D
Workshop Agenda
GLOBAL HEALTH RISK FRAMEWORK:
GOVERNANCE FOR GLOBAL HEALTH
WORKSHOP SESSION GUIDE
September 1-2, 2015
Wellcome Trust - Gibbs Building, 6th Floor - London, UK
BACKGROUND
Contracted Statement of Task for the
Commission’s Governance Workstream
“The governance for global health workstream will explore global, national, and local capabilities, to include those required by the International Health Regulations (2005), to facilitate the collective action of the governmental, intergovernmental, corporate, and non-profit sectors as they contribute to preparedness and response. . . . The Commission will deliberate and evaluate options to strengthen global, regional, national, and local systems to better prepare, detect, and respond to epidemic diseases. Interrelations between sectors will be studied.”
Overarching Objectives for Governance for Global Health Workshop
- Mobilize for the Global Health Risk Framework Commission suitable evidence and expert opinion to inform their deliberations around the pros and cons of alternative approaches to improved governance for global health.
- Illuminate the definition of governance for global health and its scope.
- Consider the key elements of “good” governance, such as targets and benchmarks, monitoring, transparency, honesty, civil society engagement, and accountability.
- Document key successes and lessons learned from past global infectious disease outbreaks and other public health emergencies and how they may inform preparation and response to future outbreaks and emergencies.
- Characterize needs, gaps, and barriers in current approaches to addressing global infectious disease outbreaks and other public health threats.
- Consider compliance-enhancing mechanisms to drive good governance and implementation of existing international norms, such as measures of compliance and monitoring for compliance, incentives for compliance, identifying and working with key actors to improve compliance, and “shadow” reports such as by independent experts and civil society.
- Consider indicators and metrics that may be used to guide and assess the resilience of the global health infrastructure to future outbreaks and emergencies.
Working Definition of Governance for Global Infectious Disease Control
In the context of infectious disease outbreaks of global significance, governance encompasses a range of integrated policy, information management, command, and control mechanisms for facilitating collective action to achieve the objectives of prevention, detection, and response. Of necessity, these mechanisms integrate actions across intergovernmental organizations, sovereign nations, communities, the corporate sector, humanitarian agencies, and civil society. They operate in not only the realm of health, but also to a variable extent in collateral spheres to include agriculture/food security, diplomacy, education, finance, migration/refugee care, security, and transportation.
DAY 1
Tuesday, September 1, 2015
Compiling Evidence About Governance for
Global Infectious Disease Control
8:00 – 8:30 AM | Registration and Continental Breakfast |
8:30 – 8:40 AM | Welcome |
Jeremy Farrar, Director, Wellcome Trust | |
David Relman, Chair of the Forum on Microbial Threats, Institute of Medicine (IOM); Professor of Microbiology and Immunology, Stanford University | |
8:40 – 8:55 AM | Victor Dzau, President, National Academy of Medicine: “Developing a Global Health Risk Framework” |
8:55 – 9:00 AM | Keynote Introduction |
David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University | |
9:00 – 9:30 AM | Keynote Remarks |
Keizo Takemi, Member of Japanese Parliament: “Governance for Global Health: Engaging Intergovernmental Organizations to Achieve Collective Action” |
Session 1: Definition of Governance for Global Health
and Lessons Learned from Outbreaks of the Past
Session Moderator: Ximena Aguilera, Director, Center of Epidemiology and Public Health Policies, Universidad del Desarrollo, Chile
Goals of Session
- Illuminate key elements of “good” governance for global health
- Examine compliance enhancing mechanisms to drive good governance and implementation of existing international norms
- Synthesize lessons learned from recent infectious disease outbreaks and opportunities to strengthen governance for global health
- Identify ways in which the International Health Regulations (IHR) can be modified to achieve its intended purpose
Part 1: Elements of Good Governance for Global Health
9:30 – 10:10 AM | Presentations |
David Fidler, Professor of Law, Indiana University: “What is Global Health Governance in the Context of Recognizing and Mitigating the Threat of Epidemic Infectious Diseases?” | |
Alejandro Thiermann, President, Terrestrial Animal Health Code Commission, World Organisation for Animal Health (OIE): “Global Health Security Begins by Assessing and Assisting National Capacities at the Animal-Human Interface” | |
10:10 – 10:30 AM | Discussion |
10:30 – 10:45 AM | Break |
Part 2: Lessons Learned from Outbreaks of the Past
10:45 – 11:45 AM | Case Study Panel |
David Heymann, Head/Chair, Public Health England/Chatham House: “SARS and the 2005 Revisions to the IHRs” | |
Harvey Fineberg, President, Moore Foundation: “How Well Did the IHRs Work During the H1N1 Pandemic and Why Were the Recommendations for Strengthening the IHRs Not Implemented?” |
Joanne Liu, President, Médecins Sans Frontières (MSF): “Ebola as a Humanitarian and Health Care Crisis: Governance Challenges as Seen from the View of a Key Nongovernmental Organization” | |
11:45 AM – 12:45 PM | Discussion |
12:45 – 1:30 PM | Lunch |
Session 2: Challenges in Governance for Global Health for Fragile States
Session Moderator: Oyewale Tomori, President, Nigerian Academy of Science
Goals of Session
- Compare and contrast different governance approaches for fragile health systems vs. other areas and identify where new approaches are relevant
- Identify how to measure and define success of governance for global health for areas with weak political systems and economies
1:30 – 2:10 PM | Presentations |
Paul Wise, Professor of Pediatrics and Health Policy, Stanford University School of Medicine; Senior Fellow, Freeman-Spogli Institute for International Studies, Stanford University: “The Challenge of Strengthening Health Systems in Areas of Political Instability and Weak Governance” | |
Mark Heywood, Executive Director, Section27 (South Africa): “An African Perspective on the Challenge of Strengthening Health Systems in Areas of Political Instability and Weak Governance” | |
2:10 – 2:40 PM | Discussion |
Session 3: Challenges in Current Design of Global Health Governance
Session Moderator: Margaret A. Hamburg, Former Commissioner, U.S. Food and Drug Administration
Goals of Session
- Highlight ways the World Health Organization (WHO) and member states can be better equipped to address global outbreaks
- Discuss recent proposals made to enhance global preparedness and response
- Identify how global security initiatives and frameworks can work together to boost preparedness and response
2:40 – 4:30 PM | Presentations |
Margaret Chan, Director General, World Health Organization: “WHO Headquarters Views 18 Months After the Outbreak Was Reported” | |
Charles Clift, Senior Consulting Fellow, Center on Global Health Security, Chatham House: “Form Should Follow Function: What’s the World Health Organization for?” | |
Colin McIff, Senior Health Attaché, U.S. Mission, Geneva: “U.S. Government Perspectives on Ways to Make the WHO/UN Health Governance System More Effective and Efficient During Health Emergencies” | |
Dame Barbara Stocking, Murray Edwards College: “Findings, Conclusions, and Recommendations of the Recently Released ‘Report of the Ebola Interim Assessment Panel’ (July 2015)” | |
4:30 – 4:50 PM | Break |
4:50 – 6:00 PM | Panel Discussion |
6:00 – 6:15 PM | Concluding Remarks |
David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University | |
6:15 PM | Meeting Adjourns |
6:30 – 7:30 PM | Reception, Wellcome Trust Museum |
Speakers, event organizers, and staff | |
7:30 – 9:30 PM | Conference Dinner, Wellcome Trust Museum |
Speakers, event organizers, and staff |
DAY 2
Wednesday, September 2, 2015
Illuminating Potential Future Mechanisms for Improved Governance
8:30 – 9:00 AM | Registration and Continental Breakfast |
9:00 – 9:15 AM | Summary of Day One |
David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University |
Session 4: Models of Governance for Global Health
Moderator: Larry Gostin, University Professor of Global Health Law, Georgetown University
Goals of Session
- Illuminate goals of governance systems considering domains from the international, national, regional, and local levels
- Compare and contrast four potential models of governance for global health, including key features of organizational structure, funding, legitimacy, authority, and accountability
- Identify a broad array of stakeholders and effective methods for integrating and leveraging partner engagements for strong governance for global health
Part 1: Systems for Governance: How Should They Fit Together?
9:15 – 10:05 AM | Presentations |
Claude de Ville de Goyet, Consultant to UN and Former WHO/Pan American Health Organization Emergency Preparedness Director: “How Should the Governance Roles of WHO Regional Offices Be Made Fit for Purpose?” | |
Ron St. John, WHO Consultant: “Observations on Governance in the Provision of WHO Assistance at the National Level” | |
10:05 – 10:20 AM | Break |
10:20 – 11:10 AM | Presentations |
Ben Anyene, Health Reform Foundation of Nigeria: “Governance and the Role of Local Humanitarian Organizations During an Outbreak” | |
Rebecca Marmot, Global Partnerships, Unilever: “Governance and the Role of Public–Private Partnerships During an Outbreak” | |
11:10 AM – 12:10 PM | Panel Discussion |
12:10 – 1:00 PM | Lunch |
Part 2: Laying Out Some Governance Options: The Work of Concurrent Panels and Debate
1:00 – 1:40 PM | Insights from Concurrent Initiatives |
Peter Piot, London School of Hygiene & Tropical Medicine: Insights from the Lancet Commission – Harvard–LSHTM Study |
Joy Phumaphi, African Leaders Malaria Alliance: “Observations on the UN Secretary General’s Commission on the Ebola Response” | |
1:40 – 1:50 PM | The Debate: Introduction [10 min for presentation; 10 min for discussion] |
Larry Gostin (moderator), University Professor of Global Health Law, Georgetown University | |
1:50 – 2:10 PM |
Model 1: A Reformed WHO
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2:10 – 2:30 PM |
Model 2: “WHO Plus.” The WHO with an attached center for humanitarian and outbreak management under the line authority of the WHO Director-General and with strategic, operational, and tactical roles. It combines both strategic and operational missions within the WHO-Geneva culture.
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2:30 – 2:50 PM |
Model 3: The Executive Agency Model. The WHO as the host for a center for humanitarian and outbreak management operating under the authorities of the UN Secretary-General and executing strategic, operational, and tactical roles. (This taps the expertise of WHO but draws from a higher level of authority for command and control and political support.) It would insulate the center from the WHO culture and the politics of the WHA but derive vast technical benefits.
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2:50 – 3:10 PM |
Model 4: Independent Entity with Interagency Composition under the Authority of the UN Secretary General.
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3:10 – 4:00 PM | Panel and General Discussion |
Harvey Fineberg (moderator): | |
Each reactor would have 5 minutes to reflect on the model they favor based on the presentations. | |
Featured Reactors: | |
1. Kenji Shibuya, University of Tokyo 2. Ann Marie Kimball, Chatham House 3. Kumanan Rasanathan, United Nations Children’s Fund | |
4:00 – 4:15 PM | Break |
Session 5: Other Considerations in Governance for Global Health
Moderator: Chris Elias, President, Global Development, The Bill & Melinda Gates Foundation
Goals of Session
- Synthesize best practices for translating research and lessons learned into actions for governance for global health
- Identify financing mechanisms that help mobilize and maintain good governance and steer policy directions
4:15 – 5:15 PM | Panel Discussion |
Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, World Bank: “The Essential Connection Between Governance and Finance” | |
Jeremy Farrar, Director, Wellcome Trust: “Governance for Health Research in the Context of Rapidly Emerging Infectious Disease Threats” | |
Daniel López-Acuña, Former WHO Senior Adviser to the Director-General: “Ensuring Health Security as a Function of Governance” |
5:15 – 5:45 PM | Open Discussion |
5:45 – 6:00 PM | Concluding Remarks and Adjournment |
Eileen Choffnes, Scholar, Board on Global Health, IOM | |
Ceci Mundaca-Shah, Senior Program Officer, Board on Global Health, IOM | |
David Relman, Chair of the Forum on Microbial Threats, IOM; Professor of Microbiology and Immunology, Stanford University |
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