Health systems for health security--Strengthening prevention, preparedness and response to health emergencies/ Contribution des systems de sante a la securite sanitaire --Renforcer la prevention, la preparation et la riposte aux situations d'urgence sanitaire.

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From: Weekly Epidemiological Record(Vol. 96, Issue 19)
Publisher: World Health Organization
Document Type: Article
Length: 3,702 words
Lexile Measure: 2060L

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Current approaches to responses to epidemics and pandemics

Continuing outbreaks, disasters and active conflict are all evidence that the world remains vulnerable to health emergencies with significant health, social, economic and political impacts. (1) During the COVID-19 pandemic, even countries considered to have strong health security and strong health systems, as measured by conventional metrics, are struggling to provide routine essential health services. The costs related to the pandemic continue to accumulate, and the world has witnessed excess morbidity and mortality from non-COVID-19 conditions. On stimulus packages alone, countries have spent US$ 15 trillion to mitigate the economic and opportunity costs and reduce the impacts on lives and livelihoods. (2) Countries that are responding well to the pandemic appear to have effective public health systems and good subnational governance and community engagement. (3) In order to strengthen and sustain prevention, preparedness and response capacities for health security, the global community should also accelerate building and investment in critical elements of health systems. (4) Although the global community has emphasized the need to strengthen public health capacities, such as laboratories and surveillance systems, it has not paid comparable attention to strengthening health systems despite them being the foundations of many of the priority public health capacities required for health security. These priority capacities include the important role of primary care, which can relieve demand at hospitals and minimize disruption in a health emergency. Greater attention and action to strengthening national health systems is required to fully advance national and global health security.

Health systems for health security (HSforHS)

The International Health Regulations (2005) (IHR) are a legally binding instrument that sets out the obligations of countries to have the public health capacities to prevent, protect against and respond to the international spread of disease in ways that are commensurate with and restricted to public health risks and which avoid unnecessary interference with international traffic and trade. (5) Following the Ebola virus disease epidemic of 2014-2016, a monitoring and evaluation framework was developed to assess countries' progress towards implementation of IHR capacities. The framework includes assessing countries' capacities in 19 technical areas, such as national laboratory systems, biosafety and biosecurity and public health workforce development.

Although the IHR capacities are necessary, they are insufficient alone to prevent, detect and respond to public health events. Health systems have not been the focus of national work to implement the IHR. Nevertheless, effective implementation of IHR capacities requires robust, resilient, responsive national health systems and also require other sectors to be involved preventive measures, absorb shocks, adapt to disruption and respond to the evolving needs and contexts of public health events while ensuring the continuity of essential health services. Responsive, resilient national health systems also contribute to improving access to health care, thus achieving universal health coverage (UHC), better population health and the United Nations Sustainable Development Goals, in particular ensuring healthy lives and promoting well-being for all at all ages. (6,7)

In March 2019, WHO convened a panel of experts in health systems and...

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