Responding to Global Health Crises

The United States has contributed to significant successes in health globally. However, the possibility of infectious disease outbreaks, the threat of conflict and resulting population displacement, and natural and man-made disasters have the potential to significantly undermine these advances. These crises demand innovative and coordinated thinking about global responses to pandemics and health-related crises.

Recent outbreaks of the Ebola virus and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), as well as other threats such as Zika, show the impact of an interconnected world on increasing vulnerability to health threats. As such, an effective U.S. response must include humanitarian intervention, robust research and development, and be integrated with global efforts to address unmet and underserved health needs with pandemic implications. Similarly, by strengthening local capacity to detect and monitor disease outbreaks, expensive response and treatment plans may be mitigated. In humanitarian crisis situations, the burden of disease and the mortality levels are bound to rise. More than one-third of maternal deaths worldwide and half of the children who die before age 5 live in fragile states. As a result, assistance to those affected should be holistic and independent from security or political agendas. Treatment for survivors of gender-based violence, promotion of optimal nutrition for women and children, water, sanitation, and hygiene, and mental health and psychological support, must all be considered and included to organize holistic systems-based response.

Clear and deliberate coordination at the systems and micro levels is paramount in complex health and humanitarian emergencies. Effective emergency response programs can help lay the foundation for stronger and more resilient health systems once a crisis has abated. Robust health systems are also critical to ensuring countries have the capacity to prevent, detect, and respond to disease outbreaks—a critical component of the Global Health Security Agenda. An integrated response to global health crises will ensure that U.S.-led response efforts are sustainable, coordinated, and reinforce critical investments in strengthening global health systems.

InterAction Recognizes

  • The United States plays a critical role in responding to global health and humanitarian emergencies. To sustain and build upon this leadership, the U.S. must take an integrated, forward-thinking approach to pandemics and global health crises. In 2015 alone, the U.S. government provided $991 million in direct support for emergency health programs. Through these investments, the U.S. has been successful in saving lives by providing essential health care such as emergency medical interventions, nutritional support, access to clean water and sanitation, and preventing the outbreak of diseases. As global health situations become more complex, it is vital to pursue an integrated disaster response model that combines short-term needs such as emergency health, water and sanitation, nutrition, and maternal and newborn care—with long-term interventions to prevent and mitigate future crises including investments in mental health, research and development for new health technologies, and building sustainable health systems.

  • Global coordination and cooperation through the Global Health Security Agenda (GHSA) and International Health Regulations are key to preventing, detecting, and responding to public health emergencies. Launched in 2014, GHSA connects the U.S. and more than 40 partner countries with international organizations and other stakeholders to work toward better coordination to prevent, detect, and respond to public health threats. The International Health Regulations (IHR) were developed by the World Health Organization and adopted in 2007 to provide a framework for the coordination and management of public health emergencies. The IHR also builds the capacities of countries to detect, assess, notify, and respond to such threats. To fulfil the promise of these initiatives, it is important to support the goals of global coordination and cooperation to prevent, detect, and respond to public health emergencies.

  • Underinvestment in water, sanitation and hygiene (WASH) compromises health systems and global health security efforts. Fewer than half of health facilities in the developing world report sustainable access to WASH, compromising infectious disease response and efforts to prevent antimicrobial resistance. During the 2014 Ebola outbreak in West Africa, a lack of WASH—especially access to water and basic protective equipment like gloves—enabled further spread of the disease among households and communities. Proper sanitation and hygiene in health care settings, even interventions as simple as handwashing, are vital to preventing antibiotic and other drug resistance. 

  • Targeted attacks against health care facilities and workers are increasing, and put already vulnerable communities at even greater risk for not being able to access the health care they need. According to the International Committee of the Red Cross’s Health Care in Danger project, “at least 4,275 people were victims of violence against health care in 4,770 acts or threats of violence.” Providing care to the sick, infirm, and wounded is a human right and the disruption of service during times of conflict undermines fundamental norms. As made clear in InterAction’s Civilians Under Fire report, governments must take concrete action to return health care facilities and workers to their internationally accepted neutrality during conflicts.  

Upcoming Opportunities

  • Provide the authorities, interagency coordination, and financial resources necessary to prepare for and immediately respond to outbreaks, natural disaster response, and humanitarian crises [Annual]:  Funding for global health and emergency response crosses a number of agency budgets. Clear coordination between U.S. agencies will help streamline complex responses. Fully funding programs and departments within Health and Human Services, USAID, the State Department, and other key agencies will help ensure that crises don’t undermine prevention, detection, and response efforts.

  • Support emergency legislation when needed, as well as opportunities to strengthen international and local health systems overseas [Ongoing]: Coordinated, rapid response to bourgeoning health crises is the key to mitigating potentially devastating effects. Congress should heed the advice of health professionals and agencies that monitor health trends and allow for quick funding to emerging threats. Legislation that similarly helps to build national capacity to respond to such threats should be seriously considered as well.

  • Ensure that research and development for new vaccines, drugs, diagnostics, and other health tools are prioritized in pandemic and emergency response strategies [Ongoing]: Emerging infectious disease is a perpetual challenge, and we will not have the tools we need to respond to the next epidemic without forward-thinking, sustainable investments in global health research and development.

  • Support investments in health systems and partnerships with local health ministries in times of non-crisis [Ongoing]: Strengthening local prevention, detection, research, and response capabilities before crises hit will help mitigate the potential for loss of life and extensive response. The U.S. government should work with partner countries on enhancing and improving Global Health Security Agenda targets and action packages—such as specific targets for frontline health workers like nurses and community health workers in the GHSA health workforce action package.

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