Is the GHSA going to prevent the next pandemic?

Let’s talk about the Global Health Security Agenda (GHSA) and how it may be the solution for preventing the next pandemic.

The Global health security what

Now don’t worry if you haven’t even heard of the Global Health Security Agenda (GHSA). It’s a relatively new endeavor launched in February 2014.

According to the GHSA website it’s purpose is to¬†“advance a world safe and secure from infectious disease threats, to bring together nations from all over the world to make new, concrete commitments, and to elevate global health security as a national leaders-level priority.”

Over 50 nations, international organizations and non-governmental partners are part of the GHSA. The GHSA was originally designed to last five years (until 2019) but during the July 2017 meeting in Seoul many member organizations pushed to extend the GHSA for another five years.

Countries actively participating in the GHSA.

Countries actively participating in the GHSA.

Part of what makes the GHSA so interesting is the assessment of partner countries through a tool called the Joint External Evaluation (JEE) tool. It’s a voluntary evaluation a country undertakes to evaluate the country’s capacity for health security. The countries are evaluated on technical areas in the core elements of:

  • preventing infectious diseases and pandemics
  • detecting threats early
  • responding rapidly and effectively

The JEE tool contains a self-evaluation and external evaluation phase. Once the results of the evaluation are complete countries can use the information for planning and priority setting. You can read the results of the United States, Somalia, Kenya, and others that have completed the JEE.

Cover of the JEE report for the United States.

Cover of the JEE report for the United States.

GHSA and pandemics

You may be thinking to yourself, “this GHSA sounds like a lofty and decent goal to bring the world together to work on common infectious disease issues”, and you’d be right. It does sound great. The framework identifies issues regarding preventing and detecting infectious disease outbreaks. The more countries who are prepared to prevent and detect infectious disease outbreaks the better chance we have of preventing that outbreak from becoming the next pandemic.

But there are some who have issues with the GHSA. While the GHSA has certainly helped countries ready themselves for a future pandemic, I question whether the motivation is to improve global health for all or to protect ourselves. That may not seem like a very big distinction but it absolutely is. Coming at this from a “global health” mindset ensures that the work will increase the health of the population. Coming at this from a “protect ourselves” mindset ensures that this initiative is another national defense initiative, and not a health initiative. By putting the GHSA into national defense situation, military connotations are sure to arise. National defense priorities rarely work towards improving population health, instead they focus on security, political and economic goals.

In fact, the United States has already started to implement the GHSA into the “protect ourselves” mindset. The US emphasizes the bioterrorism aspect of the GHSA and links the GHSA to the Department of Defense and the State Department. The two departments where defense and national security reign supreme.

Additionally, the GHSA’s focus on national security-related health goals runs the risk of diverting funds away from other humanitarian-related health goals. There is only so much foreign aid money many countries are willing to provide. By focusing foreign aid on GHSA goals the money can’t be spent on things like the Sustainable Development Goals (which replaced the Millennium Development Goals) which are more traditionally global health focused. Add in the potential decrease in focus on non-communicable diseases, which don’t create pandemics, and you can see how the GHSA sounds good in theory but may not be so good in practice.

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