Investing in Global Health for Our Future

Dzau, Victor J.; Fuster, Valentín; Frazer, Jendayi; Snair, Megan

doi:10.1056/nejmsr1707974

Cited by 39 publications

(21 citation statements)

References 5 publications

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“…Global health security has been undermined by infectious disease threat events (IDTE) such as severe acute respiratory syndrome (SARS) during 2002–2003, pandemic influenza A (H1N1) in 2009, Middle East respiratory syndrome coronavirus (MERS‐CoV) in 2012, Ebola virus disease in 2014, and Zika virus infection during 2015–2016 (Dzau, Fuster, Frazer, & Snair, ; Morens, Folkers, & Fauci, ; Paules & Fauci, ). These IDTE have caused substantial human suffering, placed considerable pressure on government resources, and inflicted significant economic damage.…”

Section: Introductionmentioning

confidence: 99%

Systemic resilience to cross‐border infectious disease threat events in Europe

Semenza

Sewe

Lindgren

et al. 2019

Transbound Emerg Dis

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Recurrent health emergencies threaten global health security. International Health Regulations (IHR) aim to prevent, detect and respond to such threats, through increase in national public health core capacities, but whether IHR core capacity implementation is necessary and sufficient has been contested. With a longitudinal study we relate changes in national IHR core capacities to changes in cross‐border infectious disease threat events (IDTE) between 2010 and 2016, collected through epidemic intelligence at the European Centre for Disease Prevention and Control (ECDC). By combining all IHR core capacities into one composite measure we found that a 10% increase in the mean of this composite IHR core capacity to be associated with a 19% decrease (p = 0.017) in the incidence of cross‐border IDTE in the EU. With respect to specific IHR core capacities, an individual increase in national legislation, policy & financing; coordination and communication with relevant sectors; surveillance; response; preparedness; risk communication; human resource capacity; or laboratory capacity was associated with a significant decrease in cross‐border IDTE incidence. In contrast, our analysis showed that IHR core capacities relating to point‐of‐entry, zoonotic events or food safety were not associated with IDTE in the EU. Due to high internal correlations between core capacities, we conducted a principal component analysis which confirmed a 20% decrease in risk of IDTE for every 10% increase in the core capacity score (95% CI: 0.73, 0.88). Globally (EU excluded), a 10% increase in the mean of all IHR core capacities combined was associated with a 14% decrease (p = 0.077) in cross‐border IDTE incidence. We provide quantitative evidence that improvements in IHR core capacities at country‐level are associated with fewer cross‐border IDTE in the EU, which may also hold true for other parts of the world.

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Section: Introductionmentioning

confidence: 99%

Systemic resilience to cross‐border infectious disease threat events in Europe

Semenza

Sewe

Lindgren

et al. 2019

Transbound Emerg Dis

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“…It took too long for trials to be planned, vetted, and initiated, and as most of the trials were neither randomized nor adequately controlled, results could not in the end support conclusions about safety or efficacy. This experience should motivate investigators to plan for the inevitable future epidemics during the interepidemic periods and to drive consensus about trial design and conduct among the various research and humanitarian organizations and local communities before the next outbreak, whether of Ebola or another pathogen [41,42]. Otherwise, we may well repeat the disappointing outcomes of the recent Ebola experience.…”

Section: Summary: Promoting Further Conversation and Consensusmentioning

confidence: 98%

Rigorous Clinical Trial Design in Public Health Emergencies Is Essential

Ellenberg

Keusch

Babiker

et al. 2017

Clinical Infectious Diseases

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Randomized clinical trials are the most reliable approaches to evaluating the effects of new treatments and vaccines. During the 2014-2015 West African Ebola epidemic, many argued that such trials were neither ethical nor feasible in an environment of limited health infrastructure and severe disease with a high fatality rate. Consensus among the numerous organizations providing help to the affected areas was never achieved, resulting in fragmented collaboration, delayed study initiation, and ultimately failure to provide definitive evidence on the efficacy of treatments and vaccines. Randomized trials were in fact approved by local ethics boards and initiated, demonstrating that randomized trials, even in such difficult circumstances, are feasible. Improved planning and collaboration among research and humanitarian organizations, and affected communities, in the interepidemic periods are needed to ensure that questions regarding the efficacy of vaccines and treatments can be definitively answered during future public health emergencies.

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“…Furthermore, few funders direct resources at upstream health and inequity determinants, and there is some critique on the role that these international organizations play in creating and exacerbating health inequalities (Mwisongo et al 2016). An illustration of a selective and narrow understanding of global health is the motivation for global health that emphasizes protection of sovereign borders from security threats, protection of trade and economic growth, mobilization of the private sector to address these issues, and development of medical products and technological solutions (Dzau et al 2017) at the expense of a more systems-based approach to health and healthcare globally. Additionally, through their choice of eligibility criteria, funding organizations can also influence opportunities for travel and mobility funding, enabling or constraining reciprocity and equitable access to such funds.…”

Section: Fundersmentioning

confidence: 99%

Human Resources for Global Health

Mogo

Oni

2020

Handbook of Global Health

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Human resources are key to global health. This chapter presents a critical examination of the input, output, and outcomes of global health endeavors and their implications for the creation of global health human resources. In so doing, we challenge the narrow conceptualization of who is considered a global health professional and the perceived "otherness" of global health practice. We encourage (this broader definition of) global health professionals to engage with global health as a discipline for developing the tools that will help them understand how activities at home influence health globally and vice versa. We present recommendations for strengthening the production, quality, distribution, and impact of global human resources for health. Finally, we present the case for health systems that include but are not limited to healthcare systems and include the non-health

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Investing in Global Health for Our Future

Cited by 39 publications

References 5 publications

Systemic resilience to cross‐border infectious disease threat events in Europe

Systemic resilience to cross‐border infectious disease threat events in Europe

Rigorous Clinical Trial Design in Public Health Emergencies Is Essential

Human Resources for Global Health

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