Building Global Health Resilience
Lindsay PackNovember 18, 2014

The Ebola epidemic has thrust into the spotlight the world’s ability (or perhaps inability) to come together to rapidly address global health crises. Although some argue that there have been successes, the general consensus is that the international response was “too little, too late,” which resulted in greater spread of the disease and more lives lost. In fact, no coordinated global response had been put in place in early September, when more than 1,800 Ebola deaths were already confirmed in Guinea, Liberia, and Sierra Leone.

So, what happened? While there are a number of factors to blame for the spread of the disease—a lack of local health infrastructure, customs in handling the dead, and even the fear-inducing nature of the virus itself—chief among them is the slow decisionmaking processes of global health organizations with the power to mobilize. In a recent Washington Post article, Joanne Liu, the International President of Doctors Without Borders, exclaimed when she heard about another U.N. initiative, “We cannot wait for those high-level meetings to convene and discuss over cocktails and petits fours what they’re going to do.”

The issue of delayed decisionmaking and lack of coordinated action is not new to the concept of disaster response. As my colleague Jack Eisenhauer discussed in his blog post last year, natural disasters like Superstorm Sandy come with unpredictability and cascading impacts that require coordination and effective communication across critical infrastructure sectors. To be truly resilient, the groundwork for this level of response must be laid far in advance with careful planning, risk management, and continuous relationship building to ensure coordinated action when the next disaster strikes.

The United States aimed to begin a similar process in global health by partnering with at least 30 countries and international entities to develop the Global Health Security Agenda (GHSA). Launched in February 2014, the GHSA intends not only to accelerate progress toward preventing and reducing future outbreaks of disease and to detect threats early, but also to provide rapid, effective, and coordinated responses to emerging threats through concrete, national-level commitments.

Map showing GHSA commitments made by countries since February 2014

GHSA commitments made by countries since February 2014 (Source: CDC)

To encourage progress toward these goals, the GHSA established 11 Action Packages that aim to facilitate regional and global collaboration toward specific GHSA objectives and targets, including zoonotic disease prevention, GHSA reporting, and personnel deployment, among others. These packages follow the “prevent, detect, respond” framework of the GHSA goals and include five-year targets as well as metrics for success and established commitments from a number of countries around the world. The Action Packages were released to the public at the end of September at the GHSA Summit hosted by the White House in order to, according to the CDC, “encourage other countries and groups outside of government to engage in the GHSA as part of a whole-of-society approach to achieve a world where all nations have the capacity to prevent, detect and rapidly respond to biological threats.”

By highlighting measurable approaches, providing mechanisms and five-year targets, and building relationships and country-level buy-in, the GHSA and its Action Packages are making strides toward the groundwork that is so critical to resilience in global health. These important components, if successful, should enable the world to respond to the next epidemic both immediately and nimbly to reduce the loss of life that is so dependent on the ability to act. When the spotlight fades on today’s Ebola epidemic, the urgency and commitment to planning efforts must remain to ensure a healthier and more secure future for all of the world’s citizens.