As World Health Day approaches this Saturday, international experts are focusing on the formidable and mounting threats to the world’s collective health security.
These include emerging and rapidly spreading diseases, environmental change, the danger of bioterrorism, sudden and intense humanitarian emergencies caused by natural disasters, chemical spills or radioactive accidents, and the effects of HIV/Aids, a disease that threatens the stability of communities in some of the poorest countries in the world.
”The uncertainty and destructive potential of disease outbreaks and acute public health emergencies gives them a high public and political profile,” said Margaret Chan, the World Health Organisation’s (WHO) director general.
”When the world is collectively at risk, defence becomes a shared responsibility of all nations,” Chan stressed. ”We live in a world where threats to health arise from the speed and volume of air travel, the way we produce and trade food, the way we use and misuse antibiotics, and the way we manage the environment.”
Globalisation
Globalisation has brought some benefits from efficient transport and trade to people across the world. But it has also allowed the rapid spread of diseases that otherwise may have been contained by geographical boundaries, or that in another era may have travelled slowly enough to be brought quickly under control, according to Invest in Health, Build a Safer Future, a WHO report launched to coincide with World Health Day.
”In today’s world, health security needs to be provided through coordinated action and cooperation between and within governments, the corporate sector, civil society, media and individuals,” the report stresses.
No single institution or country has the capacity needed to respond to international public health emergencies caused by epidemics, natural disasters or environmental emergencies, or by new and emerging infectious diseases, according to the WHO.
”Health, development and global security are inextricably linked,” UN Secretary General Ban Ki-moon said in his message for World Health Day.
”Investment in health is a cornerstone of economic growth and development, and a prerequisite for meeting many of the Millennium Development Goals [MDGs],” Ban emphasised. The MDGs are environmental, health, poverty and education-related targets that the international community agreed to reach by 2015.
Eight issues
The WHO report highlights eight issues linked to international health security.
The first concerns new, highly contagious diseases, such as severe acute respiratory syndrome (Sars) and avian influenza, which know no borders, according to the report. Their potential to cause international harm means that outbreaks cannot be treated as purely national issues.
In the past few decades, new diseases have begun emerging at an unprecedented rate of one or more per year, according to WHO estimates. ”Although the burden can be greater for the developing world, epidemic-prone diseases are a growing threat to all nations,” Chan said.
In 1997, avian influenza — or bird flu — caused the destruction of Hong Kong’s entire poultry population. In just three days, 1,5-million birds were killed by the authorities in order to prevent the spread of the disease.
Ten years later, the virus is not only affecting domestic and wild birds, but a type of avian influenza has crossed the species barrier and by April 2 was responsible for 170 human deaths — people who became gravely ill after coming in direct contact with an infected bird.
Economic stability is the second issue the report addresses, stressing that public heath dangers have economic as well as health consequences.
Containing international threats is good for economic well-being, according to the report. With fewer than 10 000 cases, Sars cost Asian countries $60-billion of gross expenditure and business losses in the second quarter of 2003 alone.
International crises and humanitarian emergencies are the third issue. These events kill and maim individuals and severely stress the health systems that people rely on for personal health security.
In 2006, 134,6-million people were affected and 21 342 were killed by natural disasters, according to UN figures.
The WHO notes that the root causes of emergencies following natural disasters are often found in land management, infrastructure and development policies.
”How many residents of New Orleans would have been saved had the levies not been breached during the aftermath of Hurricane Katrina? How many families would not have been searching for lost loved ones in the coastal areas of Sri Lanka had an effective early-warning system been activated and people known what to do when they heard it?” the report asks.
Chemical, radioactive and biological terror threats are the fourth issue the report addresses. During the 21st century, many countries have become dependant on chemical processing and nuclear power. ”Public health security, in turn, relies on the safety of these facilities and the appropriate use of their products,” according to the WHO.
Furthermore, anthrax-tainted letters sent through the United States postal system in 2001 and the release of sarin gas on the Tokyo subway in 1995 serve as reminders that although chemical and biological attacks are rare, there are individuals ready to use this brand of terrorism.
The fifth issue is environmental change, which has a growing effect on health. ”People are dying — upwards of 60 000 in recent years — in climate-related natural disasters, mainly in developing countries,” according to WHO statistics.
The sixth issue is HIV/Aids, with an estimated 39,5-million people living with the disease in 2006. The epidemic is a global phenomenon that adversely affects not only the health but also the economy and stability of many countries.
The seventh issue is building health security. A framework of collaboration laid out by the International Health Regulations (IHRs) and various existing surveillance networks can provide an effective early-warning and response system.
The IHRs aim to require mandatory reporting by any country of a ”public health event of international concern” that is identified within its national boundaries. The scope and definition of such an event is purposely broad and inclusive in order to allow for the identification and reporting of newly emerging as well as existing threats to health.
Revised IHRs, which will come into force in June this year, represent a milestone in the world’s efforts to build and reinforce effective mechanisms for disease-outbreak alert and response at national and international levels, said Ban. ”It is essential for all of us that every country implements fully these regulations,” he stressed.
The eighth priority is strengthening health systems. Functioning health systems are the bedrock of health security, but the current state of systems worldwide is inadequate, according to the report. For example, the world is currently short of more than four million health workers, with the effects most felt in developing countries.
”We have the knowledge and unprecedented resources to build a healthier, safer world. Let us take the occasion of World Health Day to mobilise the political will.,” Ban said. — IPS