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Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
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D

Workshop Agenda


GLOBAL HEALTH RISK FRAMEWORK:
GOVERNANCE FOR GLOBAL HEALTH


WORKSHOP SESSION GUIDE

September 1-2, 2015

Wellcome Trust - Gibbs Building, 6th Floor - London, UK


BACKGROUND

Contracted Statement of Task for the
Commission’s Governance Workstream

“The governance for global health workstream will explore global, national, and local capabilities, to include those required by the International Health Regulations (2005), to facilitate the collective action of the governmental, intergovernmental, corporate, and non-profit sectors as they contribute to preparedness and response. . . . The Commission will deliberate and evaluate options to strengthen global, regional, national, and local systems to better prepare, detect, and respond to epidemic diseases. Interrelations between sectors will be studied.”

Overarching Objectives for Governance for Global Health Workshop

  • Mobilize for the Global Health Risk Framework Commission suitable evidence and expert opinion to inform their deliberations around the pros and cons of alternative approaches to improved governance for global health.
  • Illuminate the definition of governance for global health and its scope.
  • Consider the key elements of “good” governance, such as targets and benchmarks, monitoring, transparency, honesty, civil society engagement, and accountability.
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
  • Document key successes and lessons learned from past global infectious disease outbreaks and other public health emergencies and how they may inform preparation and response to future outbreaks and emergencies.
  • Characterize needs, gaps, and barriers in current approaches to addressing global infectious disease outbreaks and other public health threats.
  • Consider compliance-enhancing mechanisms to drive good governance and implementation of existing international norms, such as measures of compliance and monitoring for compliance, incentives for compliance, identifying and working with key actors to improve compliance, and “shadow” reports such as by independent experts and civil society.
  • Consider indicators and metrics that may be used to guide and assess the resilience of the global health infrastructure to future outbreaks and emergencies.

Working Definition of Governance for Global Infectious Disease Control

In the context of infectious disease outbreaks of global significance, governance encompasses a range of integrated policy, information management, command, and control mechanisms for facilitating collective action to achieve the objectives of prevention, detection, and response. Of necessity, these mechanisms integrate actions across intergovernmental organizations, sovereign nations, communities, the corporate sector, humanitarian agencies, and civil society. They operate in not only the realm of health, but also to a variable extent in collateral spheres to include agriculture/food security, diplomacy, education, finance, migration/refugee care, security, and transportation.

Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×

DAY 1
Tuesday, September 1, 2015

Compiling Evidence About Governance for
Global Infectious Disease Control

8:00 – 8:30 AM Registration and Continental Breakfast

8:30 – 8:40 AM Welcome

Jeremy Farrar, Director, Wellcome Trust

David Relman, Chair of the Forum on Microbial Threats, Institute of Medicine (IOM); Professor of Microbiology and Immunology, Stanford University

8:40 – 8:55 AM Victor Dzau, President, National Academy of Medicine: “Developing a Global Health Risk Framework”

8:55 – 9:00 AM Keynote Introduction

David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University

9:00 – 9:30 AM Keynote Remarks

Keizo Takemi, Member of Japanese Parliament: “Governance for Global Health: Engaging Intergovernmental Organizations to Achieve Collective Action”

Session 1: Definition of Governance for Global Health
and Lessons Learned from Outbreaks of the Past

Session Moderator: Ximena Aguilera, Director, Center of Epidemiology and Public Health Policies, Universidad del Desarrollo, Chile

Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×

Goals of Session

  • Illuminate key elements of “good” governance for global health
  • Examine compliance enhancing mechanisms to drive good governance and implementation of existing international norms
  • Synthesize lessons learned from recent infectious disease outbreaks and opportunities to strengthen governance for global health
  • Identify ways in which the International Health Regulations (IHR) can be modified to achieve its intended purpose

Part 1: Elements of Good Governance for Global Health

9:30 – 10:10 AM Presentations

David Fidler, Professor of Law, Indiana University: “What is Global Health Governance in the Context of Recognizing and Mitigating the Threat of Epidemic Infectious Diseases?”

Alejandro Thiermann, President, Terrestrial Animal Health Code Commission, World Organisation for Animal Health (OIE): “Global Health Security Begins by Assessing and Assisting National Capacities at the Animal-Human Interface”

10:10 – 10:30 AM Discussion

10:30 – 10:45 AM Break

Part 2: Lessons Learned from Outbreaks of the Past

10:45 – 11:45 AM Case Study Panel

David Heymann, Head/Chair, Public Health England/Chatham House: “SARS and the 2005 Revisions to the IHRs”

Harvey Fineberg, President, Moore Foundation: “How Well Did the IHRs Work During the H1N1 Pandemic and Why Were the Recommendations for Strengthening the IHRs Not Implemented?”
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Joanne Liu, President, Médecins Sans Frontières (MSF): “Ebola as a Humanitarian and Health Care Crisis: Governance Challenges as Seen from the View of a Key Nongovernmental Organization”

11:45 AM – 12:45 PM Discussion

12:45 – 1:30 PM Lunch

Session 2: Challenges in Governance for Global Health for Fragile States

Session Moderator: Oyewale Tomori, President, Nigerian Academy of Science

Goals of Session

  • Compare and contrast different governance approaches for fragile health systems vs. other areas and identify where new approaches are relevant
  • Identify how to measure and define success of governance for global health for areas with weak political systems and economies
1:30 – 2:10 PM Presentations

Paul Wise, Professor of Pediatrics and Health Policy, Stanford University School of Medicine; Senior Fellow, Freeman-Spogli Institute for International Studies, Stanford University: “The Challenge of Strengthening Health Systems in Areas of Political Instability and Weak Governance”

Mark Heywood, Executive Director, Section27 (South Africa): “An African Perspective on the Challenge of Strengthening Health Systems in Areas of Political Instability and Weak Governance”

2:10 – 2:40 PM Discussion
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×

Session 3: Challenges in Current Design of Global Health Governance

Session Moderator: Margaret A. Hamburg, Former Commissioner, U.S. Food and Drug Administration

Goals of Session

  • Highlight ways the World Health Organization (WHO) and member states can be better equipped to address global outbreaks
  • Discuss recent proposals made to enhance global preparedness and response
  • Identify how global security initiatives and frameworks can work together to boost preparedness and response
2:40 – 4:30 PM Presentations

Margaret Chan, Director General, World Health Organization: “WHO Headquarters Views 18 Months After the Outbreak Was Reported”

Charles Clift, Senior Consulting Fellow, Center on Global Health Security, Chatham House: “Form Should Follow Function: What’s the World Health Organization for?”

Colin McIff, Senior Health Attaché, U.S. Mission, Geneva: “U.S. Government Perspectives on Ways to Make the WHO/UN Health Governance System More Effective and Efficient During Health Emergencies”

Dame Barbara Stocking, Murray Edwards College: “Findings, Conclusions, and Recommendations of the Recently Released ‘Report of the Ebola Interim Assessment Panel’ (July 2015)”

4:30 – 4:50 PM Break

4:50 – 6:00 PM Panel Discussion
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
6:00 – 6:15 PM Concluding Remarks

David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University

6:15 PM Meeting Adjourns
6:30 – 7:30 PM Reception, Wellcome Trust Museum

Speakers, event organizers, and staff

7:30 – 9:30 PM Conference Dinner, Wellcome Trust Museum

Speakers, event organizers, and staff

DAY 2
Wednesday, September 2, 2015

Illuminating Potential Future Mechanisms for Improved Governance

8:30 – 9:00 AM Registration and Continental Breakfast

9:00 – 9:15 AM Summary of Day One

David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University

Session 4: Models of Governance for Global Health

Moderator: Larry Gostin, University Professor of Global Health Law, Georgetown University

Goals of Session

  • Illuminate goals of governance systems considering domains from the international, national, regional, and local levels
  • Compare and contrast four potential models of governance for global health, including key features of organizational structure, funding, legitimacy, authority, and accountability
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
  • Identify a broad array of stakeholders and effective methods for integrating and leveraging partner engagements for strong governance for global health

Part 1: Systems for Governance: How Should They Fit Together?

9:15 – 10:05 AM Presentations

Claude de Ville de Goyet, Consultant to UN and Former WHO/Pan American Health Organization Emergency Preparedness Director: “How Should the Governance Roles of WHO Regional Offices Be Made Fit for Purpose?”

Ron St. John, WHO Consultant: “Observations on Governance in the Provision of WHO Assistance at the National Level”

10:05 – 10:20 AM Break

10:20 – 11:10 AM Presentations

Ben Anyene, Health Reform Foundation of Nigeria: “Governance and the Role of Local Humanitarian Organizations During an Outbreak”

Rebecca Marmot, Global Partnerships, Unilever: “Governance and the Role of Public–Private Partnerships During an Outbreak”

11:10 AM – 12:10 PM Panel Discussion

12:10 – 1:00 PM Lunch

Part 2: Laying Out Some Governance Options: The Work of Concurrent Panels and Debate

1:00 – 1:40 PM Insights from Concurrent Initiatives

Peter Piot, London School of Hygiene & Tropical Medicine: Insights from the Lancet Commission – Harvard–LSHTM Study
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Joy Phumaphi, African Leaders Malaria Alliance: “Observations on the UN Secretary General’s Commission on the Ebola Response”

1:40 – 1:50 PM The Debate: Introduction [10 min for presentation; 10 min for discussion]

Larry Gostin (moderator), University Professor of Global Health Law, Georgetown University

1:50 – 2:10 PM Model 1: A Reformed WHO
  • Charles Clift

2:10 – 2:30 PM Model 2: “WHO Plus.” The WHO with an attached center for humanitarian and outbreak management under the line authority of the WHO Director-General and with strategic, operational, and tactical roles. It combines both strategic and operational missions within the WHO-Geneva culture.
  • Ilona Kickbusch

2:30 – 2:50 PM Model 3: The Executive Agency Model. The WHO as the host for a center for humanitarian and outbreak management operating under the authorities of the UN Secretary-General and executing strategic, operational, and tactical roles. (This taps the expertise of WHO but draws from a higher level of authority for command and control and political support.) It would insulate the center from the WHO culture and the politics of the WHA but derive vast technical benefits.
  • Dr. Yasushi Katsuma, Dean and Professor, Graduate School of Asia-Pacific Studies; Waseda University

2:50 – 3:10 PM Model 4: Independent Entity with Interagency Composition under the Authority of the UN Secretary General.
  • Daniel López-Acuña
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
3:10 – 4:00 PM Panel and General Discussion

Harvey Fineberg (moderator):
Each reactor would have 5 minutes to reflect on the model they favor based on the presentations.

Featured Reactors:

1. Kenji Shibuya, University of Tokyo 2. Ann Marie Kimball, Chatham House 3. Kumanan Rasanathan, United Nations Children’s Fund

4:00 – 4:15 PM Break

Session 5: Other Considerations in Governance for Global Health

Moderator: Chris Elias, President, Global Development, The Bill & Melinda Gates Foundation

Goals of Session

  • Synthesize best practices for translating research and lessons learned into actions for governance for global health
  • Identify financing mechanisms that help mobilize and maintain good governance and steer policy directions
4:15 – 5:15 PM Panel Discussion

Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, World Bank: “The Essential Connection Between Governance and Finance”

Jeremy Farrar, Director, Wellcome Trust: “Governance for Health Research in the Context of Rapidly Emerging Infectious Disease Threats”

Daniel López-Acuña, Former WHO Senior Adviser to the Director-General: “Ensuring Health Security as a Function of Governance”
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
5:15 – 5:45 PM Open Discussion

5:45 – 6:00 PM Concluding Remarks and Adjournment

Eileen Choffnes, Scholar, Board on Global Health, IOM

Ceci Mundaca-Shah, Senior Program Officer, Board on Global Health, IOM

David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University

Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×

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Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
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Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
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Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
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Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
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Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 131
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 132
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 133
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 134
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 135
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 136
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
Page 137
Suggested Citation:"Appendix D: Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2016. Global Health Risk Framework: Governance for Global Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/21854.
×
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Since the 2014 Ebola outbreak many public- and private-sector leaders have seen a need for improved management of global public health emergencies. The effects of the Ebola epidemic go well beyond the three hardest-hit countries and beyond the health sector. Education, child protection, commerce, transportation, and human rights have all suffered. The consequences and lethality of Ebola have increased interest in coordinated global response to infectious threats, many of which could disrupt global health and commerce far more than the recent outbreak.

In order to explore the potential for improving international management and response to outbreaks the National Academy of Medicine agreed to manage an international, independent, evidence-based, authoritative, multistakeholder expert commission. As part of this effort, the Institute of Medicine convened four workshops in summer of 2015 to inform the commission report. The presentations and discussions from the Governance for Global Health Workshop are summarized in this report.

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