Achieving Health Security and Threat Reduction through Sharing Sequence Data

Global Health Security

To the Editor: Global health security is the protection of the health of persons and societies worldwide. It includes access to medicines, vaccines, and health care, as well as reductions in collective vulnerabilities to global public health events that have the potential to spread across borders. For example, transboundary zoonotic diseases such as avian influenza (H5N1) infections affect animals and humans, thereby threatening health security worldwide because of their high death rates (≈60% in humans) (1). During the past 15 years, fairly standardized responses to threats have been implemented around the globe. Some of these responses have been against severe acute respiratory syndrome and avian influenza (H5N1), which have been overseen by a well-resourced international health system (2). These global health threats have raised the highest levels of political and social concern. This concern has provoked governments and international agencies to address health threats through a security rationale, which emphasizes the themes of national security, biosecurity, and human security. This amalgamation of health issues and security concerns has produced a notion of health security, which is dominated by technical medical approaches and pharmaceutical interventions. These approaches and interventions have already begun to shape the way international health policy is formulated (3). A global vision of health security is very much part of contemporary rhetoric. However, this vision lacks the drive and speed needed to make proposals materialize and operationalize ideas in the geographic areas where they are most desperately needed. Small benefits accrue to members of vulnerable populations who in fact are those most likely to be affected by epidemic diseases. A public health security design that impinges on a global approach runs the risk of neglecting cultural, economic, ecologic, and social conditions on the ground. Regional approaches that address hazards and threats may be more inclusive of context-specific conditions (4). Global public health threats related to infectious pathogens of animal origin are expected to rise. To address these threats, several experts and strategists suggest the initiation of a worldwide early-alerting and -reporting mechanism. Aggregation of disease threats through an event-focused Web-based platform could enable this mechanism. This timely gathering of disease intelligence can inform policymakers about the nature of risks. Disease maps can display details needed to design tailored policies and control measures to tackle diseases according to their specifics (5). Leading scientists and researchers continue to try to understand the global temporal and spatial patterns of animal diseases. This understanding is gained through an array of instruments, ranging from the use of satellite images to cutting-edge molecular technologies. The momentum so far has created an open forum for decisionmakers to collaborate with the leading international agencies to advocate for surveillance, identification, and control of zoonotic diseases to uphold global public health security (6). However, global initiatives suffer from the free-rider problem and from moral hazards. Some low-income countries with weak governance have alerted the international community about their fragile health care systems to capture a nontrivial portion of funds that seldom reach their intended destinations. These resource allocations to developing countries foster aid dependence (7). The international technical agencies tasked with upholding animal and human health should remain at the forefront of identifying and addressing evolving threats. This process will demand continuous flexibility, agility, and a coordinated international effort. Attaining goals of mitigating threats and reducing risks posed by the emergence of zoonoses requires close collaborations with national health authorities and local governments. The large investments planned to improve foresight and prevention might or might not work. If they do not work, apportioning blame to countries or regions for disease flare-ups can result in social, political, cultural, and economic consequences that in the past have turned out to be unjustified, unfair, and ultimately detrimental (8). Clearly, global health threats can be reduced only by the concerted actions of national and international actors. In the years ahead, the international community will almost certainly be expected to bring its formidable technical knowledge, skills, and analytic capabilities to confront this expanded global health threat environment (9). It would be wrong, however, to forget the many insights that current advances in epidemiology and surveillance have delivered. In fact, should the impetus to finance a global health agenda encounter opposition or obstacles, it would seem easier and logical to strengthen already functional activities. Lastly, the realities and the prevalent policymaking environment have created a trap between a desire to prioritize global health by portraying aspects of it as an existential security issue and the fact that security ultimately might not be the most useful language for describing and institutionalizing the health threats and hazards confronted by societies around the world (10). Regardless of whether a trap has been created, action is urgently needed.

The concept of ‘health security’ has been increasingly apparent in recent years in both academic and policy discourses on transborder infectious disease threats. Yet it has been noted that there are a range of conceptualisations of ‘health security’ in circulation and that confusion over the concept is creating international tensions with some states (particularly from the Global South) fearing that ‘health security’ in reality means securing the West. This article examines these tensions but puts forward an alternative explanation for them. It begins by looking at the different ‘health securities' that characterise the contemporary global health discourse, arguing that there is in fact a good deal more consensus than we are often led to believe. In particular there is a high level of agreement evident over what the major threats to ‘health security’ are and what should be done about them. These are a particular set of health risks which are primarily seen as major threats by Western developed nations, and contemporary global responses – often couched in the language of global health security – have a tendency to focus on containment rather than prevention. The article makes the case that to resolve the tensions around (global) health security there is the need for a more explicit recognition of the primary beneficiaries of the current system, and of who is bearing the costs. Only following such a recognition can meaningful debates be carried out about the appropriate prioritisation of global health security in relation to other global health governance priorities.

International scientific collaborations have always been regarded as critical actions to address global pandemics, however, there was an obvious uncertainty between international collaboration and the COVID-19 control. We aim to combine digital data-based strategies to produce meaningful and advanced insights into the imbalance between COVID-19 and international collaboration, as well as reveal possible influencing factors, and ultimately enhance global collaboration. We conducted three retrospective cohort studies using respectively COVID-19 data from WHO, a complete dataset of scientific publications on coronavirus-related research from WoS, and daily data from Google Trends (GT). The results of geovisualization and spatiotemporal analysis revealed that the global COVID19 pandemic still remains serious. The global issue of imbalance between international collaborations and pandemic does exit, and the nations with good pandemic control had their own characteristics in above-mentioned correlation. Digital epidemiology provides, at least in part, evidence-based assessment and scientific advice to understand the imbalance between international collaborations and COVID-19. Our investigation demonstrates that transdisciplinary conversation through digital data-based strategies can help us fully understand the complex factors influencing the effectiveness of international scientific collaboration, thus facilitating the global response to COVID-19.

Background Member States lack of compliance with 2005 IHR implementation led to the launched of the Global Health Security Agenda. This research will provide an understanding of how the Global Health Security Agenda Steering Group (GHSA SG) governance interventions impact health system performance and global health security. This will enhance the understanding of a Steering Group's governance interventions in complex Global Health initiatives. Research questions: To what extent have GHSA SG governance interventions contributed towards enabling health system performance of WHO Member States? To what extent have GHSA SG governance interventions contributed towards the implementation of global health security among WHO Member States? Methods Correlational analysis using Spearman's rho examined the relationship between governance, health system performance and global health security variables at one point in time. A convenience non-probability sample consisting of eight WHO Member States was used. SPSS Statistics generated the bivariate correlation analyzes. Results Governance and health system performance analysis indicated a statistically significant strong positive effect size in 11 out of 18 and moderate positive effect size in the remaining seven out of 18 health system performance indicators. Governance and global health security analysis concluded three of the governance indicators had strong and moderate positive coefficients. Global health security variables demonstrated weak effects in the remaining three governance indicators. Conclusions This study presents a case for health systems embedding in global health security. Health system performance is only as effective at protecting populations when countries achieve core capacities of preparedness and response to global health threats. The associations provide stakeholders information about key characteristics of governance that influence health system performance and global health security implementation. Key messages This study provides an argument for the continued support of the GHSA 2024 Framework with implementation of global health security capabilities and meeting 2005 IHR requirements. The GHSA SG governance role remains profoundly important in establishing sustainable efforts internationally towards achieving the objectives of the GHSA in support of the 2005 IHR standards.

Global health security is concerned with the response to infectious disease outbreaks across international borders. However, its precise nature and scope are contested because of lack of agreement about its focus and beneficiaries. Informed by qualitative interviews with thirty-eight professionals working in the field, this article explores views on how the scope and boundaries of global health security should be understood. The findings illustrate the ways in which those working in global health security operate in a complex moral landscape, with a wide variety of definitional boundaries about what global health security means. Our thematic analysis of this contested area suggests that views on global health security can be helpfully understood in terms of four models, each with different conceptual and moral priorities. We label these four moral models as follows: threat model, collective model, reframing model, and humanitarian model. Understanding the field of global health security in terms of these four sometimes competing models provides a helpful way of mapping out and understanding the complex range of agreements and disagreements that arise in relation to epidemics and other global health security events.

Even though extreme containment and mitigation strategies were implemented by numerous governments around the world to slow down the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the number of critically ill patients and fatalities keeps rising. This crisis has highlighted the socioeconomic disparities of health care systems within and among countries. As new CoVID policies and responses are implemented to lessen the impact of the virus, it is imperative (1) to consider additional mitigation strategies critical for the development of effective countermeasures, (2) to promote long-term policies and strict regulations of the trade of wildlife and live animal markets, and (3) to advocate for necessary funding and investments in global health, specifically for the prevention of and response to natural and manmade pandemics. This document considers some of these challenges.

Practitioners of global health security have long warned of the risks ushered in by rapid urbanization, global interconnectivity, and increasing manipulation of environmental and ecological systems. The COVID-19 pandemic has concretized the often-abstract relationship among global and local phenomena, rendering it an objective and irrefutable physical reality. Despite the stark realization that the globe is only as safe and healthy as its least safe and healthy population, global cooperation is breaking down, power among multilateral institutions is waning, and emerging risks within the digital realm are reshaping global health security. This chapter explores how the shifting dynamics of globalization are impacting the scope and governance of global health security. It is intended to provide researchers, policy-makers, and practitioners of global health security with a primer on perennial issues within global health security, as well as an introduction to novel risks. In particular, this brief overview describes the opportunities and risks of a new class of digital technologies and how they will intersect with global health security. Attention to this shifting landscape of risk will be critical for ensuring global stability in a post-COVID-19 world.

Ebola's legacy: UK deficits and their global lessons

Blockchain technology has an enormous scope to revamp the healthcare system in many ways as it improves the quality of healthcare by data sharing among all the participants, selective privacy and ensuring data safety. This paper explores the basics of blockchain, its applications, quality of experience and advantages in disease surveillance over the other widely used real-time and machine learning techniques. The other real-time surveillance systems lack scalability, security, interoperability, thus making blockchain as a choice for surveillance. Blockchain offers the capability of enhancing global health security and also can ensure the anonymity of patient data thereby aiding in healthcare research. The recent epidemics of re-emerging infections such as Ebola and Zika have raised many concerns regarding health security which resulted in strengthening the surveillance systems. We also discuss how blockchains can help in identifying the threats early and reporting them to health authorities for taking early preventive measures. Since the Global Health Security Agenda addresses global public health threats (both infectious and NCDs); strengthen the workforce and the systems; detect and respond rapidly and effectively to the disease threats; and elevate global health security as a priority. The blockchain has enormous potential to disrupt many current practices in traditional disease surveillance and health care research.

Health security has gained significant attention at the national and global levels, "security" is not a simple term; instead, it is "essentially contested" - that is, it induces debates about what it means and how to use it. This study aimed to define three terms frequently used in health security discussions. These terms are national health security, Global Health Security, and public health. The research method was a scoping review performed in three stages. The first stage was electronic searching based on selection criteria among multiple sources at various time points during the year 2023. These sources included online literature searches, websites of non-governmental organizations (NGOs), and other governmental health agencies. The second stage involved determining the relevance of the selected papers to the study's objectives; the selected papers had moderate to high relevance to the study's objectives. The third stage was to evaluate the methodological quality of a study; we selected peer-reviewed published papers and websitesrecognized as trustworthy sources of information.The search yielded 143 articles; five met the inclusion criteria and were subjected to the definition of health security. Despite proposed definitions, agreement has yet to be reached on the content and scope of health security. Another main finding is that health security requires more state and international collaboration efforts to reach Global Health Security. To the best of our knowledge, no known government body or organization is responsible for governing health security in Saudi Arabia. However, the current study presents a definition of health security and differentiates it from the public health approach, in addition to emphasizing the importance of governing the related health sectors within each country in order to improve health security and have a positive impact on overall Global Health Security.

Facing Global Environmental Change

Currently a great number of problems have accumulated regarding the Arctic agenda in international legal, military, socio-economic, environmental, and scientific spheres. The authors of the study believe that international collaboration in the scientific and technical sphere, built upon a legal basis, is the first direction of mutually beneficial interstate collaboration in the Arctic region. The development of international scientific and technical collaboration in the field of complex Arctic study presupposes a comprehensive approach with regard to economic, legal and political aspects, and analyzing static and dynamic indicators. Thus, it is necessary to develop a legal model of collaboration. The development of the legal model of international scientific and technical collaboration in the field of complex Arctic study involves a range of actions aimed at improving the regulatory and conceptual framework, changing the system of state management of scientific and technical collaboration in the Arctic zone in order to ensure a consistent policy and eliminate existing problems.

Many studies have established the difficulties inherent in both cross-cultural and distance communication. Distance work interferes with close collaboration and trust. Physical distance and lack of time zone overlap can exacerbate cross-cultural misunderstandings. Nevertheless, international collaboration over distance is becoming increasingly common in many fields. Scientific collaborations, in particular, are becoming larger and more international in scope. There has been much research in the area of understanding cultural differences, but not as much in how technology might bridge such communication gaps in international scientific collaboration. In an effort to begin to form guidelines for such technology development, we undertook an empirical study of how computer-mediated communication tools facilitated cross-cultural communication over distance and led to greater team effectiveness in an international astrophysics collaboration.

In recent years, the concept of health security has acquired an international dimension. Global health issues incurred as a result of modern conflict, globalization, increased mobility of people, climate change, bioterrorism and emerging infectious diseases pose threats not only to national, but to global security, as well. The potential dangers of epidemics, particularly pandemics, are considered to be threats to national security and as such they have found their place in the national documents and strategies of national security. After the UN Security Council passed the first ever resolution on a health issue in 2000 - Resolution 1308, which recognized the potential of an epidemic to pose a risk to stability and security and declared 'peaceful war against AIDS' - as well as after a SARS outbreak in 2003, a H1N1 pandemic in 2009 and an Ebola outbreak in 2014, which the UN Security Council Resolution 2177 marked as a 'threat to international peace and security', more attention has been given to the concept of global health security. In this paper, we will discuss why health issues are considered to be security issues, and present how health security has been treated in the national security strategies of individual countries, but also in global health security initiatives.