GLOBAL HEALTH RISK FRAMEWORK TASK FORCE:
GLOBAL GOVERNANCE FOR HEALTH—A WORKSHOP
The current Ebola epidemic in West Africa underscores the strengths and challenges of the global public health governance structures established, ostensibly, to be mobilized in an instant to detect and respond to such public health epidemics anywhere in the world. On August 8, 2014, the World Health Organization (WHO) declared the West Africa Ebola crisis a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR). The IHR requires countries to develop national preparedness capacities, including the duty to report internationally significant events, conduct surveillance, and exercise public health powers, while balancing human rights and international trade. The IHR are legally binding regulations (forming international law) that aim to (a) assist countries to work together to save lives and livelihoods endangered by the spread of diseases and other health risks, and (b) avoid unnecessary interference with international trade and travel. The purpose and scope of the IHR 2005 are to prevent, protect against, control, and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade (Art. 2, IHR 2005).
Beyond the near-term challenge of ending the Ebola outbreak, this
public health event has demonstrated that the international framework for managing global public health events falls far short of the need. Governance structures, intra- and interinstitutional and across sectors, have been dysfunctional. Partly as a result of this, the Ebola outbreak grew for months before being recognized as a global threat. This has had a catastrophic health, economic, and social impact on Guinea, Liberia, and Sierra Leone, and it has threatened nations far beyond. Financial and human resources to end the outbreak have been slow in arriving and insufficient. Surveillance and other information systems have not been up to the task. Potentially life-saving products have also been delayed. Over the past 40 years globally significant outbreaks of HIV/AIDS, influenza, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and other infections have also identified many of these weaknesses, but the political will to provide the systems needed to implement a robust global public health framework has failed. As a result, countless lives have been lost, and billions of dollars in economic damage has been incurred.
Statement of Task
Building on earlier workshops on SARS in 2002, the H1N1 influenza pandemic of 2009, the emergence of MERS coronavirus in the Arabian Peninsula (2014), and the Ebola epidemic in West Africa (2015), an ad hoc committee will host a 2-day public workshop to inform the Forum on Microbial Threats and other participants about challenges and opportunities regarding global governance for health during infectious disease emergencies. The public workshop will feature invited presentations and discussions that may address such potential topics as
- Who is primarily responsible for the surveillance, detection, and reporting of a zoonotic infectious disease (ID) outbreak?
- Who is primarily responsible for assembling and deploying the materials and resources for responding to an ID outbreak before it is declared to be a public health emergency of international concern (PHEIC)?
- Where will these resources come from?
- Who will be responsible and accountable for ensuring that the right resources reach the areas most in need at the right time?
- Who will be responsible for the technical training of health care workers—both in-country and external to the affected area—regarding the appropriate care and treatment of the ill, the worried well, and the survivors of an epidemic of a dread disease?
- What is the role(s) of civil society organizations in responding to an ID outbreak?
- Are existing legal authorities for the surveillance, detection, reporting, and response adequate to address infectious disease emergencies?
- What reforms might be needed to improve the efficiency and effectiveness of the global response(s) to future ID epidemics/pandemics?
An ad hoc committee will plan and conduct the 2-day public workshop and an individually authored summary of the workshop will be prepared by a designated rapporteur in accordance with institutional policy and procedures.
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