The Ebola virus outbreak in West Africa has not only illustrated a lack of political commitment to public health, but it has initiated discussions on global health security. A group of leading global health practitioners have now given their thoughts on the impact of the epidemic in a series of essays published in The Lancet.
In the series, different perspectives are explored on what can be taken from the Ebola outbreak, investigating areas such as individuals’ access to health care, how the epidemic might increase political commitment to improving health security and how other issues such as antimicrobial resistance are relevant to health security.
David L. Heymann, professor of Infectious Disease Epidemiology at the London School of Hygiene & Tropical Medicine, London, UK, and lead author of the review, describes health security as “essentially the protection from threats to health.”
He states that, throughout history, the approach to threats such as the Ebola epidemic has been to focus on rapid detection of outbreaks and rapid response. This approach, according to Prof. Heymann, has been the commonly understood conceptualization of health security for centuries.
“But the crisis has also highlighted a second, equally important but less appreciated aspect of global health security – ensuring personal access to health services and products around the world,” he states. “This needs to be better recognized as part of the scope of global health security.”
One of the essays in the review suggests that global health security has been politically neglected over the past decade through legal noncompliance from certain countries and through being deemed less important by the World Health Organization (WHO).
Last month, the leaders of WHO published a statement admitting to faults in how the organization handled the Ebola outbreak, outlining that valuable lessons had been learned and promising to improve how they respond to emergencies.
Another essay argues that the Ebola epidemic is simply the most recent event to illustrate the shortcomings in the medical research and development system regarding its ability to address global health priorities.
The authors claim that three quarters of new medicines on the market add no therapeutic value, and subsequently suggest adopting a system that prioritizes development according to unmet health needs rather than financial gain would be best for boosting global health security.
Global trade in fake medicine also undermines global health security. Another essay states that one quarter of medicines in low-income countries are either substandard or counterfeit, a proportion that undermines faith in governments as well as their ability to combat infectious and noncommunicable diseases.
The increasing spread of noncommunicable diseases in particular is proving expensive for some governments. One of the essays argues that this problem could be mitigated by nongovernmental organizations holding major corporations to account, in a similar manner to strategies employed by climate change activists aiming to reduce carbon emissions.
Only by increasing commitment to improving individual access to health services that are safe, affordable and effective can global health security be achieved, the authors state.
Lancet editors Dr. Pam Das and Richard Horton state in a linked comment that the central message of the review is that there is no simple definition of health security:
“It means, variously, human security, the prevention and control of infectious diseases, attention to noncommunicable diseases, revitalizing research and development to produce global public goods, dealing with substandard and falsified drugs, considering conflict and disaster settings, addressing international migration, and building stronger health systems through universal health coverage.”
“The complexity of global health security should not induce paralysis,” they add. “But it should make us pause before we argue for quick solutions.”
Certainly, the Ebola epidemic provides the foundation for important discussions on global health priorities. Another review published in The Lancet suggests that the crisis represents a rare political opportunity for institutions like WHO to make reforms.
“If the WHO fails to lead an effective, well-funded and coordinated response when the next epidemic strikes, it could have devastating consequences in rich and poor countries alike,” warn Prof. Lawrence Gostin and Prof. Eric Friedman from the O’Neill Institute for National and Global Health Law at Georgetown University Law Center in Washington, DC.
Medical News Today previously reported on a study suggesting that the measles virus could affect Western Africa in just as devastating a way as the Ebola virus due to disruption to vaccination programs.