Health security contributes to peace and security, democracy, economic and social stability as well as wellbeing. Strengthening health security is therefore an integral target of the Sustainable Development Goals. It requires strong national health systems and a multisectoral approach at the global, regional and country levels, as well as a thorough understanding and implementation of the synergies with other important targets, such as achieving Universal Health Coverage.
Universal Health Coverage is a comprehensive concept. It covers the full spectrum of quality health services, including protection from financial hardship from the use of services. UHC is only feasible when adequate public health legislation and essential public health functions are in place. Environmental protection, food security and safety, and other population level interventions on health promotion and disease prevention, including vaccinations, contribute to UHC.
WHO Director-General Tedros has declared Universal Health Coverage to be his top priority, underlining that UHC and health security are two sides of the same coin. Indeed, sustainably funded, staffed and managed comprehensive primary health service systems, capable of reaching the entire population are the best approach to achieving UHC and pandemic preparedness. The resilience and every day operations of health systems as well as the role of front line health workers cannot be underestimated when it comes to detecting outbreaks, managing disaster risks and responding to health emergencies.
In addition to considering the high levels of human suffering and of loss of life from a severe sustained cross border public health event, the World Bank estimates that the annual global economic cost of pandemics is roughly 570 billion USD, or 0.7% of global income. Investing in health system resilience is significantly more effective and cost efficient than financing response to outbreaks. A country can develop a strong functional public health system in key technical areas even if funding is relatively limited. Surveillance can be strengthened by investing in the community based basic health services and by training health workers to detect and report public health patterns, especially unusual events. Additionally, for gaining an understanding of the early warning signs, the human health services need to work closely together with the veterinary services. The surveillance and sentinel functions and the protection of people from health risks are both rooted in the regular national systems. They need not always be expensive and rely on high technology.
To strengthen health security and pandemic preparedness, we need to take new approaches. The Joint External Evaluations have already been completed in 66 countries and national action plans in 13 countries, with planning on the way in many others. This new process has been a game changer towards understanding and addressing gaps in national capacities. An important aspect of the JEEs and the national plans is their transparency. Building intersectoral systems, regional collaborative models and learning from peers can be conducive to sustainable solutions.
Health is not only a matter for the health sector but the responsibility of all relevant sectors. This applies to UHC as well as to health security. The economic, social, environmental, as well as political and commercial determinants of health demand a whole of society approach. Resilience and preparedness of the society is the responsibility of the whole of government under the leadership of prime ministers or heads of state, in collaboration with partners.
The Agenda2030 has created obligations to all governments, civil society and the private sector to reach the ambitious goals by working together. Globally, prioritization is necessary to finance UHC. Services to reach the health-related SDGs through UHC have been estimated to require an additional 370 billion USD a year – underlining the importance of synergies. To use the momentum wisely, and to ensure that Universal Health Coverage is built in a manner that is conducive to resilience and preparedness to all hazards, we have to actively engage with different actors and sectors.
From 12 to 15 December, UHC Forum 2017 in Tokyo, Japan, jointly organized by the Government of Japan, the World Bank, the World Health Organization, the United Nations Children’s Fund (UNICEF), UHC2030 and JICA, provides an important venue for this discussion. Among other things, the Forum will address integrating pandemic preparedness with strengthening health systems towards UHC. We look forward to working with partners to better linking these two sides of the coin. Together we can ensure that the roads leading to UHC and global health security are built on a strong base, joining up.