Building Reslience to Biothreats: An Assessment of Unmet Core Global Health Security Needs

Abstract

Global health security is the bulwark against catastrophic public health events. Building this security is a timely and urgent challenge for the world as it faces an increasing rate of emergent and re-emergent infectious disease events tied to changing pressures on animals and ecosystems, resistance to antimicrobials, and avenues for intentional dissemination — all with prospects of rapid spread through our highly mobile population. To date, no end-to-end review of the components needed for effective prevention, detection, response, and recovery from major biological events of any cause, nor an assessment to determine those components that are receiving insufficient attention, has been published.

An optimized global health security system is one that effectively implements and integrates core functions and is enabled by collaborations between governments, non-governmental organizations (NGOs), industry, academia, and communities. Many efforts in various stages at subnational, national, and global levels are directed toward contributing to global health security. Some are advanced by international governing bodies and incorporated into formal frameworks through which activities are funded and coordinated. Others are put forth by networks, coalitions, and consortia of stakeholder groups to identify and implement ways of organizing, advocating for, and contributing to new approaches to health security.

Here we present a framework for rethinking global health security in a way that captures, under a single umbrella, functional areas requiring inputs from the healthcare and public health, animal health, agriculture, environmental, law enforcement and counterterrorism, defense, and disaster risk reduction sectors. It also explicitly considers functions needed to defend against events regardless of their source, whether intentional or unintentional.