18–19 March 2010
Venue: Holiday Inn Singapore Orchard City Centre Hotel
Pandemic Preparedness in an Interconnected World
Regardless of how strong a country’s national health system is, it is only as good as its neighbours’ because pandemics and infectious disease render national borders incapable of mitigating the security threat. Hence, there is a need for countries to focus on regional cooperation, as part of the larger strategy in responding to the global infectious disease crisis. This is one of several issues highlighted by Dr Noeleen Heyzer at a conference on Strengthening Health and Non-Health Responses Systems in Asia: A Sustained Approach for Responding to Global Infectious Disease Crises.
The two-day conference, which ended on 19 March 2010, was organised by the RSIS Centre for Non-Traditional Security Studies. Dr Heyzer is the Under-Secretary-General of the United Nations and Executive Secretary to the Economic and Social Commission for Asia and the Pacific (ESCAP). The Senior Minister of State for Law and Home Affairs, Associate Professor Ho Peng Kee, was the guest of honour at this event.
In her keynote speech, Dr Heyzer highlighted two additional factors, which she felt would affect the pandemic preparedness of countries. These factors are the rapidly changing contexts under which health systems operate, and the socio-economic factors that affect peoples’ health. With increasing international migration, countries whose national policies exclude migrants and undocumented migrants create risk for its population and those of its neighbours. Thus, governments should ponder how their health systems could be effective in mitigating the spread of disease in an increasingly interconnected world. On the issue of the socio-economic determinants of health, Dr Heyzer cited a World Health Organization (WHO) report which warned that “social injustice is killing on a grand scale”, clearly suggesting that health equity is crucial to improving healthcare for the people. Thus, Dr Heyzer stressed that governments must strive to ensure affordable and accessible healthcare to all.
In her final remarks, Dr Heyzer concluded that countries should focus on strengthening regional collaboration rather than concentrating solely on their respective national health systems. She also called for a standardisation of health systems across countries since health systems have cross-border implications in addition to the obvious national dimensions. In her final analysis, she warned that a lack of investment in healthcare in one country can jeopardize the health of citizens in neighbouring countries.
Socialising the National Health Systems: Think Global, Act Local
Building upon the call for greater international cooperation, participants pointed out that countries must also think globally and act locally in securing their national health systems. They warned that a country’s programme must be sensitive to the socio-economic status of its population since much research has shown that several national health systems appear disconnected from the socio-economic reality of the population. As a result of the disparity, certain segments of the local population may find themselves more vulnerable to the threats of pandemics despite the presence of a strong national health system. In fact, many participants argued that the most vulnerable communities in societies should be accorded more protection and assistance. One participant went further to suggest that one way of strengthening national health systems is for developing countries to collaborate with global and regional institutions, developed countries, the media and civil society groups. Each of these actors can play a role in ensuring that the national health systems and pandemic preparedness strategies are comprehensive and sensitive to the needs of the local communities.
In discussing the barriers that impede improvements to the delivery of national healthcare services, participants pointed out that many countries have a weak public health infrastructure, limited collaboration with non-state actors and a lack of epidemiology and laboratory capacity. These shortcomings are prevalent in a number of developing countries and may have dire consequences on a regional or global scale. The participants also noted that there is a lack of flexibility in several countries’ pandemic preparedness plans. Although countries have improved their national health systems and infrastructures, these systems are built around specific types of viruses and epidemics, which may yet again leave the general population vulnerable to other types of pandemics that, require a different response.
Participants therefore stressed that it is imperative to develop an efficient and effective early warning disease detection system at the global and national level. Such a system is necessary, especially in an increasingly globalised and interconnected world, to ensure countries are able to control an epidemic disease from the onset. In addition, participants noted that early warning systems should be reinforced by an equally effective regional and national epidemic response system. However, it requires greater international cooperation and data sharing, inter-state investments in technical facilities and public health infrastructures, which can only be achieved with greater economic cooperation amongst states.
Looking ahead, the participants agreed that there is a need to emphasise on problem and policy-oriented research, and capacity building. Research in public healthcare in the context of pandemics should be problem-solving-oriented and driven towards studying the equity and vulnerability issues of the poor while policy-oriented research should study the effectiveness of existing healthcare policies and pandemic preparedness strategies. This is in part driven by the observation that the uncertain nature of pandemics has led to confusion among policymakers and public officials, resulting in the occasional incoherent and inconsistent policies and actions. On that note, participants called for greater transparency in information sharing and for national agencies to share their experiences and expertise with other countries. At the level of capacity building in the community, more can be done to educate and prepare the public on appropriate social behaviour such as social distancing, the use of surgical masks and the practice of public hygiene during times of crisis.
In conclusion, apart from placing greater emphasis on research, policy reforms, increased investments in public health systems and infrastructures, and more involvement from non-state actors, there needs to be a synergy in the participation of both state and non-state actors. This synergy should ultimately lead to improved trust and communication between the public and the state which would enhance the overall global capacity to mitigate the spread of diseases.
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