BOUSKILL-GlobalHealthSecurity-2019

Introduction to Global Health Security

• Authors: Kathryn E. Bouskill and Elta Smith (RAND Corporation, 2019)

• Publication Source: Access via JSTOR (stable URL)

• Purpose: The document discusses the evolution of global health security, its current scope, challenges, and emerging threats in today's interconnected world.

Bioterrorism and Health Threats

• Scenario: Imagine a bioterrorism attack using genetically engineered pathogens.

  • Public health institutions inundated with patients fearing infection and those who are genuinely sick.

  • Scientists would be tasked with quickly identifying the unknown pathogen.

  • The potential for massive social, economic, and political disruption.

  • Historical Context: The mortality of the 1918 Spanish flu (estimates of 50 million deaths) compared to World War I (approx. 20 million deaths).

Current Public Health Vulnerabilities

• Emerging Threats: More covert than direct attacks; examples include:

  • Mental Health Crisis: Depression now the most significant cause of disability globally.

  • Opioid Crisis: Ongoing potential for catastrophe without clear solutions.

  • Infectious Disease: Outbreaks of diseases like measles serve as reminders of past vulnerabilities.

  • Antimicrobial Resistance (AMR): Projected to cause more deaths than cancer by 2050 if unaddressed.

  • Impact of Climate Change: Changes in vector-borne diseases and connections to noncommunicable diseases.

Interdependence of Health Systems

• Globalization Impact: Increased human-animal-environment interaction raises epidemic risks.

• Holistic View: Recognition of interconnected health systems is vital.

• Public Trust Issues: Growing mistrust toward medicine, particularly influenced by movements like anti-vaccination.

Evolution of Global Health Security

• Definition of Health Security: Originally limited to infectious diseases; calls for broader perspectives include mental health, AMR, and environmental health.

• Collective Vulnerabilities: Global health security requires reconceptualization away from narrow definitions focused solely on immediate threats.

Objectives of the Perspective

• Aims:

  • Review scope of global health security.

  • Identify emerging threats.

  • Evaluate adequacy of existing frameworks in addressing current and future challenges.

Primary Challenges Identified

• Trade-Offs in Policy: Navigating swift decisions under crises while considering long-term implications.

• Funding Gaps: Lack of financial resources hinders effective action in health security.

• Systems Thinking: Emphasizing prevention, surveillance, and response frameworks in addressing complex global health challenges.

Slow-Burn Issues vs. Emerging Technology Threats

• Slow-Burn Issues: Long-term health problems often ignored until critical damage has occurred.

  • Example: Opioid abuse significantly impacting the economy.

• Emerging Technologies: Positives (like precision medicine) balanced against negatives (potential for misuse).

Intersection of Health and Security

• Health & Security Relationship: Economic downturns compound health crises, and vice versa.

• Key Contextual Examples: The cholera outbreak in Yemen illustrates profound ties between health crises and security environment.

Conclusion

• Future of Global Health Security: Urgent need for comprehensive frameworks that accommodate long-term solutions beyond infectious disease prevention alone.

• Call to Action: Encourage multi-sector collaboration and treat health security as a national security concern.