This event summary on GHC’s WHA71 side event, Getting Local with Global Health Security: A Path Toward Sustainable Action, was written by GHC member and WHA delegate Jo Anne Bennett.
Speakers at this opening-day session characterized the key to health security in terms of addressing health systems’ endemic problems: absent or insufficient frontline health workers, inefficient supply chains, and poor data systems. In other words, the foundation for preventing epidemics is a well-functioning health system ‘on the ground’ in communities.
A point repeatedly made was the need to get past identifying system weaknesses and take action to ‘close the gaps.’ A common theme was prioritization, specifically the challenge of prioritizing in the context of competing priorities and prioritizing according to available means. Rwanda’s health minister framed this challenge as stepwise moving toward Universal Health Coverage: focusing in communities ‘because that’s where problems are and that’s where solutions must be.’ Community action plans start with a large list of priorities that becomes shorter as actions are taken.
Tom Frieden, President and Chief Executive Officer of Resolve to Save Lives and former Director of the Centers for Disease Control and Prevention (CDC), explained how countries participating in the Global Health Security Agenda can use Joint External Evaluations (JEEs) to help clarify priorities related to core capacities. The few JEEs conducted thus far provide a good news/bad news story: The good news is that progress is possible: countries have improved along some criteria that have not been fully achieved. The bad news is that for some criteria no countries have progressed and some countries show no progress on any criteria. Frieden said the disappointing results called for analysis and action.
Keynote speaker Peter Sands, Executive Director of The Global Fund, took up the call for analysis of the underlying weaknesses. Smart investing, he said, rests on the “right analysis,” i.e., analysis that turns knowledge about gaps to costed action plans. He provided the business case for investing in prevention rather than preparing for response. Using MERS and Zika as examples, he described how the staggering local and worldwide economic impacts of even relatively small epidemics reach far beyond the affected region(s). Smart investing looks at activities that can achieve dual outcomes, not just emergency preparedness. He pointed to the Global Fund as an example of recognizing the links across programmatic silos. Similarly, basic public health activities can be leveraged to strengthen core health security capacity.
Chief Executive Officer at Foundation for Innovative New Diagnostics (FIND) Catharina Boehme’s remarks lent further support to prioritizing prevention over response: the reality is that there is no quick scale-up for diagnostics and no diagnostics are available for six of the nine diseases prioritized by WHO.
Dr. Rüdiger Krech, Director of the Department of Ethics and Social Determinants of Health at the World Health Organization (WHO), reflected on the importance of country ownership and political will. National leadership provides the system-wide view to ensure that all parts of the whole are being addressed. The JEEs simply expose weaknesses. Everyone needs to understand the implications of just one case.