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The GPW: Making the Impossible Work of the World Health Organization Possible

This post was written by Elizabeth Montgomery Collins, MD, MPH, DTM, Global Health Council individual member and delegate to the 71st World Health Assembly in Geneva, Switzerland. 

In 2000 the United Nations (UN) marked a new era in global development policy by adopting eight highly ambitious Millennium Development Goals (MDGs) to be achieved by 2015 to address the world’s most basic development needs, ranging from fighting extreme poverty to fighting HIV/AIDS.  Building on the MDGs’ success, the UN subsequently extended its global development agenda by adopting the Sustainable Development Goals (SDGs), which represent an even broader and more audacious attempt to eliminate poverty, hunger, and disease from the world.  The SDGs are so ambitious, in fact, that many of the 17 goals appear to be virtually impossible to attain.

So, how will the world accomplish these very specific levels of achievement by 2030?

As with the MDGs, achieving the SDGs will require a combination of local, regional, and global action.  Member States are expected to continue the initiatives that enabled them to achieve many of the MDGs, and the UN, through its various subsidiary organizations, will no doubt continue to push for advancement on all fronts; but the question remains:  How, specifically, will the World Health Organization (WHO), as the official UN body charged with overseeing international health policy and progress, tackle those objectives relating to health on the SDG list—in particular, SDG 3, which seeks to “ensure healthy lives and promote well-being for all at all ages”?

WHO Director-General, Dr. Tedros Ghebreyesus (Dr. Tedros), proposes to make this seemingly impossible goal a reality by implementing the step-by-step plan set forth in the 13th General Programme of Work (GPW 13) for 2019–2023.  In GPW 13, Dr. Tedros seeks to transform the vague exhortations of SDG 3 into a concrete, measurable plan of action.

And, he fast-tracked the plan for approval.

In January 2018, after input from UN Member States, other UN bodies, WHO staff, non-State actors, and an Expert Reference Group, GPW 13 was presented as a draft to the WHO Executive Board (EB) at WHO headquarters in Geneva, Switzerland.  With some revisions, the EB adopted GPW 13 for consideration as resolution EB142.R2.  Following discussions of the 46-page draft document A71/4 as provisional agenda item 11.1 in May 2018, the Seventy-first World Health Assembly (WHA71) delegates formally approved GPW 13, one full year in advance of its proposed implementation date.

Many countries made strong statements in support of GPW 13 during the plenary session of WHA71, including Singapore, Jamaica, Poland, and the Republic of Korea, with Denmark stating that “we want these ambitions to be translated into implementable policies.”

In accepting GPW 13 as resolution WHA71.1, the Member States also requested that the Director-General use GPW 13 to form budgets, keep Member States informed of progress, provide contextual guidance and support regarding the plan to regional and country offices, and apprise WHA75 attendees in 2022 of any intention to extend the plan an additional two years, to 2025, in order to align with the UN’s larger strategic plan cycle.

GPW 13 is a plan of work not just for the Secretariat of the WHO, but also for each UN Member State, as well as the various other stakeholders that seek to achieve the SDGs’ objectives.  In fact, the document makes it clear that it is intentionally drafted in almost impossibly ambitious terms because, as Dr. Tedros declared, “it must be.”  And because no single entity can accomplish the goals on its own, GPW 13 by design invites assistance from the private sector and other strategic partners.

This roadmap, subtitled “Promote health, keep the world safe, serve the vulnerable” lays out three strategic priorities that will lead us to the overarching goal of healthy lives and well-being for all:  universal health coverage (UHC), health emergencies, and healthier populations.

Achieving Universal Health Coverage

The primary objective for this priority is to have 1 billion more people benefitting from universal health coverage.  This number was calculated to achieve SDG target 3.8 of UHC for all by 2030; to do that, at least 1 billion more people will need to have access to essential health services in each five-year period between 2015 and 2030.  The focus is on infectious diseases, noncommunicable diseases, and basic provision of reproductive, maternal, newborn and child healthcare.  Another central aim of the plan is to ensure that out-of-pocket healthcare expenses do not cause catastrophic financial hardship or increase poverty among families, households, and countries.  In order for coverage to be truly universal, WHO will particularly emphasize healthcare access for women and children, and people who have disabilities or difficulty accessing care due to poverty, stigmatization, location, or other challenges.  It is estimated that the investment necessary to create an educated workforce to achieve UHC will account for 50% of the WHO’s total budget for SDG 3.

Addressing Health Emergencies

The goal is to better protect 1 billion more people from health emergencies.  The WHO has committed to a new vector control strategy, cooperated with the Coalition for Epidemic Preparedness Innovations (CEPI), and begun work with Member States to form a Health Reserve Force prepared to immediately respond to health-related emergencies.  The architects of GPW 13 recognize that the methods ultimately adopted for measuring readiness and improvements in rapid response mechanisms will need to be developed in consultation with its myriad partners, and that people who are living in conflict zones or who have been displaced will be among the most challenging groups to protect.

Promoting Healthier Populations

To ensure that 1 billion more people enjoy better health and well-being, WHO is pursuing its agenda across 5 tracks:  increasing human capital throughout the entire lifespan, preventing and fighting non-communicable diseases (NCDs) including mental health conditions, accelerating elimination of the most impactful infectious diseases, knocking out antimicrobial resistance, and crushing climate change effects on health.  Perhaps the most difficult goal to measure, the assessment of this priority will be a composite estimate derived from adding multiple SDG life-improving targets, and scoring “life improving interventions” vs. “no intervention” scenarios, to see how much progress is made when improvements are attempted.  In particular, the WHO will seek to discourage unhealthy behaviors and marketing (particularly towards children) involving tobacco, harmful alcohol use, unhealthy diets, and inactivity.

Dr. Anders Nordström, Ambassador of Global Health for the Swedish Ministry of Foreign Affairs and former WHO Acting Director-General, pointed out at the Panel Discussion of the 13th General Programme of Work hosted by The Graduate Institute of International & Development Studies, that the factors which differentiate GPW 13 from the dozen that came before it, are that “now we have the SDGs” and “in this GPW…we have a goal, a number:  3 billion— and this pushes us to measure”.  In other words, GPW 13 establishes specific objectives that will make measurement and incremental progress achievable, and serve as stepping stones toward achieving the ultimate goal of SDG 3, one billion people at a time.

The WHO seeks to accomplish all this by making strategic shifts in leadership, driving public health impact in every country, and focusing “public health goods” (i.e. norms, standards, conventions, regulatory recommendations, assessment reports, open databases, etc.) on impact.

The WHO will also make organization shifts, reshaping its operating model to drive, measure, and manage impact at the country, regional, and global levels; transforming partnerships, communications, and financing; strengthening systems, health information systems, and processes; and changing the work culture.  Collectively these will entail incidental improvements such as paying interns a wage for the first time, paving the way for more representation by developing countries, increasing the number of women in leadership roles, and creating a more transparent, collaborative, and seamless WHO, unified and acting as one with the UN.

As Dr. Tedros stated in his speech at the Opening of the Seventy-first World Health Assembly “our new GPW or strategic plan is not about reinventing the wheel. It’s about making a bigger impact than we already make.”

Although the plan’s efficacy will be difficult to implement and measure, the WHO intends to focus on outcomes and impact.  One interesting way they might check progress towards their overall mission is to measure healthy life expectancy around the globe.

Because all components of the plan interact with and build upon each other, I believe the GPW has the potential to create exponential improvements in healthcare outcomes as each goal advances, culminating in healthier people living in a safer world, five to seven years from now.  That in fact may be the primary benefit of striving for the impossible:  even if we fall short of some of our marks, we can likely still make remarkable progress.

I commend Dr. Tedros’ leadership on establishing GPW 13 and encouraging states to “walk the talk” on these objectives.  The WHO must, through inspirational leadership, motivate individuals, families, communities, nations, and regions to address all of these items at the earliest junctures possible, for individuals at the earliest age possible, while aiming for the highest quality of healthcare and health possible.  One of the most important steps in making the SDGs a reality will be the creation of higher education centers to provide the necessary training of healthcare workers worldwide.  Partnering to build, distribute, and appropriately pay a capable health workforce will contribute substantially to the triple-billion goals.  If the WHO can enlist the help of academia for expertise, the private sector for resources, and civil society for input, including from children and adolescents, the world’s citizens may indeed enjoy healthier and happier lives, and reap the physical and emotional benefits of a health-focused world built from the GPW 13 blueprint.

When Dr. Ilona Kickbusch, Director of the Global Health Centre of The Graduate Institute-Geneva and moderator of the Introduction to the WHA: a briefing for delegates held just before the WHA 71 kicked off, asked about society’s current mindset in relation to the WHO’s master plan, Loyce Pace, President and Executive Director of the Global Health Council, answered emphatically that “[t]he shift from healthcare to health is something that the public can understand.  Civil society is ready for an emphasis on health…and the public wants to access more health.”

Adding, “We are ready.”

In his WHA71 Closing Speech, Dr. Tedros laid out the challenge that ultimately stands before us: “Now it’s time to implement it.  We have no time to lose.  Five years is no time.”

Kwanele Asante: “It’s Our Lives That Are At Stake”

This post is originally published on Johns Hopkins Bloomberg School of Public Health Global Health NOW and is written by Brian W. Simpson

South African lawyer and bioethicist Kwanele Asante is a non-communicable diseases advocate at #WHA71. (Image: Brian W. Simpson)

Kwanele Asante speaks her mind. And what’s on her mind at this year’s World Health Assembly is real action on noncommunicable diseases.

The South African lawyer and bioethicist lives with 3 NCDs and has participated in a half dozen panels. She wants the millions of other people worldwide with similar conditions to get the kind of quality care she receives. “I don’t want to feel this discomfort of knowing that I have access to privileged health care in a developing world context and the majority of my compatriots don’t have the same access,” she said in a Thursday interview following a side event on universal health care. “It’s immoral. Health is something that we need.”

Are you representing an organization here?

I actually came here on behalf of the NCD Alliance. I’ve recently been asked to join their 2018 Global Advisory Committee, but particularly to help them focus a rights-based appeal for the upcoming UN high-level …  meeting on NCDs.

If we’re going to be in a UN context where, from 1946, the preamble to the UN constitution gives this notion of the highest attainable standard as a fundamental human right of every person. That’s their language, and it’s just very ironic that now we’re sitting in 2018 and when population groups around the world are starting to say, “Hi, we’re going to hold you to your rights discourse,” there is a sense of high-level discomfort as though we’re being revolutionary or we’re being unreasonable.

If you had one major goal to achieve here at the World Health Assembly what would that be?

My one major goal is just to emphasize this message of we need to stop with the rhetoric. It’s nice to have a new [WHO Director-General] who says all the right things, but the proof is really going to be what we do when we go to the UN high-level meeting this time around on NCDs, and what amount of global real resources in terms of finance is going to be given to close the current global health disparities.

Do you feel a special responsibility here at WHA? You’re not only speaking for yourself, but for so many other people who suffer from NCDs?

I feel a particular, very personal responsibility actually. I was diagnosed at age 37. I was told that my prognosis was really bad. I wouldn’t see 38, but I’m here. Once I had recovered my health sufficiently I started working with people in informal settlements in South Africa, and I met 3 awesome women who were living with the complications of chemotherapy like I was. The only sad thing is they all didn’t make their 35th birthday. They died. These were mothers, these were hugely intelligent people, very dignified people, but what was different was they didn’t have access to the essential medicines that I have access to.

I feel a very strong sense of moral duty, and I’m really committed to use my legal training and my voice to just ask everybody to sit up and realize that we’re talking about lives here, you know?

You’re obviously impatient to get beyond the words here to action, to results. Will you leave here feeling optimistic at all or do you feel like it’s just a lot more talking?

I feel more optimistic. I’m exhausted. This was my sixth panel, but I saw especially in panels where I had more engagement, I saw a grappling, I saw a discomfort and a sitting up to say, “Wow, yeah. You’re right. Thanks for calling us out. Yes, we commit.” Even with the one panel I spoke on civil society engagement with DG [Tedros Adhanom Ghebreyesus], he said, “We need civil society to hold us accountable.” When I started my first panel I promised them that. I told them that I am going to be one of the people who are going to disrupt this opulence and rhetoric, and I’m gonna make them get real. In some platforms I’ll speak in beautiful English. In some platforms I’ll just be in your face because millions of patients’ lives are at stake.

Really, I’m going to borrow the script from the AIDS movement … this notion of nothing about us without us. Patients’ inclusion, substantive inclusion, that’s what we want. We don’t want this peripheral atonement. We want to be central to what’s happening, because ultimately it’s our bodies and it’s our lives that are at stake.

Back To The Circus: Loyce Pace On The Value Of The World Health Assembly

This post is originally published on Johns Hopkins Bloomberg School of Public Health Global Health NOW and is written by Brian W. Simpson

Loyce Pace, the president and executive director of the Global Health Council, at #WH71 in Geneva. Image by Brian W. Simpson

The World Health Assembly can be crowded, exhausting and chaotic yet Loyce Pace keeps coming back. This is her 11th WHA. The reason? For all its flaws, it’s still the people getting together and trying to solve health problems, she says.

Between meetings and leading events with US Secretary of Health and Human Services Alex Azar and other leaders, the president and executive director of the Global Health Council paused to share her thoughts on key issues, including US involvement in global health, universal health coverage and why the WHA is relevant.

What are your priorities here at this year’s World Health Assembly?

If you just think about the agenda items, the actual Global Health issues that are up for discussion, we’re paying attention to all of them, arguably, given our vast membership and broad portfolio, but we’re especially keen to track things like the [General] Programme of Work.

What do you think about it? It’s a good strategic plan for WHO?

I think so, yeah. It’s ambitious, but it fits Dr. Tedros’s brand. I don’t think he was going to come in and propose or attempt anything small. I know that there are outstanding questions about how it gets done. I think he readily recognizes and accepts that challenge. Related to another thing we care about, he recognizes that WHO shouldn’t necessarily do it alone. I think that’s why he’s so confident in it because it’s not really intended just to be a WHO plan. Granted, it lives here. I think he invites multiple stakeholders to help WHO meet those objectives. That’s the only way you can really hit these triple billion targets, honestly, is by bringing all resources to bear.

Other things you’re following?

There’s still work to be done in the global health security space to be sure, which is why we are still very much tracking the issues. It’s not enough to, for example, identify the problems and gaps. We actually have to fill them. In the conversations we’re having as part of our events this week and with government and other stakeholders, they recognize there are still some shortcomings to capacity and response and that readiness and resilience we’re all striving for across all countries. Not everyone is there yet. That’s the reality.

Obviously, Tedros really emphasized universal health coverage as the theme for the World Health Assembly.

He did.

Do you see that there’s real meat on the bone here about that, or is it more of a slogan that he needs to keep maintaining?

That’s interesting. I do view it somewhat as an overarching framework. That works. I think it works as a rallying cry for all stakeholders to come around. I think there are some outstanding questions to your point of how we get it done. Some of that is fleshed out in the Programme of Work and from other forums as well. I think that’s a very important conversation to have with WHO as well as Member States and civil society.

I want to ask you about the US government and global health. When we last spoke here, last year, there was, obviously, the new US administration and a lot of uncertainty and a lot of rhetoric. Tom Price was here and seemed to make nice with everybody and then he was gone. A lot of change. How has the last year has rolled and what your thoughts on the US government presence here?

Last year was a really, wow … . We still had a lot of question marks around the current administration. I remember us responding to the proposed budgets even while during the week we were in Geneva at WHA, but also being very pleased to see the US have a presence and have Tom Price led the delegation, then Secretary Price, and really speak eloquently to a number of issues including global health security and reiterate the US’s leadership role.

I haven’t been able to meet the current secretary [Alex Azar] just yet, but he will be speaking at our event [Thursday]. I know that he has otherwise made himself available for other dialogs, as has his delegation… . They’re still very much showing up and, again, expressing support for this work.

That enables us to be somewhat encouraged that at least US engagement in this space will continue. How that moves forward, no one can ever know under any administration, but there seems to be support for Dr. Tedros and his agenda and, again, an openness to the broader Global Health community with regards to our agenda and asks.

What would you say to people who work in global health about the World Health Assembly and what happens here? Why is the WHA important? Is it actually relevant to what they do?

It’s a fair question. I ask myself why I keep coming back every year. I think I’ve been coming since 2008, which is a pretty long time to show up for this circus that is WHA. There are a few reasons. One is if we really do see the World Health Organization as the premier institution or agency to guide us all to better health for all, then we have to show up and help them set their agenda or at least inform what that should look like. This is where they decide what’s important, what they’ll do, how they’ll move forward with whom and how and why, arguably. That’s critical.

For the person out there who wonders what happens here, I think that’s what it is. There are people in need all over the world of better health and wellness. And [representatives from] countries from all over the world come together and try to figure that out for their people and for the greater good. That’s why I come back every year.

I think one thing we always want to make sure we see is that it doesn’t just stay stuck here. This cannot just be a conversation in the hallways in Geneva, Switzerland, but something that translates on the ground.

It’s another reason why we come because we feel like we represent the voice of the people to some degree. We even have people like that on our delegation. We have people who have been affected by chronic diseases, for example, or who have other personal stories that they can share with country delegates or as part of events so that we all remember why we’re here.

Do you feel that you and civil society, nonstate actors, in general actually do have a voice, do have the access, do have an impact?

I think that that has … been noticeably different this year. I don’t recall a time when there were so many civil society-focused events. There was a major event last night, which Dr. Tedros attended, that focused on civil society engagement. He had commissioned this taskforce to assess how WHO had been engaging civil society and to what degree that could be improved.

They continue to collect information to advise WHO accordingly, but I think that’s a great sign. It was nice to see that culminate last night with the presentation of those efforts but also a commitment to continue that dialog.

Help Shape the Future of Collaboration of Civil Society with WHO

This post was written by Kate Dodson,  Vice President, Global Health, United Nations Foundation. On May 22, Global Health Council, United Nations Foundation and several partners hosted an official side event on the sidelines of the 71st World Health Assembly intended to foster dialogue and build consensus among Member State delegates, WHO officials, and civil society representatives around how civil society can best contribute – in partnership with WHO and governments at all levels and in varying contexts – to delivering the goal of Health for All. View the live-takeaways on Twitter using the hashtag #Together4Health.

Dr. Tedros at the WHA71 side-event on May 22. Photo: GHC

Early this year, at the request of WHO Director-General Dr. Tedros Adhanom Ghebreyesus, a Task Team was established to explore how to strengthen WHO’s collaboration with civil society organizations at all levels (country, regional and headquarters), and to examine the range of ways in which civil society can help advance the new General Programme of Work, adopted at the 71st World Health Assembly.

 Through a series of workshops, consultations, and a survey of over 150 globally diverse CSOs, the Task Team has identified opportunities to deepen, systematize and capitalize on WHO’s partnerships with CSOs going forward. This presentation outlines very preliminary recommendations, which will be developed and refined through further consultations with the Task Team, WHO, and CSOs more broadly. This Task Team’s preliminary set of recommendations can be found here: http://bit.ly/CSOTaskTeam.

Now is your opportunity to help shape the future of collaboration with WHO. Please review the recommendations and provide feedback via this online survey: https://www.surveymonkey.com/r/BDT5CK3

Partnership was a major theme of discussions last week in Geneva. According to Dr. Tedros, “We need to believe in the power of partnerships. This was the essence of the SDGs. We are lagging behind in reaching these goals and we need to work together4health to move forward.” This is just the beginning – the Task Force needs your input as they advise WHO’s next steps.

Please provide feedback no later than Friday, 8 June. The Task Team will convert these recommendations into a full report, planned for a mid-summer release.

 

 

Local Participation is the Key to Success in Global Health Security

This guest post was originally published by Management Sciences for Health. The post is written by Ashley Arabasadi and is an overview of “Getting Local with Global Health Security,” a World Health Assembly side-event co-sponsored by partners under the Global Health Security Agenda Consortium including MSH, the Global Health Council, Resolve to Save Lives at Vital Strategies, Nuclear Threat Initiative, PATH, the Global Health Technologies Coalition, the Global Health Security Agenda Next Generation Network, and US Pharmacopeia. 

Loyce Pace of the Global Health Council moderates an expert panel at the WHA71 side event in Geneva, May 22, 2018. Panelists included Dr. Diane Gashumba, Rwanda’s Minister of Health; Catharina Boehme, CEO of the Foundation for Innovative New Diagnostics; and Rüdiger Krech, Director of Health Systems and Innovation at WHO. Photo credit: MSH

Is the world safer today from the threat of infectious diseases than it was a generation ago?

It is true that we have more tools at our disposal: better surveillance and diagnostic systems, stronger frameworks and regulations, such as the Global Health Security Agenda and Joint External Evaluations (JEE), and a deeper understanding of how diseases spread and what is needed to stop them. It is also true that climate change, deforestation, population growth, and our proximity to farm and wild animals are making the threat of epidemics greater than ever before. Although the challenge is great, we have the knowledge to solve it. So what do we need to do?

This is the question we set out to answer during a discussion on the sidelines of the 71st World Health Assembly in Geneva last week. Industry experts, including Dr. Tom Frieden, President and CEO of Resolve to Save Lives, an initiative of Vital Strategies; Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Dr. Diane Gashumba, Rwanda’s Minister of Health; Rüdiger Krech, Director of Health Systems and Innovation at the World Health Organization; and Catharina Boehme, CEO of the Foundation for Innovative New Diagnostics, engaged a room of more than 200 people on what they see are critical gaps—and how to fill them—in global health security.

Knowledge is King

“Three years ago, we were flying blind,” said Dr. Frieden, reflecting on the progress the world has made in strengthening our capacity to prevent, detect, and respond to infectious disease threats. “There was no information about which countries were ready, what they were ready for, or what needed to be done.” While we’ve made important progress in understanding where the gaps are and how to address them, says Frieden, we’re far from filling those gaps.

To date, more than 76 countries have completed the JEE process, and a few dozen of them are developing national action plans for health security. However, virtually none have costed these plans, identified necessary resources to implement programs, or established sustainable systems to close gaps and stop outbreaks at the source.

Frieden signaled where the gap is greatest: “Countries in Africa have the furthest to go and require the greatest partnership, following the leadership of countries like Rwanda, which are in front of implementing effective programs.”

The better we understand the gaps in a country’s capacity to prevent, identify, and fight infectious disease outbreaks, the better positioned we are to implement the right interventions to strengthen health systems in support of health security. But we need to move from awareness into action.

Money Motivates

“The number of infectious disease outbreaks is going up,” Peter Sands said. “This is not a problem that is going away as mankind gets bigger and richer. This is a problem that seems to be increasing in magnitude.”

“Although we appear to be getting better in controlling the mortality impact of such outbreaks because of the advances in medical science, we actually appear to be getting more vulnerable to the economic impact,” Sands continued. Fear of an outbreak travels fast, and the behavioral consequences of that fear are extremely powerful and can disrupt economies, even in countries where the disease never appeared.

The challenge is to recognize the cost of epidemics and prepare locally in advance. We must invest now in prevention and preparedness or pay later in lost lives, closed businesses, and disrupted economies.

Prepare Locally

Poor planning and preparation leaves populations vulnerable to illness and undercuts efforts to treat patients and curb new infections. Each country needs to understand its weaknesses so they can start addressing them right away.

Rwanda, for example, recently finished its JEE.  “Each country has to adapt global health security work to its own specific situation,” said Dr. Gashumba, reflecting on the process. “Sometimes it is very difficult to make priorities, especially when you have lot of health and social issues . . . the strategy we adopted is to focus everything on the ground because the issues are on the ground, but also the solutions are on the ground.”

If we are to get local with global health security, we must get local in context and recognize that the threats facing communities today may be endemic diseases, like malaria, tuberculosis, and HIV. Active prevention and constant readiness must break down silos and follow an integrated and holistic approach to health.

Better Diagnostics

The ability to quickly and accurately diagnose an infectious disease where it starts, at the community level, can make or break an epidemic. According to Catharina Boehme, diagnostics is a “blindspot” in global health security. “Effective, affordable diagnostics is critical to every country’s surveillance and response system . . . and diagnostics is one of the pieces that is absent in many of the countries that would be most in need to have early response and preparedness mechanisms.”

She continued: “For six of the nine blueprint pathogens, we have no diagnostics available at all, and even when diagnostics exist, health systems are rarely equipped to deploy them when needed.”

Early response, aided by efficient diagnostics, could save countless lives and billions of dollars every year. According to Boehme, only one laboratory in all of Africa (Senegal) today can confirm yellow fever. For Ebola, she says, despite progress, it took three months in 2014 to diagnose it. “Now in the current Ebola outbreak in DRC, we’re faced with a situation where there’s again a major access problem to diagnostics.”

This is an area where the world clearly hasn’t made enough progress over the years compared with vaccines, says Boehme. “There’s no manufacturing capacity in place to scale up diagnostic manufacturing when needed.” Local partnerships, sample sharing, clinical trial capacity in countries, and local R&D are also lagging far behind. Speaking about the progress made by global vaccine initiatives, she says, “it wouldn’t take much money to leverage these same mechanisms towards some diagnostics.”

A Political Choice

Epidemic preparedness is within any country’s reach, said Rüdiger Krech. But in the end, it’s a matter of political choice. “By and large we know what to do. It’s not that we can’t afford it. We can afford it. That is why it’s a political choice.”

“There will be outbreaks and epidemics if you have weak health systems,” Krech said. “For quite some time, we’ve tried to address the low-hanging fruit, which is disease-specific programs, and we’ve always thought that this was done on the basis of well-functioning health systems, but as we’ve seen, that is not the case.” To make real progress, he says “ We need to much better align the JEE and the Global Health Security Agenda with what’s actually going on in health systems.”

No matter where you live in the world, the risk is universal. To stop outbreaks at the source and prevent threats from becoming epidemics, local preparedness is key. We know that bridging the gap between awareness and action requires us to engage citizens, communities, frontline health workers, and those working with animal populations in the direct reporting of suspected outbreaks. It also requires having in place the tools and skills needed for an effective and efficient response that ensures essential services remain in place when battling an outbreak. The challenge now is to persuade government leaders that preparedness is worth the price tag.

Read more about this event from Global Health NOW: https://www.globalhealthnow.org/2018-05/local-path-global-health-security