How do strong health systems impact stability and security?

Ebola, Zika, swine flu and avian flu — these were all severe outbreaks that cost human lives, engulfed communities, and hit economies hard in both developed and developing countries. Did we expect them and are we prepared for what’s to come?

To learn more about the intersection between health and security, Devex has released a special report in partnership with PATH, asking 40 of the world’s top experts in health, security, development, and business how health and security are linked; how health-related threats are evolving; what global health organizations and programs are contributing to global stability; and what is needed to advance global health security solutions.

Here are the five things we now know.

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One

There’s an intersection between health and stability and security, globally.

The recent outbreaks of Ebola in 2014 and Zika in 2015-2016, have spurred an increased understanding of just how seriously diseases, illnesses, and harmful substances can affect entire populations with all interviewees unanimously stating that they see a clear link between health and security.

According to interviewees, healthier societies mean stronger economic growth and productivity.

Interviewees made a link between outbreaks and disruption of normal social activity and highlighted their ability to destabilize governments. It was also noted that poor health infrastructure can exacerbate the situation, causing mass migration, distrust in government, local disputes and even public disorder.

“We can no longer talk about security as one set of issues and health as another set of issues...this intersection is going to play out on the ground...”

Paul Reed

interim director, Center for Global Health Engagement, Uniformed Services University

Two

Today the risk of epidemics is higher and they have the potential to spread faster than before.

Interviewees named infectious disease outbreaks, especially airborne influenza, like the Spanish flu of 1918-1919, as the greatest contemporary health threat, with the global emergence of resistant microbes and the release and global spread of biological agents, including bacteria, toxins, and viruses via bioterrorism, as other contributing risk factors.

“I think that the anti-microbial resistance problem is growing both in developed and underdeveloped countries. It’s one that the security people are catching on to now...”

Simon Rushton

Associate fellow, Centre on Global Health Security at Chatham House and lecturer in politics, University of Sheffield

Some 50 percent of interviewees pointed to these factors as rationale for their belief that the international community isn’t prepared to deal with a public health emergency or state of international concern.

Three

Continued collaboration and increased partnership globally is critical.

With so many leaders in health, security, governance, and policy sharing the view that the world isn’t prepared for the pandemics to come, what can be done to get prepared?

The report finding is clear: Collaborate.

“Global health engagement is a great avenue for partnership across the U.S. government and among other health and security institutions...”

Dr. David Smith

acting assistant secretary of defense for health affairs

Many believe that constructive partnerships — such as the Global Health Security Agenda, a partnership between 60 countries — are the way to go. Most respondents acknowledged there had been some progress in this area, but said global coordination needed to improve.

Global partnerships with multi-sectoral involvement could be a key component in ensuring preparedness for the next pandemic.

“The GHSA is becoming a mechanism for horizontal collaboration across a number of different types of programs to advance countries’ whole health systems and, more importantly, to achieve specific, measurable targets...”

Dr. Elizabeth Cameron

senior director for global biological policy and programs, Nuclear Threat Institute, and former senior director for global health security and biodefense on the White House National Security Council

Top groups or bodies critical to advancing global health security

Some 40 percent of interviewees said joined-up thinking didn’t only need to happen between leaders at the government level, but with international organizations, civil society, and the private sector. For example, the private sector provided critical support to the Ebola relief and recovery effort and GHSA’s private sector roundtable, led by Johnson & Johnson and the GE Foundation, harnesses the power of the private sector in preparing and responding to health-related crises. Partnerships of this type, replicated worldwide with multi-sectoral involvement, could be a key component in ensuring preparedness for the next pandemic.

“Global health security is a great example of public-private partnership. It’s bringing forward what we do best.”

Dr. Alan Tennenberg

Chief medical officer, Johnson & Johnson

Four

Investments in global health don't just improve health.

Partnership isn’t the only component needed to improve emergency preparedness and global security. The report revealed that many believe further investment is vital to preventing potential harm from pandemics and outbreaks. According to interviewees, healthier societies mean stronger economic growth and productivity, which in turn provide a foundation for local, national, regional, and global stability.

According to the World Bank, the Ebola outbreak in 2014 cost Liberia, Guinea, and Sierra Leone jointly an estimated loss of $2.2 billion in 2015 in gross domestic product.

Health and security leaders interviewed believe the same could happen to other countries if adequate health systems and infrastructure aren’t in place, and can further catalyze tensions in fragile states. Indeed, 79 percent of interviewees said that health emergencies disrupt economic activity, trade, and labor productivity, causing economic losses.

“Health equals wealth. We know that when communities are healthier that they're wealthier, that there's more opportunity for economic development...”

Caroline Roan

vice president, corporate responsibility, Pfizer Inc., and president, Pfizer Foundation
The recent outbreaks of Ebola in 2014 and Zika in 2015-2016, have spurred an increased understanding of just how seriously diseases, illnesses, and harmful substances can affect entire populations.

Interviewees stated that the potential impact of a disease outbreak is exacerbated by the interaction of multiple risk drivers that affect an economy. Aside from the direct cost of treating illness, health events can cause public fear and hysteria that reduce work force productivity and impact a wide range of sectors, including trade, tourism, and transport.

"Afghanistan has historically been one of the least healthy nations in the world, which is closely related to the country’s instability...”

Dr. Anthony Fauci

director, U.S. National Institute of Allergy and Infectious Diseases

Five

Strong health infrastructure underpins health security.

This interconnected state of affairs highlights the critical need for investment in health systems, not only as a barrier to poor health, but also as a preventative method against a breakdown in economies and states of peace.

Percentage of respondents that cited health system strengthening as essential to improve health security

Building resilient health infrastructures that make the world safe and secure will require going beyond the initiatives already in place.

The majority of interviewees suggest that both long-term prevention and emergency response are equally important and agree that building resilient health infrastructures that make the world safe and secure will require going beyond the initiatives already in place.

More needs to be done.

“There is an emphasis today on creating global mechanisms to detect and respond to infections, which is a good safety net. However, the most...”