Professor Rebecca Katz, Director for Global Health Science and Security, Georgetown University, US, at One Health Security Conference, 14-15 Oct 2019, THL, Helsinki

1. Challenges in Global
Health Security
Rebecca Katz, PhD MPH
October 2019

2. GeorgetownCenterforGlobalHealthScience&Security
About the Center for
Global Health Science &
Security
The Center for Global Health Science
and Security analyzes policies and
practices used throughout the world
to prevent, detect, and respond to
emerging health threats before they
become international crises.
Our multi-disciplinary team develops
evidence for action, providing
decision makers with the tools they
need for sustainable capacity
building.

4. Public Health Emergencies of International Concern
Ebola DRC Declared PHEIC July 2019

5. 2005
WHA adopts
the Revised
IHR
IHR enters
into force
2007
2012
2014
Request
extension
States report
meeting all
core capacity
requirements
OR
States assess
core
capacities
States plan/
implement
capacity building
Request 2nd
extension
States report
meeting all
core capacity
requirements
OR
2016
2019
States should
have met core
capacities
Core capacity
built in
priority
countries
PHEIC: H1N1
PHEIC:
Ebola
Global Health Security
Agenda launched
WHA
establishes
working group
to revise the
IHR
SARS
WHA
adopts
resolution
to revise
the IHR
2004
1995
2015
2009
HIV/AIDS,
emerging
infectious
diseases,
hemorrhagic
diseases
MERS PHEIC:
Zika
Fully
implemen
ted
21%2-year
extension
obtained
(with
implemen
tation
plan)…
2-year
extension
requested
(no
implemen
tation
plan)…
No report
14 % Fully
implem
ented
33 %
2-year
extensi
on
request
ed
42 %
No
report
25 %
2012 2014
PHEIC:
Polio

6. Accelerate
implementation
of IHR and other
health security
frameworks
Advance
progress toward
a world safe and
secure from
infectious
disease threats
Bring together
nations to make
new, concrete
commitments to
capacity
building
Elevate global
health security
as a priority for
leaders
worldwide
Global Health Security Agenda (GHSA) launched in
February 2014

7. Private Sector and
Health Security

8. 1. Annual Reporting
obligatory self reporting
2. After action review
voluntary, real events
3. Simulation exercises
voluntary, non-real events
4. Joint External evaluations
voluntary, repeat every ~5 years
Current IHR Monitoring and
Evaluation Framework
https://extranet.who.int/spp/ihrmef

9. JEE Scale Up
Joint External Evaluation—Development and Scale-Up of Global Multisectoral Health Capacity
Evaluation Process
Elizabeth Bell, Jordan W. Tappero, et al
https://www.cdc.gov/globalhealth/socialmedia/cards/mp4/joint-external-evaluation-
assessments.html

10. Sample frame
Political Recognition

11. Global
Health
Security
2019Sydney 18–20 June 2019
www.ghs2019.com

15. GHS is a state of freedom from the scourge of infectious disease, irrespective of
origin or source. It is achieved through the policies, programmes, and activities taken
to prevent, detect, respond to, and recover from biological threats. There are
numerous challenges that pose significant risk to GHS, including a wide array of
pathogens that present an existing and ongoing threat to both individual and
collective health, AMR and the emergence of currently untreatable infections, the
potential for deliberate use of a biological weapon, and the synthesis of eradicated or
novel pathogens. The complexity of addressing these challenges is amplified by a
multitude of contextual factors. These threats know no borders and have global
consequences requiring more effective collective action.
Sydney Statement

16. Sydney Statement Principles:

17. Prioritization
Coordination
Governance
Global Health Security Challenges

18. Prioritization

19. Sample frame
D. Brockmann, D. Helbing. Science 342, 1337 (2013)
Hypothetical epidemic, spread by worldwide air transportation networks

20. The Lancet
380:9857, 1-7 Dec
2012, pp. 1946-
55.
A health
threat
anywhere
is a health
threat
everywhere
Nature Reviews
Microbiology
2013;11: 133-141.

24. Allen, et al. Nature Communications 8:1124

26. Linking public health and security authorities
Antimicrobial resistance
Immunization
Funding for AMR, globally

27. Linking public health and security authorities
Global AMR capacity
Antimicrobial resistance
Immunization

28. Linking public health and security authorities
Antimicrobial resistance
Immunization
Track funding across target efforts

29. Linking public health and security authorities
Antimicrobial resistance
Immunization
Identify misalignment of funding & need

30. Financing preparedness at a national level
30
• All countries should complete JEE/PVS assessments
and convert results into costed plans
• Countries should prioritise health security in budgets
and increase domestic resource mobilisation where
necessary
• Development partners should focus on: 1) one-off
capital investments; 2) regional initiatives; 3)
failed/fragile states
• National governments should engage the private
sector in preparedness and response planning
• Insurance should be leveraged to finance response
and incentivise better preparedness
• IMF/WB should incentivise national investment in
preparedness (via Art IV, CPIA, SCD)
Slide from Peter Sands

32. Global Fund synergies with health security
for Uganda, Kenya and Vietnam
33.8% of activities and 35.7% of budget supported health security
 Budgeted greater than US $695,000,000 for activities that support health
security in these three countries
17.3 %
16.5 %Items
Direct
Indirect
Budget 19.9 %
15.8 %
Direct
Indirect

33. Prioritization
Coordination
Governance
Global Health Security Challenges

34. Coordination

35. Laboratory capacity
Linkingpublic healthand securityauthorities
Immunization
Surveillance
Global Health Security: Surveillance and Laboratory
Capacity generally well-funded

37. Governance

38. The article argues that the controversy inflicted serious
damage on the IHR because the Emergency Committee
abused its authority under the IHR and acted outside
the authority the IHR prescribes for this committee. The
damage done, and the manner in which it happened,
raises bigger questions about the IHR’s meaning,
influence, and future in global health governance
TO DECLARE OR NOT TO DECLARE: THE CONTROVERSY OVER
DECLARING A PUBLIC HEALTH EMERGENCY OF INTERNATIONAL
CONCERN FOR THE EBOLA OUTBREAK IN THE DEMOCRATIC
REPUBLIC OF THE CONGO
David P. Fidler

42. What are we doing?
URL: GHSS.GEORGETOWN.EDU/WORK

43. Synergies between Global Fund-supported
activities and health security
 Mapping Global Fund activities in
Kenya, Uganda, Vietnam, DRC,
Guatemala, Guinea, India, Indonesia,
Nigeria and Sierra Leone to indicators
in the Joint External Evaluation Tool
(JEE)
Qualitative research with
implementers and in-country experts

44. Viral Sovereignty, Technology Transfer, and the Changing
System for Sharing Pathogens for Public Health Research
Edited by Sam Halabi and Rebecca Katz
Forthcoming Cambridge University Press 2020

45. Insert Slide Title Option 2
https://tracking.ghscosting.org/

46. Track progress and highlight successes

47. Communicate funding impacts

48. Highlight patterns of global influence

49. Predictors of Global Health Security Investment

51. The International Law Impact and Infectious
Disease (ILIAID) Consortium brings together
academics, lawyers, researchers, and policy-
makers from diverse backgrounds and
disciplines to examine issues relating to the
impact of international law on infectious
diseases.
International Law Impact and Infectious Disease
(ILIAID) Consortium
Based at the Georgetown University Center for Global Health Science and Security

52. The Consortium for International Law’s
Impact on Infectious Diseases (ILIAID) has
considered the potential reform of the
International Health Regulations. The central
finding of this report is that the International
Health Regulations require reform, in order to
better meet the needs of global health health
security.
Primary study authors:
Rebecca Katz, Mark Eccleston-Turner, Alexandra Phelan, Clare Wenham
Proposal: IHR Reform

53. Thank you!
@RebeccaKatz5
@georgetown_ghss
GHSS.GEORGETOWN.EDU