Global health security: the wider lessons from the west African Ebola virus disease epidemic

Abstract

The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security—its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing.

The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

“…Investments in public health systems have frequently been driven by efforts to control infectious diseases such as HIV, polio, and malaria. More recently the US-inspired global health security agenda 225 has driven public health systems development in response to concerns relating to emerging infections with pandemic potential and to bioterrorism.…”

Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014–2016 Ebola Epidemic

“…This epidemic in the three countries and its introduction to seven other countries illustrates how all countries are connected and that a threat in one country is a threat everywhere. Readiness to detect and respond to outbreaks of infectious disease such as Ebola is the goal of the Global Health Security Agenda (GHSA) (17), an initiative supported by countries, government agencies, and international organizations to assist countries with attaining compliance with the International Health Regulations (18) and accelerate progress toward detecting and mitigating infectious disease threats quickly and effectively (19,20). The U.S. government has committed to working in at least 30 countries to implement GHSA, including Guinea, Liberia, and Sierra Leone, where CDC has established new country offices to provide direct technical assistance with implementation.…”

Development assistance for health: critiques, proposals and prospects for change

“…The foundations of the existing system of DAH and ODA were built after the Second World War and decolonization, and were initially framed as 'foreign aid', with recipients in a hierarchical relationship of dependence on donors. Alternative framings have since emerged, including 'cooperation', which implies a more equal relationship based on the principle of mutual benefit; 'national security', based on the argument that infectious diseases or other health threats arising in a foreign country may spread back to the donors' country unless managed at the source; 'global public goods', which emphasizes the responsibility of all states to contribute to the shared benefit of health; 'health diplomacy', which can include the use of DAH to achieve a donor's other foreign policy goals; 'investment', eyeing future commercial relationships to be built between a donor and recipient country; 'restitution', which emphasizes obligations to remedy past and/or ongoing wrongs; 'global solidarity', based on the notion of the emergence of a global society bound together by relationships of interdependence (Commission on Macroeconomics and Health, 2001; Mackintosh et al, 2006;Frenk and Moon, 2013;Heymann et al, 2015;Kickbusch, 2016). Each of these framings implies different institutional arrangements for DAH and is reflected in various reform proposals for the DAH system.…”