March 28, 2018

Event Briefing: Policy And Global Health Security

Over the past few weeks, HSP Intern, Libby Cha has attended various events in Washington, D.C. relating to health security. Below are her key take-away messages from each:

February 26, 2018 Ready or Not: Protecting Public Health from Disease, Disasters and Bioterrorism - Trust for America’s Health Congressional Briefing Presentations by John Aeurbach, President and CEO of TFAH; U.S. Congresswoman Debbie Dingell (MI-12); Lillian Riviera, RN, MSN, PhD, Administrator/Health Officer of Florida Department of Health in Miami-Dade County; and Karen Remley, MD, MBA, MPH, FFAP, CEO/Executive Vice President of the American Academy of Pediatrics. Key Take-Home Points: After listening to all four presentations, it was evident that public health preparedness and response efforts must have robust systems in place, and that funding is critical for effective capacity building. The Trust for America’s Health (TFAH) annual report highlights what is currently known about our nation’s preparedness and offers recommendations for improvement. The issue report recommends reforming baseline abilities to diagnose, detect and control health crises: foundational capabilities; supporting stable and sufficient funding for ongoing emergency preparedness; supporting global health security; and maintaining a robust, well trained public health workforce. Speaker Lillian Riviera analogized, “It wasn’t raining when Noah built the arc,” meaning we need to devise solutions ahead of disasters. In 2006, The Pandemic and All-Hazards Preparedness Act (PAHPA) was passed, and authorized funding through 2018 to improve public health and medical preparedness, as well as emergency response capacities. The PAHPA act is set to expire on October 1st, 2018 and speakers urged attendees of the pressing need to advocate for its reauthorization. Funding is critical for capacity building, and there is a huge need for investments that are timely, flexible and discretionary to maintain strong systems. Speaker Karen Remley explained, “Supplemental funding for emergencies is not enough” and Congresswoman Debbie Dingell stressed that with funds eroding, the government must take steps to make real improvements. PAHPA is so important because of its impact in the face of national health security issues posed by natural disasters and epidemics.

March 6, 2018 Roundtable with Robin Davies of the Indo-Pacific Health Security Initiatives This discussion provided a unique perspective on the global health environment in the Asia/Pacific region and Australia’s engagement with the Global Health Security Agenda (GHSA). Australia’s Health Security Initiative works to build regional capacity in the Asia/Pacific region by setting the dialogue through the investments they make in capacity building, R&D, and outbreak response. Key Take-Home Points: The Australian government is committed to advancing the goals and objectives of the GHSA through its Health Security Initiative (HSI). This will be possible through multilateral engagement, promotion of research and development of practical capacity building, and by leveraging resources from existing regional players. Additionally, the Australian HSI is working to blend domestic and international efforts to create a mutual investment towards the GHSA. They will focus on making use of strong domestic institutions as an entry point into broader action. The discussion quickly shifted focus to Australia and U.S. relations on global health security. From the Australian perspective, the U.S. government has exhibited strong signs of commitment yet little budgetary action. With proposed cuts to the budgets of the CDC and USAID programs – which promote the GHSA – the Australian government pledged to step in when necessary. However, an attendee cautioned Davies about the rhetoric surrounding this subject, warning that if it appears that the Australian government is stepping in, the current U.S. Administration may feel less accountable and repeal completely. These discussions are critically important because they allow the international community to better align its approaches in pursuit of the same overall goal.

March 12, 2018 U.S. and Global Health Security at a Time of Transition - Henry J Kaiser Family Foundation This event focused on the future of global health security, and included a keynote address from Anne Schuchat, Acting Director of the CDC; followed by a panel discussion with Beth Cameron, VP for Global Biological Policy and Programs, Nuclear Threat Initiative (NTI); Rebecca Katz, Associate Professor and Co-Director of the Center for Global Health Science and Security at Georgetown University; Nancy Knight, Director of the Division of Global Health Protection, CDC; and J. Stephen Morrison, Senior VP and Director of CSIS Global Health Policy Center. Key Take-Home Points: Throughout the first half of the GHSA, there have been many accomplishments in capacity building and rapid response to emerging infectious disease outbreaks. It is unclear, however, what the future of U.S. engagement in global health security will look like. Although there has been positive commitment from political figures, the future of global health security ultimately depends on monetary investments. There is bipartisan interest stemming from the memory of Ebola and SARS outbreaks, however these investments have subsided dramatically along with the outbreaks themselves. With budget uncertainty and programmatic cuts, backsliding has already begun. Fortunately, the impacts are not so deep as to be irreversible yet, thus it is imperative that we make amends now. GHSA 2.0 will focus more exclusively on tracking progress and commitments. The U.S. aims to apply pressure on countries that do not yet have capacity, however it is important that we determine where our presence would be most strategic and impactful. This brings with it new challenges, like balancing funding for a risk that is unknown, and funding broader global efforts to strengthen less tangible networks.  

Despite different programmatic focuses across these three policy events, a common theme was still prevalent. There is a critical need for increased, stable and sustained investments to bolster health systems. Failure to do so will undoubtedly lead to an increase in disease outbreaks and national security threats.