Global Health Risk Framework Governance for Global Health: Workshop Summary (2016) / Chapter Skim
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6 Elements of a Governance Framework
6 Elements of a Governance Framework
Pages 65-82
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From page 65... ...
(Farrar, Fineberg, Kimball, Liu) • Because WHO is not a homogeneous organization, strong and capable regional offices can make significant contributions 65
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From page 66... ...
López-Acuña discussed the concept of global health security and the current alert and notification systems when a health emergency reaches pandemic levels, complemented by Jeremy Farrar of the Wellcome Trust who discussed challenges and opportunities for research in outbreak response. Speakers also gave perspectives on roles of the WHO regional offices, national governments, local humanitarian organizations, and the need and benefits of public–private partnerships in creating a holistic governance framework.
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From page 67... ...
A proliferation of entities, funds, mechanisms, and multistakeholder partnerships for global health over the past two decades have joined long-existing multilateral and bilateral struc tures to create a new global health landscape, characterized by parallel and sometimes duplicative objectives and governance structures. • Global public goods for health are health interventions that require international collective action, such as those that ensure global health security.
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From page 68... ...
A clear provision for humanitarian crises triggered by epi demics will need to be developed jointly by the humanitarian and the outbreak alert and response communities within the United Nations, López-Acuña observed. Elias responded to López-Acuña's conclusions that it is currently impossible to supersede the nation-state paradigm, that WHO should lead any global public good for ensuring health security, and that decisions regarding emergency alert and response should be informed by an independent advisory committee.
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From page 69... ...
The current global response system is the weakest component of what is needed to ensure health security, which clearly represents a vital need and a global public good, according to López-Acuña. Its shortcomings were apparent during the Ebola crisis, during which the Global Outbreak Alert and Response Network (GOARN)
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From page 70... ...
Additional measures to support a coordinated response to health and humanitarian emergencies would include more active engagement of the UNISDR in the prevention and mitigation of global health risks as part of its preparedeness agenda, and the mainstreaming of actions to address global health risks in the UN Development Assistance Framework, he noted. Notification of a Public Health Emergency of International Concern In conclusion, López-Acuña asserted, it is possible to enable global public good for ensuring health security from basic elements of the existing health and humanitarian response architecture.
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From page 71... ...
Similarly, it remains to be determined whether antiviral treatment saves lives or prevents secondary transmission of the influenza virus, arguably the most devastating global health threat and the cause of a 2009 pandemic to which one-sixth of the world's population was exposed. Farrar noted that the International Severe Acute Respiratory and Emerging Infection Consortium,1 an effort under way by the Heads of International Research Organizations (HIRO)
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From page 72... ...
Any discussion about global health governance must include provisions for research, Farrar insisted. The ethics of research approaches should be debated in civil society in order to ensure that the voices of patients and affected populations are heard by the many and often dissociated actors who may implement research protocols during an epidemic, he advised.
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From page 73... ...
, discussed governance for health emergencies on the part of WHO regional offices. Goyet urged participants to consider the ways this structure benefits member states and their populations in general, beyond the context of the Ebola crisis.
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From page 74... ...
Established by the Global Health Cluster, the FMT Initiative coordinates the assistance of medical teams during health emergencies, employing a model developed for earthquake response. Its success shows that health governance for outbreaks requires adaptation, not reinvention, he said.
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From page 75... ...
regional operations carried out by the organizations regions • Direct management, coordination, • Technical, financial, and logistic and support to field operations support to the region in the crisis (unless the emergency is on • Mobilization of GOARN public an interregional scale or larger) health experts and FMTs • Supporting the ministry of health in • Mobilization of resources on-site coordination and tasking of • When required, appointment external assistance, FMTs, and a crisis manager in the UN clusters of affected countries • Ensuring maintenance of basic • If due to the scale of the public health programs, in problem or the lack of capacity partnership with the ministry or governance in a region, of health.
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From page 76... ...
He also confronted the unfortunate reality that the massive costs of emergency response dwarf what is generally spent on emergency preparedness in the form of planning and training -- reinforcing earlier calls for attention to health capacity building, which can create a more prepared health system and community. Establishing Incident Management Systems Typically, local first responders to any emergency manage it on their own unless and until their capacities are exceeded, St.
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From page 77... ...
Ben Anyene of the Health Reform Foundation of Nigeria cautioned that the Incident Management System, as it currently exists, does not adequately integrate nonstate actors that increasingly contribute to emergency response efforts. Nonstate actors tend not to be represented at emergency operations centers, he observed, and yet they perform a variety of functions that others cannot.
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From page 78... ...
ROLE OF LOCAL HUMANITARIAN ORGANIZATIONS Ben Anyene is leader and founding member of the Health Reform Foundation of Nigeria,4 which works within the contexts of national, state, and local health governance in that country. Illustrating the point made by Stocking and others that the lack of basic health care constitutes an actual and ongoing health crisis for low- and middle-income countries (LMICs)
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From page 79... ...
Further strengthening of health emergency response capacities should involve the creation of accountability frameworks to encourage "effective synergy" among relevant government agencies and local and international organizations, Anyene advised. He also suggested that training in health emergency response become part of Nigeria's mandatory civic education program, which includes a year of service in the country's National Youth Service Corps, and that similar training be extended to local humanitarian organizations.
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From page 80... ...
Unilever also seeks better alignment with the UN cluster system in anticipation of future health emergencies, said Marmot. In general, the private sector wants to know how to be useful to health emergency response
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From page 81... ...
Unilever has played a role in developing the Sustainable Development Goals and hopes to contribute to developing the Global Health Risk Framework as a model for emergency response to be developed and tested before the next crisis strikes. For such a framework to succeed, she concluded, "business and the NGO community and UN and civil society will need to interact even more than they have done before." Kimball asked the public-sector speakers to reflect on their experiences working with the private sector in response to health emergencies.
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From page 82... ...
Marmot stressed that the possible contributions companies can make to a recovery effort extend well beyond those that might appear to boost their sales and, most significantly, would involve the use of their expertise in solving complex problems associated with emergency response. Unilever's participation in multisectoral efforts to effect systemic change, such as the World Economic Forum, is another way the company engages with civil society for the common good, she added.
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