Momentum for global health security

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This speech and the US-WHO Memorandum of Understanding that it cited signal a formal recognition of global health security — a commitment to improve both population health and the security of nations. 

Global health security recognizes that early detection and response to health emergencies anywhere, built on a foundation of strong public health systems everywhere, can mutually benefit  population health  and national, regional and international security.  Historically, countries have focused on measures to defend only their own people; global health security represents a shift from a strategy of isolation to one of international cooperation.  

Support for this concept has coalesced over the past decade, requiring political will that transcends silos of defense and development.  In the U.S., agencies that focus on security and foreign policy now include public health among considerations of political and economic stability.  Initiatives to help partner states build their disease surveillance and response capacities are supported not only by health agencies, but by the defense, development and diplomacy communities.  

The U.S. does not stand alone in this whole of government approach.  In 2005, WHO’s Member States acknowledged the need for new tools to confront health threats that can, and do, spread across borders thanks to commonplace international travel, with potentially catastrophic effects.  By adopting the revised International Health Regulations, 194 State Parties agreed not only to report health crises transparently and quickly but also to establish the capacities needed to detect, report, and respond to public health emergencies of international concern.
In recent years, the U.S. and its partners have explored avenues to strengthen disease surveillance networks through the G-8 Global Partnership, UN Security Council Resolution 1540 implementation activities, and under the aegis of the Biological and Toxin Weapons Convention.   

This securitization of health is not without controversy.  Global health stakeholders worry that the focus on emerging disease threats could divert attention from the more immediate disease burdens borne by the world’s most vulnerable populations.  Some of their counterparts in security remain skeptical of non-traditional security issues not amenable to military solutions.   Nonetheless, the question of where public health fits into foreign policy discourse is not likely to disappear, given the globalization of risk factors for disease. 

 
This year, a high-level summit under the UN General Assembly addressed the global agenda for non-communicable diseases such as cancers, cardiovascular and respiratory diseases, and diabetes – disorders which do not threaten pandemic spread, but which take an enormous toll on economic productivity worldwide.  Leaders cautiously endorsed a strategy for pursuing “best buys” in prevention and early treatment, but skirted commitments to specific metrics in a time of global economic uncertainty. 

This very reluctance illustrates just how much perceptions of global health needs and the potential for action have changed.  Donor states may have demurred, but no one questioned whether global health initiatives on a grand scale are possible.  As the 2012 deadline for implementation of the International Health Regulations approaches, the U.S. and its partners have stepped up efforts to help countries build public health capacity around the world to improve population health and national security.  

The high level political attention to make global health security a real platform for action is there. Agreements are in place, and the world is ready.  The key is to invest in stronger global public health systems between, rather than only during, emergencies – and to use the growing evidence base to make the most of existing resources.  The community of public health and medical practitioners, donors, and foreign policy experts around the world must seize this political opportunity.  This is not a time to hesitate.

Julie E. Fischer is a Senior Associate at the Stimson Center; Rebecca Katz is an Assistant Professor at the George Washington University School of Public Health and Health Services.  Fischer and Katz co-direct the project “Global Biosecurity, Local Action.”