Rebecca Katz, PhD MPH
In 2016, Dr. Adam Kamradt-Scott
of the University of Sydney and I independently started thinking that the field of global health security (GHS) was evolving, and it was time to hold an international scientific conference. In early 2017, we joined forces to plan a conference and started raising travel bursary funds that would eventually support approximately 100 researchers from 31 low income countries.
In June 2019, approximately 900 participants from 65 countries converged in Sydney, Australia to participate in the first International Scientific Conference on Global Health Security. Participants included academic scholars; local and national governments; international organizations, non-governmental organizations; public health institutions; animal health organizations; security professionals; and the private sector.
The purpose of the conference was multifold. We intended to:
- Bring together stakeholders working in global health security to measure progress, determine gaps, and identify new opportunities to enhance national, regional and global health security;
- Provide a venue for government officials and International Organizations to share policy developments, hear from the research community, and create a space for side meetings that advance the health security agenda;
- Through an open call for abstracts, highlight work from partners around the world, bringing cutting edge, evidence-based research to the community; and
- Provide an opportunity for students to showcase their research.
By creating this forum, we hoped to establish and solidify a health security ‘community of practice’. This was particularly important as the discipline has been evolving, and often researchers and practitioners were operating with few proximate colleagues. Many researchers were unaware of ongoing work, and few decision makers were accessing research in GHS, even by professionals within their own countries.
In late April 2018, we opened the call for abstracts, in part as a leap of faith. We knew of high profile, well-published colleagues in mostly Western, prominent research institutions. We were also aware of disparate academics interested in this area of study, as we received occasional emails from early career researchers and students, but we were shocked and delighted to receive over 1100 abstract submissions from all corners of the world. In the end, approximately 250 abstracts were selected by the scientific committee to be presented for oral presentations and an additional 200 abstracts selected for poster presentations.
The conference week opened with a two day military health security summit, with a focus on the Indo-Pacific region. One hundred and seventy military and civilian leaders, organized by the Australian and U.S. military, engaged in dialogue on the role of militaries in GHS with a focus on military medical capabilities, and how to advance military-civilian cooperation in GHS, including exploring the need for common legislative frameworks on biosafety and biosecurity. The military summit was followed by a seminar on whether international law has prepared us for the next pandemic. With the WHO just days before deciding not to declare the Ebola outbreak in the Democratic Republic of Congo and Uganda a public health emergency of international concern, this seminar became a timely debate over the future effectiveness of the International Health Regulations.
The first formal day of the conference was reserved for skills based workshops. Conference delegates selected from workshops on infectious disease modeling, drug resistant Tuberculosis, harnessing the power of partnerships, event based surveillance, the Nagoya Protocol, roles for non-governmental actors in messaging and implementation, drug-resistant STIs, environmental risks, biological risks due to advances in technology, and scaling up health emergency preparedness. The next two days of the conference were a mix of plenary sessions, including the kick off plenary of representatives from Centers for Disease Control around the world, and smaller panel sessions. The panel sessions were broken into themes of health emergencies, emerging threats, partnerships, governance and financing, and new technologies and approaches. Each panel was limited to two to three presenters and a moderator, allowing for significant audience participation and dialogue.
This conference was more than just another gathering. This conference led to the development and adoption of The Sydney Statement
, designed to capture our collective thinking on how we define global health security, and priorities for action to develop capacity and improve outcomes around the world. It provided a venue for the head of Africa CDC to find himself in a deep debate with a young intern; for early career legal experts to lead a 200 person discussion on the role of the IHR; for GHS implementers from several African Ministries of Health to meet for the first time and create a virtual network with plans for a monthly VTC to share best practices; for policy makers to be challenged and engage in open discourse around how best to advance GHS; for the leaders of GHS initiatives to engage in constructive dialogue; for governments to learn about research that directly links to their project implementation; for side meetings between donors and recipients- some meeting in person for the first time; and for better understanding the opportunities and challenges associated with private sector contributions to GHS.
GHS2019 clearly established and solidified a health security ‘community of practice’ that should be nurtured and sustained. We are stronger together, and collectively we will advance global health security.
THE SYDNEY STATEMENT ON GLOBAL HEALTH SECURITY
Global health security is a state of freedom from the scourge of infectious disease, irrespective of origin or source. It is achieved through the policies, programmes, and activities taken to prevent, detect, respond to, and recover from biological threats. There are numerous challenges that pose significant risk to global health security, including a wide array of pathogens that present an existing and ongoing threat to both individual and collective health, antimicrobial resistance (AMR) and the emergence of currently untreatable infections, the potential for deliberate use of a biological weapon, and the synthesis of eradicated or novel pathogens. The complexity of addressing these challenges is amplified by a multitude of contextual factors. These threats know no borders and have global consequences requiring more effective collective action.
Addressing global health security threats should be guided by the following set of principles:
1. Global health security interventions must strive to be inclusive, equitable, and data driven.
2. A minimum level of disease prevention, detection, and response capabilities are critical for all countries, as epidemics anywhere threaten the health of everyone. Achieving global health security is also intricately linked with efforts to achieve universal health coverage, efforts to strengthen other vital aspects of broader health and security systems, and the Sustainable Development Goals.
3. Governments must cooperate programmatically, organizationally and financially to foster compliance with the International Health Regulations and other associated legal and regulatory agreements to ensure effective global governance of public health emergencies, and in so doing, encourage international organisations and NGOs to maintain the integrity of international norms, respect for human rights, and social justice. Transparent discussion, sharing, and measurement of global health security capacities is vital for achieving this goal.
4. Achieving global health security requires individual, group, and systems decision making and activities that strengthens capacity across all levels of societal interaction and disciplines. Making the world a healthier, more equitable, and safer place requires action and engagement from all, including the philanthropic, public and the private sector.
5. Global health security must embrace a One Health approach, not only to prevent and respond to disease, but also to protect ecosystems that underpin human, animal, and environmental health. All relevant sectors must be meaningfully involved and engaged, including health, agriculture, environmental, security, and other vital components.
6. Countries with higher capacity to respond to adverse public health events have a moral and ethical duty to work in partnership with those with lower capacity to strengthen their capabilities in a sustainable manner.
7. International partners and national governments must commit to sustainable, comprehensive funding mechanisms to support global health security.
Long-term strategic thinking for global health security must be supported by a diverse, inclusive community of practice, committed to providing the best evidence possible to inform transparent decision making. Achieving global health security requires commitment to the above principles, and the institutional arrangements that advance them globally, to reduce infectious disease threats, including local empowerment, capacity building, data and benefits sharing, transparency, and accountability. Stronger health systems, Universal Health Coverage, and Health-In-All-Policies, from the local to the global levels are all dependent upon and supportive of global health security.