This week in Rotterdam, the United States will join the Netherlands and other participants in the 55-country Global Health Security Agenda (GHSA), as well as non-governmental organizations, foundations, and private sector stakeholders, as they take collective action to address epidemic threats. The GHSA is a signature global health and national security priority for President Obama. It was launched in 2014 – before the first cases of Ebola in West Africa came to light – due to leadership of the United States and partners from every region of the world. In only three years, the GHSA has sparked historic commitments and kindled new momentum to establish global capacity to address devastating outbreaks – whether naturally occurring, deliberate, or accidental. Equally important, the GHSA involves all sectors of government and engages leaders from around the world – the level of commitment required to prevent, detect, and respond to biological threats that cross borders in an increasingly globalized world. The GHSA has also ignited innovative and historic common targets and tools so that all countries can better share information, know where they stand, measure progress using the same metrics, and work collectively to fill remaining gaps.
Under President Obama’s leadership, the commitment of the United States to advance the GHSA is second to none. When the GHSA was launched, only approximately 30 percent of all countries were able to report that they had the necessary capacities in place to address public health emergencies. Since the launch of the GHSA in 2014, 17 at-risk countries are receiving $1 billion in United States assistance to address epidemic threats, 31 countries and the Caribbean Community are developing 5-year plans with common targets and milestones to measure outcomes, the G-7 Leaders have made a collective commitment to assist 76 countries and regions, 18 countries – including the United States – will have undergone a World Health Organization (WHO) Joint External Evaluation (JEE) by the end of this week, and over 30 additional countries are scheduled to do so.
Additionally, even as we respond with urgency to today’s outbreaks, we must be smart enough to think ahead, and bold enough to invest in future solutions. One of the ways we are doing that is by sourcing innovations through USAID’s Combatting Zika and Future Threats Grand Challenge. This week, USAID announced a second set of awards to combat future threats. From issuing new technology to deliver critical medical supplies in remote areas to the use of big data to prevent future disease outbreaks, innovators across the globe are responding with solutions to tackle the outbreaks of today and strengthen our position in the fight against the outbreaks of tomorrow.
But much remains to be done, and all countries must play a major role in their own preparedness and in assisting those that cannot become prepared on their own. Accordingly, the GHSA is becoming increasingly relevant as the United States fights Zika at home and abroad and as it partners with other countries to combat antimicrobial resistance, rebuild health systems in West Africa, and remain vigilant against the threat of bioterrorism. We call on all countries and partners to work together across all sectors and at the highest levels of government to achieve the vision of the GHSA: a world safe and secure from infectious disease threats.
United States Commitments and Next Steps to Advance the GHSA
The United States is committed to achieving all of the GHSA targets at home, assisting other countries to achieve these goals and working cooperatively with governments, international organizations, and non-governmental stakeholders to enhance global capacity to prevent, detect, and respond to biological threats, whether naturally occurring, deliberate, or accidental. This includes implementation of the International Health Regulations (IHR) and other relevant global health security frameworks such as the Performance of Veterinary Services Pathway of the World Organization for Animal Health.
U.S. commitment to partner with 31 countries and the Caribbean Community to achieve the GHSA targets
The United States has made bilateral commitments to partner with 31 countries and the Caribbean Community to achieve the targets of the GHSA, including the development of five-year national Roadmaps. In July 2015, the U.S. government announced its intent to invest more than $1 billion in resources to expand the GHSA to prevent, detect, and respond to future infectious disease outbreaks in 17 partner countries. To date, all of these countries have completed assessments of GHSA target capacities and have designed five-year Roadmaps that reflect input from multiple sectors, including health, agriculture, livestock, development partners, and non-governmental stakeholders. In addition, most of the Roadmaps have been published on GHSAgenda.org, demonstrating country commitment to transparency and the achievement of GHSA targets. In addition, the United States is partnering with 13 additional countries, as well as the Caribbean region, to design Roadmaps and forge the partnerships needed to achieve the GHSA targets.
U.S. commitment to external assessments
The United States supports the JEE and its targets. In 2016, the United States underwent and published a Joint External Evaluation (JEE) for IHR implementation. Further, the United States is actively providing technical and financial resources to implement JEE assessments in countries around the world. In 2014, during the GHSA Summit at the White House, five countries volunteered to undergo a pilot external assessment. In 2015, Finland, the United States, and other GHSA partners developed and tested 11 GHSA targets and a GHSA assessment tool, which was finalized during the September 2015 GHSA High Level Meeting in Seoul. Building on the GHSA assessment tool, the WHO released the JEE tool in early 2016. The tool contains the GHSA targets as well as other measures of national capability to implement the IHR.
Leveraging U.S. Leadership toward global preparedness
During the 2016 G-7 Leaders’ Summit at Ise Shima, G-7 Leaders reinforced support for a coordinated approach to help 76 countries and regions build the capability to prevent, detect, and respond to infectious disease threats. Specifically, the G-7 will offer to assist partners in developing national plans and will measure progress according to the targets of the JEE tool, which includes each of the targets of the GHSA.
Preventing Future Outbreaks from Becoming Epidemics: Since its launch in 2014, the GHSA has brought together partners and sectors from over 50 countries and international organizations around the world to enhance global capacities to prevent, detect, and rapidly respond to infectious disease threats by achieving measurable targets. The GHSA Steering Group includes 10 countries, chaired in 2015 by Finland, in 2016 by Indonesia, and in 2017 by the Republic of Korea. The GHSA Steering Group currently includes: Canada, Chile, Finland, India, Indonesia, Italy, Kenya, the Kingdom of Saudi Arabia, the Republic of Korea, and the United States.
The GHSA invests in needed capacity – infrastructure, equipment, and skilled personnel across sectors – and enhances coordination and commitment for countries, international organizations, and civil society to work together to achieve the following specific targets: Countering antimicrobial resistance; preventing the emergence and spread of zoonotic disease; advancing a whole-of-government national biosafety and biosecurity system in every country; improving immunization; establishing a national laboratory system; strengthening real-time biosurveillance; advancing timely and accurate disease reporting; establishing a trained global health security workforce; establishing emergency operations centers; linking public health, law and multi-sectoral rapid response; and enhancing medical countermeasures and personnel deployment.
As the Ebola outbreak in West Africa reached epidemic levels in September 2014, the White House hosted a high-level meeting with 44 countries to announce over 100 commitments to strengthen capabilities under the GHSA. In 2015, the Republic of Korea hosted the second high-level event to bring together countries and organizations participating in the GHSA to highlight new commitments and progress. This week in Rotterdam, the Netherlands is hosting the third GHSA high-level event to highlight and implement country commitments. These high-level meetings, and the commitments formed and implemented through them, help to achieve a world safe and secure from infectious disease threats.