Executive Order Prioritizes Our Shared Global Health Security

A health care worker checks on patients admitted to the Ebola Treatment Unit in the Island Clinic, Monrovia, Liberia, Sept. 22, 2014. /Morgana Wingard

Today, President Obama signed an executive order to advance the ambitious Global Health Security Agenda (GHSA) and ensure that this multilateral and multisectoral effort to detect and respond to new infectious disease threats such as yellow fever or highly pathogenic avian influenza is sustained.

This formal policy will further strengthen and institutionalize our ongoing work to establish the capacity that every country needs to prevent, detect and rapidly respond to epidemic threats.

The next pandemic could begin anywhere—in South Asia, the Amazon basin, Central Africa, or on the Arabian Peninsula. In countries with weak health systems, the first cases at the start of an outbreak likely will be missed in the absence of sensitive surveillance, rapid laboratory support, and good information systems. Globalization and trade mean dangerous pathogens can be transported from an isolated, rural village to any major city in as little as 36 hours.

GHSA promotes global health security as a national priority through targeted capacity building activities, such as improving laboratory systems, strengthening disease surveillance, improving biosafety and biosecurity, expanding workforce development, and improving emergency management.

Over the last three years, we have worked tirelessly with partners around the world to launch and implement the GHSA and to leverage our engagement and leadership to gain concrete commitments from others. The GHSA has now grown to include 55 countries, international organizations, NGOs, private sector stakeholders, and a next generation leaders’ initiative.

Sparked by the GHSA, G-7 leaders, Nordic countries, and key G-20 partners have stepped up with new commitments, and the World Health Organization has now adopted a mechanism to assess countries using external evaluators and specific metrics. The Joint External Evaluation, as it is called, is an open, transparent, independent process to assess and improve global protection against health threats. The JEE is a stress test that allows countries to clearly identify the most urgent needs within their public health system and establish national plans, often for the first time, to address those needs using common metrics.

Avian influenza surveillance at Bangkok’s Klongtoey Market. / Richard Nyberg, USAID

But the JEE is just the beginning. As gaps are identified, they must be addressed. And to do that, we must continue to recognize that global health security is our national security and that this is a multisectoral effort, with health ministers working with agricultural and security ministers. And that the private sector and other NGOs are crucial to our success.

New diseases are emerging, drug resistance is rising, and more laboratories are processing dangerous microbes. This reality is the driving force for what we all want and what GHSA promises — a tighter, more sophisticated, collaborative and standardized global effort to advance both accountability and assistance and use the best science and tools to detect and defeat disease at the earliest possible moment.

To help advance GHS objectives, USAID is building on our long-running development efforts with not just ministries of health, but also ministries of agriculture, livestock, environment, rural development, and economic development — and private sector partners. USAID is actively working with our interagency partners in all 17 Phase I GHSA countries. We are actively supporting all 11 GHSA Action Packages with a special focus on zoonotic diseases, workforce development, disease surveillance, and antimicrobial resistance.

The unifying theme of our work is the so-called “One Health” approach, which brings together the sectors of animal health, human health, and the environment to address the burden of disease.  This multisectoral approach allows us to better address the full range of infectious diseases now emerging, including those that spill over from animals or result from antimicrobial resistance.

Combating zoonotic diseases is especially important because more than 70 percent of new infectious disease outbreaks originate in animals. Our work in this area involves strengthening animal health services, laboratory detection, outbreak response, and control programs.

Surveillance has been another focus for USAID, especially the detection of emerging and reemerging viral diseases emanating in animals. To date, USAID has targeted wildlife and livestock species (bats, rodents, poultry, swine and wild birds) that have historically been associated with spillover of zoonotic pathogens to people. Animals are sampled at high-risk disease transmission spots (such as mining sites, farms, markets) where there is likely exposure to humans.  The pathogens detected and their genomic signatures are used by host countries for risk assessments and for strengthening control programs. The program is actively sampling wildlife in 11 countries and has taken samples from more than 8,000 animals, proving the feasibility of mapping the global virome.

The comprehensive framework the Obama Administration is launching today will have a far-reaching impact on our ability to partner with new sectors to prevent, detect and respond to epidemic threats; leverage the full power and leadership of the U.S. Government for this effort; and move us closer to achieving the vision of a world safe and secure from infectious disease threats.

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