Taking temperature, taking stock: Sustaining global efforts to combat endemic (and emerging) diseases

4 Oct

Editor’s note:  This post is written by Karin Perro who is currently finishing up graduate study at John Jay College of the City University of New York.   During her limited time in the UN Security Council, Karin witnessed the Council’s efforts to address the peace and security implications of the Ebola outbreak.  As she notes, however, Ebola is not the only health-related threat to peace and security, or for that matter to the fulfillment of the post-2015 Sustainable Development Goals.

Recently, the halls and chambers of the UN have resonated with horror over the growing specter of Ebola in West Africa. And rightly so – the current epidemic poses an urgent health threat to global human security, with the potential to undermine the already fragile economic and democratic vitality of afflicted states. While immediate, heightened efforts to staunch the deadly outbreak are imperative, we must be mindful that the current crisis not overshadow the need for continued vigilance in combating extant endemic diseases such as malaria, tuberculosis, and cholera. Such diseases are largely curable with early detection and treatment, yet account for an alarming number of global mortalities, with some estimates attributing over five million deaths annually to endemic pathogens. The transmission of polio virus is on the rise after two decades of near eradication. The Center for Disease Control warns that the polio virus could conceivably paralyzed more than 200,000 children worldwide annually over the next decade if coordinated curtailment measures are not initiated now.

The combination of an insidious persistence of endemic diseases – and the potential for more Ebola-like emerging disease outbreaks – has the potential to undermine the objectives articulated in the Post 2015-Millennium Development Goals. Health is a fundamental human right, and crucial to global security. It needs to be prioritized.

New challenges continue to exacerbate the underlying malaise already stifling international health security. This month’s briefing to the UN by Every Woman, Ever Child (EWEC) noted impressive progress in reducing maternal and infant mortality, with Dr Robert Orr of the UN Executive Office of the Secretary General announcing that the lives of 17 thousand children are saved daily as a direct result of EWEC initiatives. While laudable, such goal attainments might ironically lead to an increase in those populations most susceptible to endemic diseases, and a further taxing of already resource-scarce national health plans. In addition, the disturbing proliferation of armed insurgencies worldwide are creating unrelenting burdens in delivering health care and essential medicines to those suffering in conflict zones.

Access to affordable, essential drugs and vaccines in developing countries is fundamental in combating endemic diseases. Greater political commitment and funding is needed to address the inadequate access to such drugs by undeveloped countries. In addition, many organized criminal networks have redirected their enterprises from the illicit drug trade to marketing in counterfeit drugs that often prove more lucrative. Current anti-counterfeiting policy measures have proven inadequate in stemming the flow of pharmaceutical counterfeits, particularly to developing nations where treatments based on fake essential drugs, such as anti-malarials, imperil the lives of millions in Africa, South East Asia, and parts of Latin America.

As we approach the final adoption of the Sustainable Development Goals (SDGs) and initiate their implementation, it is incumbent on all stakeholders to take stock of the current overall global health “temperature” and reconfirm their commitment to their stated goals as they relate to global health security. The focus of the SDGs on eradicating poverty and promoting universal education is inextricably intertwined with the physical health of targeted populations. Poverty and endemic disease are tandem barriers to the overall socio-economic health of developing states, while the success of SDG educational goals are predicated on the physical well being of the communities they aim to serve.

Without adequate support for the prevention, treatment, and control of endemic diseases, malaria-stricken children will be incapable of attending SDG-inspired education programs and initiatives. Women debilitated by tuberculosis will be prevented from participating in community or regional governance in a sustainable and substantive manner. Adults weakened from cholera will be denied the ability to provide economically for their families through newly developed, SDG-inspired employment opportunities. And emergent diseases, conceivably affecting large swaths of regional populations, will only compound the severe obstacles already facing global health objectives.

For the moment, we must divert our energies to suppressing the dire Ebola outbreak in West Africa. The Secretary General’s formation of the United Nations Mission for Ebola Emergency Response (UNMEER) is a positive step in addressing the current heath crisis. However, with unabated world deforestation and climate shocks, deadly new pathogens will certainly continue to emerge. We need to take proactive steps now to avoid dilatory, reactive attempts at squelching pathogenic wildfires in future. To that end, it is hoped that the recently developed Crisis Response Mechanism of the United Nations will provide an effective framework for predicting and then responding to current and future health crises. At the same time, the Global Health and Security Agenda (GHSA) calls for accelerated progress in combating biological threats, including control and prevention measures, through a five-year implementation plan. But timely and intensified responses are critical. As stated by the Chair of GHSA, “a biological threat anywhere is a biological threat everywhere” and “the consequences of not acting are unfathomable”.  ‘Health keeping’ now rivals the importance of peace keeping in the struggle for global security.

Synergy across sectors (a considerable UN refrain) will be essential in achieving not only SDG health initiatives, but also rapid response strategies to avert future epidemics. Triangular partnerships will need to be forged between governments, the private sector, and civil society. Uneasy alliances will be required linking corporate sponsors and health NGOs. Moving forward, corporate partners must demonstrate transparency in achieving local health objectives consistent with national health priorities. They will need to ensure that their efforts are not predicated on profit bottom lines, and must be open to accountability if their credibility as health actors is to be maintained. ‘Might’ in this instance rarely equates with ‘right’.

Likewise, NGOs must refrain from appropriating bureaucratic, big business practices that can stifle flexibility towards the achievement of urgent health response.  The inclusion of all stakeholders must be real and substantive, not sidelined as merely rhetorical participation. Perhaps most importantly, political will is paramount in avoiding what might be seen as ‘anemic’ responses to global health challenges. Eradicating the ‘ills of the world’, as articulated within the SDGs, could well be undermined by more literal, health-related ills if threats from both endemic and potentially emerging diseases remain inadequately addressed by all relevant stakeholders.

Karin Perro, GAPW Intern

 

 

 

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