TWN Info Service on Health Issues (April 07/01)

10 April 2007

WHO highlights threats to global health security

In its call for the urgent need to improve international health security in light of growing threats to the global collective health security, the WHO has identified eight issues which include economic stability; emerging diseases; chemical, radioactive and biological threats; environmental change; humanitarian emergencies; and HIV/AIDs. The article below highlights the problem.

It is reproduced with permission from South-North Development Monitor (SUNS) #6227, 10 April 2007.

With best wishes
Evelyne Hong

Health: WHO highlights threats to global health security

By Kanaga Raja, Geneva, 5 April 2007                                                                       

The World Health Organization, on the occasion of World Health Day on 7 April, has highlighted the urgent need to improve international health security in light of growing threats to the global collective health security.

Among the threats highlighted by the UN health agency are: emerging and rapidly spreading diseases, environmental change, the danger of bio-terrorism, sudden and intense humanitarian emergencies caused by natural disasters, chemical spills or radioactive accidents and the impact of HIV/AIDS.

''Threats to health know no borders. In an age of widespread global trade and travel, new and existing diseases can cross national borders and threaten our collective security,'' said WHO Director-General Dr Margaret Chan, in her message for World Health Day.

Threats to health security are many and varied, Dr Chan said, adding that tackling the health effects of these threats involves working collectively to improve preparedness and effective responses when they occur.

A high-level global debate involving political, business and opinion leaders took place in Singapore on 2 April, in advance of World Health Day, to raise the profile of international health security.

In her speech at the high-level debate, Dr Chan said: ''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.''

''All of these activities affect one of the greatest direct threats to health security: outbreaks of emerging and epidemic-prone diseases,'' she added.

In his message for World Health Day, UN Secretary-General Ban Ki-Moon said that ''health, development and global security are inextricably linked. Investment in health is a cornerstone of economic growth and development, and a prerequisite for meeting many of the Millennium Development Goals.''

The WHO had prepared a background paper for the high-level debate in Singapore titled "Invest in Health, Build a Safer Future" that profiled eight issues linked to international health security.

The eight issues included emerging diseases; economic stability; international crises and humanitarian emergencies; chemical, radioactive and biological terror threats; environmental change; HIV/AIDS; building health security; and strengthening health systems.

The WHO paper said that globalization has brought the benefits of efficient transport and trade to many people across the world. 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.

In today's world, said WHO, health security needs to be provided through coordinated action and cooperation between and within governments, the corporate sector, civil society, media and individuals. No single institution or country has all the capacities needed to respond to international public health emergencies caused by epidemics, natural disasters or environmental emergencies, or by new and emerging infectious diseases.

In respect of emerging diseases (such as avian influenza and Severe Acute Respiratory Syndrome), the WHO document said that since new diseases partly arise from fundamental changes in the way humanity inhabits the planet, the emergence of new diseases is likely to continue, if not escalate.

In the last decades of the 20th century, new diseases began emerging at the unprecedented rate of one or more per year. From 1973 to 2000, 39 infectious agents capable of causing human disease were newly identified. Even more worryingly, the rate of drug failure due to the development of microbial resistance outpaced scientific discovery of replacement drugs.

The potential inability of affected countries to engage fully in surveillance and sustain an emergency response system over months, if not years, in the case of a severe pandemic, is the single most important obstacle to international health security, the WHO warned.

Increasing global economic integration has alleviated poverty significantly in many lower income countries of the world, said WHO. Yet, along with greater access to commercial and public goods comes exposure to global public "bads", such as the international transport of tainted food products, black markets, or the spread of disease.

SARS did not become a global pandemic, nonetheless it was responsible for sizeable economic losses and insecurity in markets across Asia and worldwide. With fewer than 10,000 cases, the outbreak cost Asian countries a dramatic $60 billion of gross expenditure and business losses in the second quarter of 2003 alone.

Global public "bads" not only have health consequences; they have economic ones as well. Controlling the international spread of disease is therefore good practice for economies as well as for those whose health is at risk, the health agency emphasised.

The WHO paper noted that humanitarian emergencies can maim already stressed health systems that people rely on for maintaining health security. In 2006, 134.6 million people were affected, and 21,342 were killed by natural disasters.

''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,'' asked the WHO.

Disaster preparedness strategies and humanitarian response operations together can create a balanced approach to alleviating the negative impact of natural disasters.

The WHO also said that for much of the world, 21st century life has become greatly dependent 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.

However, incidents such as anthrax-tainted letters being sent through the US postal system in 2001 and the release of Sarin (a nerve gas) on the Tokyo subway in 1995 reminds the world that although chemical and biological attacks are rare, there are individuals and groups who are ready to use this brand of terrorism.

The WHO also highlighted the impacts of environmental change on health, saying that the earth's climate is changing. Temperatures are rising; tropical storms are increasing in frequency and intensity; and polar ice caps and permafrost regions are melting. People are dying - upwards of 60,000 in recent years in climate-related natural disasters, mainly in developing countries.

Solutions to the impact of global warming and changes in the environment can only emerge from collaboration and commitment between governments, corporations, foundations and non-governmental organizations. Combating these changes will require policy decisions that will change the way people and corporations live and work.

HIV/AIDS continues to pose personal health security threats in many developing countries striving to provide access to antiretroviral drugs, even though it has become a manageable, chronic epidemic in many other parts of the world, said WHO.

The WHO also noted that some countries would find it difficult to confront threats to health security effectively. This could be because they lack the resources needed, because their health infrastructure has collapsed as a consequence of under-investment and shortages of trained health workers, or because the infrastructure has been damaged or destroyed by armed conflict or natural disaster.

With respect to building health security, the WHO said that the framework of collaboration laid out by the International Health Regulations (IHR) and various existing surveillance networks provide an effective early warning and response system. The IHR aim to achieve maximum protection against the international spread of disease with minimal disruption to trade and travel.

The Regulations work through requiring 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 so as to allow for identification and reporting of newly emerging as well as existing threats to health.

Collaboration between states, especially between developed and developing countries, to ensure the availability of technical and other resources is a crucial factor not only in implementing the Regulations, but also in building and strengthening public health capacity and the networks and systems that strengthen international health security, stressed the WHO.

''The revised International Health Regulations, 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 the national and international levels. It is essential for all of us that every country implements fully these regulations,'' said UN Secretary-General Ban.