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Health Security is a serious global concern. Outbreaks such those seen with severe acute respiratory syndrome (SARS), Nipah virus infection, avian influenza A (H5N1) and A (H7N9), Ebola virus and the ongoing outbreak of Zika virus have killed thousands of people and led to huge economic losses. While SARS infected 8000 people, the economic cost was estimated at $30 billion in 4 months. [1],[2]
Key challenges in East Asia Pacific
In many ways, the East Asia Pacific (EAP) region has been at the epicentre of some of these emerging and re-emerging diseases. While there are ongoing regional health security initiatives – on capacity development and disease surveillance, for example –sustainable financing for health security and pandemic preparedness remains a key challenge.
In 2016, over 80 participants including EAP government delegations (i.e. ministries of health, agriculture/livestock, and finance); representatives of regional organizations; multilateral agencies and development partners came together to discuss regional collaboration and sustainable financing of health security efforts. A key recommendation from the meeting was the development of a health security financing assessment tool that encompasses the one health/all hazard approach, and builds on existing tools and mechanisms.
Partners established a Technical Task Force (TTF) to guide the development of the assessment tool and to support health security financing assessments. The World Bank Group is facilitating the establishment of the TTF.
The TTF has since developed a health security financing assessment tool that encompasses one health/all hazard approach and builds on existing tools and mechanisms.
Regional collaboration
The meeting had the following objectives:
Review and discuss the revised draft of the Health security financing and institutional assessment tool (HSFAT).
Discuss implementation details of the HSFAT at a country level.
Discuss next steps with respect to test piloting HSFAT.
Discuss and finalize the draft questions and indicators on financing to be included in a Joint external evaluation (JEE) tool.
The Viet Nam Vice-Minister of Health hosted the meeting, and included participants from the Governments of Vietnam, Indonesia, Myanmar, Cambodia and Lao PDR; a range of international organizations such as the World Bank, FAO, OIE; and bilateral partners like Australia, and the United States.
Through its Department of Foreign Affairs and Trade (DFAT), the Government of Australia generously financed the meeting, and will also support the first country assessments of the tool.
The meeting led to a number of proposed revisions of the tool, and the TTF anticipates that the final version will be approved in June 2017. The first country to use the tool will be Viet Nam.
Asia Pacific Leaders Malaria Alliance (APLMA)’s role
APLMA occupies a unique role in regional health collaboration and financing. As a core element of a key regional platform, the APLMA secretariat was invited to review the tool and support its implementation. Most importantly, going forward, APLMA will work with partners to help identify the most suitable political framework and processes for strengthening regional health security collaboration and forward-looking domestic and external financing.
Dr Ben Rolfe, APLMA Executive Secretary, highlighted the strong links between malaria elimination and health security. [3]
“We were pleased to contribute to this important meeting. Malaria and health security are intimately connected,” said Dr Rolfe. “By building strong surveillance, and laboratory and response systems, and by addressing the drivers of drug resistance, we can advance the malaria elimination agenda while addressing future health security threats. To do so effectively, the region needs effective collaborative platforms like APLMA.”
[1] World Bank. Sustainable Financing and Regional Cooperation to Improve Health Security and Pandemic Preparedness. Bali, Indonesia (2016).
[2] Other data are available here: http://www.worldbank.org/en/topic/pandemics/overview
[3] There are strong links between malaria and regional health security. The arrangements required for cross-border cooperation around malaria and other health threats are the same. To reach and sustain malaria elimination, health systems need to build stronger surveillance, laboratory and response systems for malaria outbreaks. Strengthening these systems also builds the capacities required for tracking other infectious disease outbreaks and health security threats, such as dengue and epidemic influenza. Over time, reducing the need to respond to malaria cases and outbreaks frees disease surveillance, response and clinical staff/facilities to be able to deal with other infectious diseases and epidemics. It is an investment with short-term gains and a long-term legacy. Elimination of drug-resistant malaria will require systems that address the drivers of drug resistance – not only for malaria treatment, but also of other antimicrobial agents – which are serious emerging health security threats. APLMA’s work on malaria elimination has, for example, already brought together drug regulators from the region to discuss stronger cooperation on pharmaceutical regulation.
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