Jhabindra Bhandari

Global health is broadly a field of study, research and practice that places a significant priority on achieving equity in health for all populations. In principle, it is about achieving better health outcomes for vulnerable populations and communities around the world. The health interventions largely aim at eliminating health disparities in low-resource settings through research, education and collaborative approaches.

Emerging challenges
Obviously, the global health has a particular focus on broad and multi-disciplinary approach to better understand emerging health challenges, considering social, cultural, economic, political and environmental factors that have profound impacts on health inequities and social justice. The transition from international to global health governance requires aligning the competing values, interests, and motivations of multiple actors towards a coherent governance framework that effectively addresses emerging and re-emerging global health challenges.
In this context, global health security is the existence of strong and resilient public health systems that can prevent, detect, and respond to infectious disease threats. The concept of global health security largely refers to the protection of individuals and societies from acute public health events worldwide.

More significantly, the global health security underpins the current framework for international preparedness and response to emerging infectious diseases. The landscape of global health security has profoundly changed due to globalisation, urbanisation, migration, cross-border travel and trade. Therefore, the global health risk factors need to be critically reviewed for designing cost effective health interventions that help address the immediate health care needs of poor and vulnerable communities.

In order to meet the commitments under International Health Regulations (2005), the global health security agenda demands concerted efforts to strengthen national public health capacities to prevent, detect, and respond to infectious disease threats around the world. According to WHO, through IHR (2005), countries have agreed to build their capacities to detect, assess, and report public health risks and emergencies that can have devastating impacts on human health and economies.

More importantly, strengthening global health security requires national ownership in terms of mainstreaming the IHR (2005) into health systems in order to significantly advance universal health coverage by establishing a multi-pronged and sustainable approach for preparedness and effective response during health emergencies. The regulations will help build and maintain core public health capacities for disease surveillance and response.

In the recent years, health services in many developing countries are struggling to both tackle COVID-19, and provide essential health care services for populations. The pandemic has badly threatened to set back hard-won global health progress achieved over the past two decades - in combating a range of infectious diseases and improving maternal and child health.
In an age of global pandemics, no country can achieve public health on its own. Health security planning is absolutely needed. Therefore, there are critical needs of strengthening national capacities on readiness, preparedness and timely response of the pandemics and other health emergencies. Building resilient health systems is a top priority for sustained response to the COVID-19 pandemic and other health emergencies.

Risk Communication and Community Engagement (RCCE) is a new strategy that enables individuals and communities to make choices and take actions to protect themselves, their families and communities from life-threatening health hazards. This approach promotes information dissemination and feedback mechanisms, and enables the community members to make informed decisions to protect themselves and their families by adopting and maintaining healthy behaviours.

The pandemic has taught us a good lesson that no one is safe until everyone is safe. However, more consistent efforts are urgently needed to protect poor and the most vulnerable communities against health emergency risks in rural and remote areas. As a matter of priority, many developing countries continue their efforts to achieve equitable access to safe and effective vaccines, tests and treatments and ensure the health systems are capable of delivering the health services.

In many countries, Health Emergency Operations Centres (HEOCs) have been instrumental in planning and management of public health emergencies and relief activities. Therefore, the HEOCs are becoming more and more recognised as a means for effective national and international collaboration in preparing for and responding to the public health events and emergencies. For example, the role of HEOCs at the federal and province levels has been crucial in responding the pandemics and other health emergencies.

While the international commitments to advance universal health coverage and Sustainable Development Goals (SDGs) are gaining momentum, there are incredible challenges to monitor and address health inequities related to critical issues around income, gender, ethnicity, education, occupation, disability, living in rural or urban areas. In order to harness the potential of global health, strengthening the capacity of developing countries in health data and information systems is necessary to report on progress towards the health-related SDGs.

Delivery platforms
Apart from the revitalised efforts to contain communicable diseases, concrete policies and strategies are equally needed to enhance global access to interventions for the prevention, control, elimination, eradication of neglected tropical diseases, including some zoonotic diseases. To this end, a coordinated approach is important to integrate delivery platforms, mainstream with local health systems, strengthen national capacity, and mobilise regional and global resources.

Undoubtedly, there is an emergent need for evidence driven resilient health systems to address diverse challenges of global health security. The health systems need to develop innovative ways to harness the principles of health equity, right to health, multi-sector approach, partnership, and universal access to health care within a socio-political context. Creating these systems will require not only sustained financial investment but also shared values of cooperation, collective responsibility and equity.

(PhD in global health, Bhandari writes on health and development issues.)