’s relationship with industry, and gets Dr. Martin’s take on why an ounce of prevention is indeed worth a pound of cure.

Tina Flores: The CDC recently published a series of studies that explore the economic impact of pandemic outbreaks on the U.S.What was the impetus for the studies and why was the focus on impact to the private sector, specifically? 

Dr. Rebecca Martin: We have to start by acknowledging a reality of our world today, that disease knows no borders. Pathogens exploit gaps in the world’s ability to prevent, detect, and respond to existing or emerging diseases, and in today’s interconnected world, diseases can spread from a remote village to major cities in as little as 36 hours.

These studies help make a clear business case for investing in public health capacity building around the world.

The first economic impact study, for example, Relevance of Global Health Security to the U.S. Export Economy, depicts the extent to which the U.S. economy is affected by infectious disease outbreaks in other countries.

1) Using 2015 U.S. Department of Commerce data, CDC assessed the value of U.S. exports and the number of U.S. jobs supported by those exports to a set of countries where CDC supports health security activities.
2) U.S. exports to the countries where CDC is partnering to strengthen and improve health security exceeded $308 billion and supported more than 1.6 million jobs across all U.S. states in agriculture, manufacturing, mining, oil and gas, services and other sectors.
3) These exports represented 13.7% of all U.S. export revenue worldwide and 14.3% of all U.S. jobs supported by all U.S. exports.
4) The economic linkages between the United States and these global health security countries illustrate the importance of ensuring that countries have the public health capacities needed to control outbreaks at their source before they become pandemics. We must all work together to close these gaps to protect the health and safety of Americans and U.S. interests.

Tina: How can these studies help policymakers, at home and abroad, make decisions about resource allocation and further the discussion of how health, finance, trade, and agriculture can work together to prevent and minimize the threat of outbreaks?

Dr. Martin: These studies demonstrate and quantify that even in a country where a disease outbreak does not spread to U.S. shores, it can trigger direct and measurable economic fallout in communities in the United States. Global health security is important for us all, and we are only as strong as our weakest link.

For example, the CDC study, Impact of a Hypothetical Infectious Disease Outbreak on U.S. Exports and Export-Based Jobs, predicted that the hypothetical outbreak would carry a cost inside the United States of between almost $13 million to $64 million if only one country was affected, and that it would quickly escalate as the epidemic spread to more counties, peaking at about $8 billion to $41 billion, if the outbreak were to spread to nine countries.

These results demonstrate that there is value in investing in systems to strengthen the tools and policies in countries for detecting disease at the earliest possible moment, and for responding decisively when an outbreak occurs—value for the country facing the disease threat, and for preventing potential disruptions to markets and associated economic and job losses in the U.S.

The U.S. government strongly supports the Global Health Security Agenda (GHSA) as a mechanism to focus the world on the capacities to prevent, detect, and respond to human and animal infectious disease threats, whether they are natural, accidental, or deliberate.  U.S. government support of the GHSA is truly a whole-of-government effort and is a model for program coordination of health security activities. For example:

1) CDC remains committed to supporting the U.S. Government’s July 2015 pledge of $1 billion to support GHSA capacity building in 17 partner countries over five years.
2) In addition to the $1 billion investment in 17 countries, the U.S. continues to partner with 14 additional countries and the Caribbean Community to make progress toward GHSA targets.
3) As highlighted in the U.S. government’s GHSA Annual Report, published in March 2018, we have shown measurable progress from our investments in global health security, including demonstrated improvements in partner country capacity to detect and respond to health threats faster and more effectively.

Tina: What are the implications for industry– for healthcare companies as well as other sectors?

Dr. Martin: In our increasingly interconnected world, outbreaks can destabilize countries, disrupt economic forces, and affect businesses no matter where they are located.

We know that successful businesses need healthy, productive employees and the presence of disease threats can diminish that essential need. We also know that a disease outbreak—and in some cases even the threat of a disease outbreak—distorts the economy in powerful ways that can touch both global and domestic businesses.

During the Ebola outbreak, for example, imports to the three affected countries—Liberia, Guinea and Sierra Leone—plummeted.  The number of commercial airline flights to the region decreased, providing further disruption to travel and trade. All three countries had rapidly growing economies before the Ebola outbreak, and even into the first half of 2014. By the end of 2014, the World Bank reports that the total fiscal impact felt by the three countries was over half a billion dollars, nearly 5 percent of their combined GDP.

Tina: For many people, global health security is quite amorphous. But disease detection, infection prevention and control, vaccines and supply chains are such a critical part of the global health security equation. What are some of the ways the CDC collaborates or can collaborate with companies and organizations that do this work?

Dr. Martin: No single country, sector or organization can achieve global health security alone. Multi-sectoral collaboration and public-private partnerships are critical to ensuring the world will be ready to prevent, detect and respond to the next inevitable infectious disease outbreak. Businesses and NGOs have a stake in the success of these endeavors―their investments, workforce, and mission is affected positively or negatively by the capacity of a country’s public health system.

For more than 70 years, CDC has worked in partnership around the world to protect the health, safety, and security of the American people, to protect U.S. interests and save lives. We have seen examples of synergies in expertise, knowledge, and technologies―most recently partnering in the Global Health Security Agenda―and for many years in HIVmalaria, and immunization.

For example, in the area of vaccines, CDC is working with Gavi, The Vaccine Alliance and public and private sector partners on vaccine delivery technologies. These innovations are addressing some of the major hurdles to vaccine delivery so that we can eliminate barriers and reach at-risk populations faster and more efficiently than we do today.

Tina: How can investments in global health security strengthen health systems, and especially the health workforce?

Dr. Martin: More than anything else, stopping disease outbreaks early and decisively takes capable, well-trained frontline personnel that can spot, identify and respond to threats correctly. These facts underlie much of CDC’s work abroad, helping train “disease detectives” in countries, and improving the knowledge and capabilities of laboratory technicians, as well as an array of other health care officials ranging from policymakers to those involved in immunization campaigns and other disciplines.

Source: CDC

We have to protect our frontline workers, as they are at increased risk and play a vital role in detecting and rapidly responding to disease. For example:

1) During the Ebola 2014 outbreak, ExxonMobil partnered with CDC Foundation to support improvement to healthcare worker safety and infection prevention and control (IPC) at Nigerian healthcare facilities through the Field and Epidemiology Training Program (FETP).
2) In December 2016, CDC provided technical assistance to Nigeria’s African Field Epidemiology Network as a pilot with 34 Field
3) Epidemiology Training Program (FETP) residents. Shortly thereafter, a health worker at a hospital in southwestern Nigeria died after being admitted with Lassa Fever. Six of the residents who participated in the training investigated this outbreak, helping to prevent the spread of Lassa Fever to any further health workers at the medical center.
4) In 2017, through FETP, CDC trained nearly 2,000 “boots on the ground” disease detectives in partner countries around the world. These disease detectives were among the first on the scene to identify and contain outbreaks of international concern like yellow fever, Ebola, and Marburg virus. FETP graduates form the backbone of the public health effort in many countries, with a high percentage also moving into leadership positions in their respective ministries of health and related organizations. Since 1980, FETPs have trained more than 10,000 disease detectives in more than 70 countries.

Tina: Let’s talk regionally. The recent CDC study exploring the impact of a hypothetical outbreak on the U.S. economy focused on Southeast Asia. What was the thinking around focusing on this region?

Dr. Martin: There are two reasons that Southeast Asia is a fitting region for illustrating the potential economic impact on the U.S. economy:

1) Risk – CDC tracks many disease outbreaks that start in Southeast Asia, from SARS to avian influenza. One reason is that animals and humans live in close proximity to one another and a virus that infects wildlife or farm animals can more easily spread to humans.
2) Trade ties – Southeast Asia is an important economic partner for the U.S. A large-scale infectious disease outbreak in the region presents one of the biggest risks of significantly disrupting the U.S. export economy.

Tina: Africa is a big focus of global health security. In terms of public-private engagement, how does the post-Ebola landscape different from the pre-Ebola environment? Do you see more openness to industry collaboration?

Dr. Martin: CDC has always worked strategically with industries from many sectors. It is clear that the private sector, and especially businesses, can offer a great deal during an emergency response.  For example, The Paul G. Allen Ebola Program, the William and Flora Hewlett Foundation, and Mark Zuckerberg and Dr. Priscilla Chan (through their donor-advised fund at Silicon Valley Community Foundation) provided financial support to help build, furnish, and supply temporary and permanent emergency operations centers in Guinea, Liberia, and Sierra Leone during the Ebola epidemic in West Africa.

All of the emergency structures stood up during the Ebola response, contributed significantly to the control of this epidemic and have been activated for subsequent responses such as measles, vaccine-derived poliovirus, and the recent meningococcal disease outbreak in Liberia.

There is no doubt that in the aftermath of Ebola, the desire to find additional ways to work with industry to advance mutual goals and priorities has expanded. Private sector partners have been some of the most important champions for global health security—and it is a win-win partnership, with countries and companies both benefiting. Private sector expertise, innovation, and capabilities are critical in logistics and supply chain, diagnostics, drugs and vaccines, health, technology, data management and financial services. In addition, companies often have great connections with local communities and their respective workforces, which can play an important role in moving public health goals forward through community engagement.

Finally, it is important to emphasize that partnership opportunities need not be limited to financial support or public health emergencies. Our work with partners―both government and private―have repeatedly demonstrated this point and the mutual benefits, such as in our work related to HIV, malaria, vaccine preventable diseases and global health security.

Shortchanging Global Health Now Will Cost Us Later

This guest blog was originally posted on STAT News’s website. The blog was written by Ashley Arabasadi, Health Security Policy Adviser at Management Sciences for Health.  Management Sciences for Health (MSH) works shoulder-to-shoulder with countries and communities to save lives and improve the health of the world’s poorest and most vulnerable people by building strong, resilient, sustainable health systems. MSH is a 2018 Global Health Council member.

A council worker sprays disinfectant while cleaning up a market in Antananarivo, Madagascar, in October 2017 during an outbreak of plague. Rijasolo/AFP/Getty Images

The White House recently released a report outlining the progress and investments the U.S. has made to make the world safer from the threat of epidemics. But the key to epidemic preparedness and response is the Centers for Disease Control and Prevention, whose operations abroad will radically scale back due to looming funding cuts.

Every global health security expert warns us that it’s not a matter of whether the next deadly epidemic will happen, but when. Withdrawing global health funding now will virtually guarantee that any future outbreak will be far-reaching and economically disastrous; the World Bank estimates that an epidemic such as the 1918 Spanish Flu could cost as much as 5 percent of global GDP.

The CDC faces an 80 percent cut to global health security programs in 39 of the 49 countries in which the agency currently focuses, many considered hot spots for emerging infectious diseases. This could have a negative impact on the health, economy, and security of the U.S. The proposed cuts rightly drew an outcry from a number of health organizations and was thoroughly covered in the media.

In addition to stopping vital CDC programs, the funding cliff jeopardizes other U.S. investments in global health, such as those made through USAID. This money protects Americans at home and abroad, saves lives, strengthens fragile states, and promotes social and economic progress. Programs that invest in women and children, HIV, malaria, and other key areas create more resilient health systems that are the first line of defense against emerging disease threats.

As CDC Acting Director Anne Schuchat has said, “Here in the U.S., we rely on frontline health workers to detect and respond to health emergencies. But we can’t protect our citizens unless other countries can also protect theirs through strong investments in health systems.”

Health workers are indeed the frontline response mechanism for infectious disease outbreaks. And in many parts of the world, their work is supported by international donors, with the United States traditionally leading the pack.

Take Madagascar, which had a severe outbreak of plague last year. Thanks in part to a cadre of community health volunteers working with Madagascar’s authorities and, among other U.S. players, Management Sciences for Health — the nongovernmental organization where I work — a coordinated and swift local response quickly stopped the disease from spreading.

Past investments in HIV/AIDS have trained health workers and strengthened surveillance systems, laboratory networks, and biocontainment capabilities that helped to stop Ebola in its tracks in Nigeria and the Democratic Republic of Congo.

At this point, there should be little resistance to the notion that it is in our country’s interest to fund programs that detect and contain diseases at their source. After all, a pathogen can travel around the globe in as long as it takes to fly a plane from Liberia to Dallas.

The proposed CDC cuts will cost the U.S. much more down the road. The economic burden of epidemics is well-documented: massive expenditures, disrupted global business and supply chains, costly trade implications, and more. Ebola cost U.S. taxpayers a total of $5.4 billion, and it put American lives at risk.

The 2002-2003 outbreak of SARS, or severe acute respiratory syndrome, cost the global economy an estimated $40 billion. According to the World Bank, the next severe pandemic could cost the world economy up to $6 trillion. Additionally, global health security, which relies on the capacity of all countries to detect and control health threats, is critical to the U.S. economy and jobs.

Strategic investments in public and animal health and pandemic preparedness need to be a national security priority of governments and a key commitment from multilateral agencies, development banks, NGOs, academia, and private sector stakeholders worldwide.

When calculated in terms of lives lost, economic meltdowns, and global instability, infectious disease outbreaks can cause catastrophic losses when not stopped at the source. Doing that requires investing in the CDC and USAID, and the programs and people watching and working in vulnerable countries. Now is not the time to scale back.

Global Health Security Agenda Programs Protect Americans from Infectious Disease Threats

This guest blog was originally posted on Centers for Disease Control and Prevention (CDC)’s website. The blog was written by Anne Schuchat, MD (RADM, USPHS), Former Acting Director, CDC. The Centers for Disease Control and Prevention is one of the major operating components of the Department of Health and Human Services. The CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.

Today’s world of increasing interconnectivity and mobility accelerates the shared global risk to human health and well-being. The United States cannot effectively protect the health of its citizens without addressing infectious disease threats around the world. A pathogen that begins in a remote town can reach major cities on all six continents in 36 hours. When the SARS coronavirus outbreak struck Beijing in 2003, we saw a city of 14 million people come to a standstill– empty airports, hotels and restaurants; schools and universities closed; and travel and trade interrupted. When Ebola struck West Africa in 2014, killing 11,000, the tremendous loss of life shook the world. As we saw with Ebola, even the threat of spread of an infectious disease can have a significant impact in the United States. Helping other countries to control disease outbreaks where they start is by far the most effective and cost-efficient way to prevent diseases from spreading to the United States.

Dr. Anne Schuchat visiting the Disco Hill Cemetery in Liberia where many victims of the Ebola outbreak are buried. Picture courtesy: CDC

The Global Health Security Agenda (GHSA), launched in 2014, is a partnership across countries, international organizations, and other partners to build sustainable health systems to prevent, detect, and respond to infectious disease threats whether naturally occurring, accidental, or deliberately released. In fiscal year 2015, the United States committed $1 billion over 5 years to support GHSA. In the three years since this commitment, the United States has strengthened public, human, and animal health systems to prevent, detect, and respond to infectious disease threats. CDC is proud of the notable gains over the first years of implementation of the GHSA.

In 2017, CDC and partners, both governmental and nongovernmental, continued to fulfill the vision of GHSA, providing leadership in health security capacity building programs around the world. The work support by CDC has translated into faster detection, response, and containment of disease threats. This week, the U.S. government launched a report on 2017 accomplishments, titled “Implementing the Global Health Security Agenda: Progress and Impact from U.S. Government Investments.” Yesterday, the White House released a statement about the report.

I want to highlight just a few examples of the accomplishments highlighted in this report. In April 2017, Liberia reported 14 cases, and eight deaths, from an unidentified illness. The country quickly mobilized 14 U.S.-trained Liberian disease detectives, activated the new national Public Health Emergency Operations Center (PHEOC), and deployed a national rapid response team. By happenstance, I arrived in Liberia in early May 2017 for a series of visits to see the GHSA-funded activities. I had the chance to meet some of these first responders – each and every one of whom praised CDC’s frontline disease detective training and talked about how critical this was to their success in controlling this outbreak. Local laboratory testing ruled out Ebola within 24 hours, and CDC laboratories in the United States confirmed the cause as meningococcal disease, a deadly bacterial illness; CDC laboratories also provided reagents to Liberia for further testing. Rapid and coordinated response interventions, such as contact-tracing, limited the outbreak to 31 cases and 13 deaths.

Vietnam’s national EOC was inaugurated in February 2015. Picture Courtesy: CDC

Live bird market in Hanoi, Vietnam, 2017. Picture courtesy: CDC

Additionally, CDC has spearheaded efforts to enhance event-based surveillance (EBS) in U.S.-supported GHSA countries. For example, the EBS pilot platform in Vietnam trained nearly 9,000 public health workers and reported more than 4,000 potential events, 317 of which required a public health response. CDC brings a “One Health” approach to our work in Vietnam to ensure deadly bugs that circulate among animals don’t threaten humans. When I visited Vietnam in August 2017 and spent time touring the live bird market in Hanoi, I was reminded how fine a line exists between animal and human health. In 2018, the Vietnam Ministry of Health is preparing to integrate EBS into its national surveillance system and launch it across the entire country. A recent issue of Emerging Infectious Diseases further highlights accomplishments from CDC and partners to protect Americans and the global community by supporting containment of health threats at their source.

Even if some diseases never reach American shores, they can threaten the US economy. Two recently published CDC analyses show that in addition to tragic loss of life, the next global infectious disease outbreak could harm the U.S. export economy and threaten U.S. jobs. Rapidly detecting and controlling disease threats in other countries is critical to the U.S. economy and jobs.

While we have made progress, there is still much work to do to accomplish the GHSA vision of a world safe and secure from infectious disease threats. CDC’s continued focus on global health security in 2018 and beyond will help ensure that critically important, but still fragile, accomplishments in some of the most world’s most vulnerable places can be sustained and further enhanced in the months and years ahead. By helping other countries protect themselves, we are able to better protect Americans.

Resources:

On Monday, March 12 the Kaiser Family Foundation held an event on the future of U.S. global health security efforts with a panel of leading experts. Watch  Dr. Anne Schuchat, CDC Acting Director’s keynote address at the event. Please see the video of Dr. Schuchat’s keynote address or recording on Facebook.