Global Health Security

Detecting and Responding to Diseases in a New Health Security Paradigm

The New Global Health Environment

Policymakers and the public have placed growing pressures on the global public health community to protect against emering infectious diseases (some only anticipated, like a new pandemic influenza strain); fight HIV/AIDS, tuberculosis, malaria, and a host of "neglected diseases" in the developing world; and expand its mission to include accidents, violence, and chronic illnesses.  Developed nations increasingly emphasize disease surveillance as a strategic tool to detect deliberate or natural disease outbreaks before they harm their own citizens or economic interests.  Since its inception, the World Health Organization (WHO) has served as the coordinating body for international disease detection and response efforts -- mostly aimed at containing simmering local epidemics before they affect travel and trade -- but with little to compel its member states to share information that might hurt their own economic interests.

The Lessons of SARS

Allegations that China concealed critical information in the early days of the 2003 SARS outbreak highlighted the weakness of existing international disease reporting obligations.  In 2005, the 193 member states of the World Health Organization approved sweeping revisions of the International Health Regulations, increasing the stringency of national disease reporting requirements, but also allowing WHO to bypass state parties to collect information about outbreaks.

The Challenges

• Globalization has been accompanied by a focus on truly global public health, rather than merely international disease detection and response efforts, with concommitantly complex demands.
• The number of global public health players has increased dramatically in the last decade, with philanthropists and public-private partnerships independent of national interests and oversight playing major roles.
  
• The effectiveness of the new WHO regulatory framework depends not only on states reporting outbreaks promptly even when the information might damage tourism and trade, but investing the necessary capital to create sensitive disease surveillance systems capable of detecting outbreaks at the local and national level in real time, a daunting technical prospect.
  

The Solutions

To implement policies that meet increasingly urgent global health security demands without sacrificing human security imperatives -- the obligation, as articulated by the WHO constitution, to seek "the attainment by all peoples of the highest possible level of health" -- new governance mechanisms will be required.  The Stimson Center Global Health Governance Program focuses on identifying practical solutions to governance challenges by studying national, international, and global responses to real transnational disease threats (SARS, potentially pandemic influenza and bioterrorism, smallpox, polio, and HIV/AIDS) and placing the unmet needs in the context of current global health security politics.

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