Four Pillars Part 1: Global Health Security

Dear GHC Community,

Last month, I laid out Global Health Council’s (GHC) four priorities for the next year. In the coming weeks, I will be taking a deeper look at each individual pillar beginning with global health security.

At our most recent Global Health Landscape Symposium, GHC called for a new definition for global health security; something we believe is long overdue. The current paradigm, relies heavily on national security as the primary driver of the U.S. global health funding agenda. This approach, which conflates health security with national security, was first introduced with the HIV/AIDS epidemic, as wealthier nations began to see how public health crises in other countries could be detrimental to the safety of citizens at home. This has become even more pronounced during the COVID-19 pandemic, which has served as a painful reminder that a single health condition can disrupt the entire societal structure. 

Despite the collective trauma of the past two years, there are indications that we have not yet learned our lesson. Congress has failed to provide supplemental funding for the U.S.’s role in the global COVID response, despite USAID’s warning that it is quickly running out of money for these efforts. As the Biden Administration plans for its second COVID Summit on May 12, these actions beg the question: is the U.S. living up to its promises in helping to ensure the world is secure from the pandemic? And how will our current actions hurt us in the face of current and future global health crises?

National security cannot be the primary justification for global health security decisions. This approach is not only unsustainable but also unjust. Responding to health emergencies, rather than planning and preventing them, results in unpredictable funding. In turn, this leads to a repeat cycle of panic and neglect rather than long-term, sustainable solutions. As attention is diverted away from what high-income governments consider less immediate health challenges, the support for investing in comprehensive public health needs will be lacking. Middle and lower-income countries will be left to pay a disproportionate price.

Most importantly, basing global health decisions on national security is a myopic approach that fails to include the critical concerns of human rights, equity, dignity, and thriving development. These must all be central to any actions governments and multilateral agencies take to further global health security. 

How will we make this new definition of global health security actionable? Certainly, funding is a key component, but not the only one. Last week, GHC hosted a town hall with Dr. Atul Gawande, assistant administrator of USAID’s Bureau for Global Health. Dr. Gawande’s long-standing focus on primary health centers as a critical component of global health, along with USAID’s efforts to increase locally-led development, are also important pieces of the global health security puzzle.

Other puzzle pieces were highlighted in GHC’s recent report, From Security to Solidarity. In it, we called for specific actions related to global health security including: 

  • Ensuring that low- and middle-income countries, as well as civil society, are involved from the outset as policy and funding decisions are made;
  • Placing greater emphasis on human rights;
  • Considering the human security needs of a person or population, rather than only the needs of the state.

The recent failure of a global COVID-19 funding package are an indication that we have our work cut out for us in terms of redefining global health security. Doing so will require all of our efforts. So, watch this space – as one of GHC’s four focus areas, this is a topic we will revisit often in the coming months. We look forward to working with this community to make global health security more multidisciplinary, holistic, and centered on the safety and security of all people

All the best,
Elisha Dunn-Georgiou

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