scholarly journals Strengthening National Capacities for Pandemic Preparedness: A Cross-Country Analysis of COVID-19 Cases and Deaths

2021 ◽  
Author(s):  
David B Duong ◽  
Andrew J King ◽  
Karen A Grépin ◽  
Li Yang Hsu ◽  
Jeremy F Y Lim ◽  
...  
Keyword(s):  
International Health ◽  
Ordinary Least Squares ◽  
Health Coverage ◽  
Least Squares Regression ◽  
Global Public Health ◽  
Pandemic Preparedness ◽  
Health Security ◽  
Country Level ◽  
First Case ◽  
Two Indices

Abstract The International Health Regulation—State Party Annual Reporting (IHR-SPAR) and the Global Health Security Index (GHSI)) have been developed to aid in strengthening national capacities for pandemic preparedness. We examine the relationship between country-level rankings on these two indices, along with two additional indices (the Universal Health Coverage Service Coverage Index and World Bank Worldwide Governance Indicator (n = 195)) and compared them to the country-level reported COVID-19 cases and deaths (Johns Hopkins University (JHU) COVID-19 Dashboard) through 17 June 2020. Ordinary least squares regression models were used to compare weekly reported COVID-19 case and death rates per million in the first 12 weeks of the pandemic between countries classified as low, middle, and high ranking on each index, while controlling for country socio-demographic information. Countries with higher GHSI and IHR-SPAR index scores experienced fewer reported COVID-19 cases and deaths, but only for the first 8 weeks after the country’s first case. For the GHSI, this association was further limited to countries with populations below 69.4 million. For both the GHSI and IHR-SPAR, countries with a higher sub-index score in human resources for pandemic preparedness reported fewer COVID-19 cases and deaths in the first 8 weeks after the country’s first reported case. The UHC-SCI and WGI country-level rankings were not associated with COVID-19 outcomes. The associations between GHSI and IHR-SPAR scores and COVID-19 outcomes observed in this study demonstrate that these two indices, although imperfect, may have value, especially in countries with a population under 69.4 million people for the GHSI. Preparedness indices may have value; however, they should continue to be evaluated as policymakers seek to better prepare for future global public health crises.

scholarly journals Strengthening health security: an intuitive and user-friendly tool to estimate country-level costs

2018 ◽  
Vol 3 (4) ◽  
pp. e000864 ◽  
Author(s):  
Rebecca Katz ◽  
Ellie Graeden ◽  
Stephanie Eaneff ◽  
Justin Kerr
Keyword(s):  
Capacity Building ◽  
International Health ◽  
Action Plans ◽  
International Health Regulations ◽  
Cost Estimates ◽  
Health Security ◽  
Country Level ◽  
User Friendly ◽  
Health Regulations

Member States of the WHO working to build capacity under the International Health Regulations (IHR) are advised to develop prioritised, costed plans to implement improvements based on the results of voluntary external assessments. Defining the costs associated with capacity building under the IHR, however, has challenged nations, funders and supporting organisations. Most current efforts to develop costed national action plans involve long-term engagements that may take weeks or months to complete. While these efforts have value in and of themselves, there is an urgent need for a rapid-use tool to provide cost estimates regardless of the level of expertise of the personnel assigned to the task. In this paper, we describe a tool that can—in a matter of hours—provide country-level cost estimates for capacity building under the IHR. This paper also describes how the tool can be used in countries, as well as the challenges inherent in any costing process.

scholarly journals Synergies and Fragmentation in Country Level Policy and Program Agenda Setting, Formulation and Implementation for Global Health Agendas: A Case Study of Health Security, Universal Health Coverage, and Health Promotion in Ghana and Sierra Leone

2020 ◽  
Author(s):  
Irene Akua Agyepong ◽  
Fredline A.O. M’Cormack-Hale ◽  
Hannah Brown-Amoakoh ◽  
Abigail N.C. Derkyi-Kwarteng ◽  
Theresa Ethel Darkwa ◽  
...  
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Sierra Leone ◽  
Agenda Setting ◽  
Structural Constraints ◽  
Health Coverage ◽  
Health Security ◽  
Country Level ◽  
Universal Health

Abstract Background: Global health agendas have in common the goal of contributing to population health outcome improvement. In theory therefore, whenever possible, country level policy and program agenda setting, formulation and implementation towards their attainment should be synergistic such that efforts towards one agenda promote efforts towards the other agendas. Observation suggests that this is not what happens in practice. Potential synergies are often unrealized and fragmentation is not uncommon. In this paper we present findings from an exploration of how and why synergies and fragmentation occur in country level policy and program agenda setting, formulation and implementation for the global health agendas of Universal Health Coverage (UHC), Health Security (HS) and Health Promotion (HP) in Ghana and Sierra Leone. Our study design was a two country case study. Data collection involved document reviews and Key Informant interviews with national and sub-national level decision makers in both countries between July and December 2019. Additionally, in Ghana a stakeholder workshop in December 2019 was used to validate the draft analysis and conclusions. This study is part of a series of country case studies to inform the Lancet Commission on synergies between UHC, HS and HP.Results: National and global context, country health systems leadership and structure including resources were drivers of synergies and fragmentation. How global as well as country level actors mobilized power and exercised agency in policy and program agenda setting and implementation processes within country were also important drivers. Conclusions: There is potential in both countries to pull towards synergies and push against fragmentation in agenda setting, formulation and implementation of global health agendas despite the resource and other structural constraints. It however requires political and bureaucratic prioritization of synergies, as well as skilled leadership. It also requires considerable mobilization of country level actor exercise of agency to counter sometimes daunting contextual, systems and structural constraints.

Part II Predominant Security Challenges and International Law, Environmental Security, Ch.32 Pandemics and Other Health Emergencies

2021 ◽  
Author(s):  
Heath J Benton
Keyword(s):  
Global Health ◽  
International Health ◽  
Disease Outbreaks ◽  
Legal Framework ◽  
World Health ◽  
Global Public Health ◽  
Global Health Security ◽  
Security Issue ◽  
Health Security ◽  
Internal Governance

This chapter traces the normative challenges underlying the legal framework for health security. Today’s challenges can be understood as the result of three successive stages of development in global health law. First was the securitization of global public health, whereby a diffuse group of international and national health officials, outside experts, and advocates worked to redefine infectious disease outbreaks as a critical national and international security issue. Secondly, this concept of global health security was inscribed in law through the 2005 revisions to the International Health Regulations, which adopted a governance framework that appeared to be deliberately modelled on domestic emergency powers regimes. Thirdly, this development, rather than settling the World Health Organization’s (WHO) authority in health emergencies, has in turn set off waves of contestation that concern the nature of global health security and how it should be institutionalized. This includes contestation about the internal governance arrangements within the WHO; external conflicts of jurisdiction between the WHO and other institutions; and disagreement about the normative orientation and scope of the WHO’s emergency power.

scholarly journals The potential effectiveness of the WHO International Health Regulations capacity requirements on control of the COVID-19 pandemic: a cross-sectional study of 114 countries

2021 ◽  
pp. 014107682199245
Author(s):  
Martin CS Wong ◽  
Junjie Huang ◽  
Sunny H Wong ◽  
Jeremy Yuen-Chun Teoh
Keyword(s):  
Regression Models ◽  
Control Strategies ◽  
International Health ◽  
International Health Regulations ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Health Security ◽  
First Case ◽  
Incidence And Mortality ◽  
Health Regulations

Objectives We examined if the WHO International Health Regulations (IHR) capacities were associated with better COVID-19 pandemic control. Design Observational study. Setting Population-based study of 114 countries. Participants General population. Main outcome measures For each country, we extracted: (1) the maximum rate of COVID-19 incidence increase per 100,000 population over any 5-day moving average period since the first 100 confirmed cases; (2) the maximum 14-day cumulative incidence rate since the first case; (3) the incidence and mortality within 30 days since the first case and first COVID-19-related death, respectively. We retrieved the 13 country-specific International Health Regulations capacities and constructed linear regression models to examine whether these capacities were associated with COVID-19 incidence and mortality, controlling for the Human Development Index, Gross Domestic Product, the population density, the Global Health Security index, prior exposure to SARS/MERS and Stringency Index. Results Countries with higher International Health Regulations score were significantly more likely to have lower incidence (β coefficient −24, 95% CI −35 to −13) and mortality (β coefficient −1.7, 95% CI −2.5 to −1.0) per 100,000 population within 30 days since the first COVID-19 diagnosis. A similar association was found for the other incidence outcomes. Analysis using different regression models controlling for various confounders showed a similarly significant association. Conclusions The International Health Regulations score was significantly associated with reduction in rate of incidence and mortality of COVID-19. These findings inform design of pandemic control strategies, and validated the International Health Regulations capacities as important metrics for countries that warrant evaluation and improvement of their health security capabilities.

scholarly journals Synergies and fragmentation in country level policy and program agenda setting, formulation and implementation for Global Health agendas: a case study of health security, universal health coverage, and health promotion in Ghana and Sierra Leone

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Irene Akua Agyepong ◽  
Fredline A. O. M’Cormack-Hale ◽  
Hannah Brown Amoakoh ◽  
Abigail N. C. Derkyi-Kwarteng ◽  
Theresa Ethel Darkwa ◽  
...  
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Sierra Leone ◽  
Agenda Setting ◽  
Structural Constraints ◽  
Health Coverage ◽  
Health Security ◽  
Country Level ◽  
Universal Health

Abstract Background Global health agendas have in common the goal of contributing to population health outcome improvement. In theory therefore, whenever possible, country level policy and program agenda setting, formulation and implementation towards their attainment should be synergistic such that efforts towards one agenda promote efforts towards the other agendas. Observation suggests that this is not what happens in practice. Potential synergies are often unrealized and fragmentation is not uncommon. In this paper we present findings from an exploration of how and why synergies and fragmentation occur in country level policy and program agenda setting, formulation and implementation for the global health agendas of Universal Health Coverage (UHC), Health Security (HS) and Health Promotion (HP) in Ghana and Sierra Leone. Our study design was a two country case study. Data collection involved document reviews and Key Informant interviews with national and sub-national level decision makers in both countries between July and December 2019. Additionally, in Ghana a stakeholder workshop in December 2019 was used to validate the draft analysis and conclusions. Results National and global context, country health systems leadership and structure including resources were drivers of synergies and fragmentation. How global as well as country level actors mobilized power and exercised agency in policy and program agenda setting and implementation processes within country were also important drivers. Conclusions There is potential in both countries to pull towards synergies and push against fragmentation in agenda setting, formulation and implementation of global health agendas despite the resource and other structural constraints. It however requires political and bureaucratic prioritization of synergies, as well as skilled leadership. It also requires considerable mobilization of country level actor exercise of agency to counter sometimes daunting contextual, systems and structural constraints.

scholarly journals Lifestyle-based health awareness using digital gadgets and online interactive platforms

2021 ◽  
pp. 295-310
Author(s):  
Iqra Khan ◽  
Salman Akhtar ◽  
Mohammad Kalim Ahmad Khan
Keyword(s):  
Human Health ◽  
International Health ◽  
Communicable Diseases ◽  
International Travel ◽  
World Health ◽  
Smart Devices ◽  
Health Coverage ◽  
Health Security ◽  
The Difference ◽  
Health Organization

With the transforming world, awareness of lifestyle-based variation is necessary. The availability of the locally available network and smart devices like wearable health devices (WHDs) based on artificial intelligence (AI) technology prompted us to learn about the disease, its causes, spreads, and precautions. Socioeconomic, environmental and behavioural factors, international travel and migration foster and increase the spread of communicable diseases. Vaccine-preventable, foodborne, zoonotic, healthcare-related and communicable diseases pose significant threats to human health and may sometimes threaten international health security. On the other hand, non-communicable diseases, also known as chronic diseases, are more prolonged. It could be the cause of different factors like genetic, environmental, behavioural or physiological disturbances. Smart wearables help to keep these diseases in check through different sensors installed in them. They can check for the difference in body function, but they can also help the needy consult the physician or practitioner. The data collected from these devices can also check the current health status when compiled with data collected practically. Organizations viz., World Health Organization (WHO), Food and Drug Administration (FDA) work collaboratively, leading global efforts to expand health coverage. WHO keeps the nation safe through connecting its people on the health and awareness interactive platforms, and FDA promotes public health through supervision and control, defending its role in human health and services.

scholarly journals Performance of Deming regression analysis in case of misspecified analytical error ratio in method comparison studies

1998 ◽  
Vol 44 (5) ◽  
pp. 1024-1031 ◽  
Author(s):  
Kristian Linnet
Keyword(s):  
Regression Analysis ◽  
Least Squares ◽  
Measurement Errors ◽  
Method Comparison ◽  
Ordinary Least Squares ◽  
Least Squares Regression ◽  
Analytical Error ◽  
First Case ◽  
Error Ratio ◽  
Deming Regression

Abstract Application of Deming regression analysis to interpret method comparison data presupposes specification of the squared analytical error ratio (λ), but in cases involving only single measurements by each method, this ratio may be unknown and is often assigned a default value of one. On the basis of simulations, this practice was evaluated in situations with real error ratios deviating from one. Comparisons of two electrolyte methods and two glucose methods were simulated. In the first case, misspecification of λ produced a bias that amounted to two-thirds of the maximum bias of the ordinary least-squares regression method. Standard errors and the results of hypothesis-testing also became misleading. In the second situation, a misspecified error ratio resulted only in a negligible bias. Thus, given a short range of values in relation to the measurement errors, it is important that λ is correctly estimated either from duplicate sets of measurements or, in the case of single measurement sets, specified from quality-control data. However, even with a misspecified error ratio, Deming regression analysis is likely to perform better than least-squares regression analysis.

scholarly journals Strengthening global health security by embedding the International Health Regulations requirements into national health systems

2018 ◽  
Vol 3 (Suppl 1) ◽  
pp. e000656 ◽  
Author(s):  
Hans Kluge ◽  
Jose Maria Martín-Moreno ◽  
Nedret Emiroglu ◽  
Guenael Rodier ◽  
Edward Kelley ◽  
...  
Keyword(s):  
Global Health ◽  
Health System ◽  
International Health ◽  
Health System Strengthening ◽  
Health Coverage ◽  
International Health Regulations ◽  
Global Health Security ◽  
Health Security ◽  
High Level ◽  
Health Regulations

The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

scholarly journals Mind the gap: an analysis of core capacities of the international health regulations (2005) to respond to outbreaks in Yemen

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanan Noman ◽  
Fekri Dureab ◽  
Iman Ahmed ◽  
Abdulwahed Al Serouri ◽  
Taha Hussein ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
International Health ◽  
World Health ◽  
Health Staff ◽  
International Health Regulations ◽  
Health Security ◽  
Country Level ◽  
Health Organization ◽  
Health Regulations

Abstract Background Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are essential to public health security. The aim of this study is to assess the implementation of the International Health Regulations (IHR 2005) core capacities under the current ongoing conflict in Yemen. Methods The study simulated the World Health Organization (WHO) Joint External Evaluation (JEE) tool to assess the IHR core capacities in Yemen. Qualitative research methods were used, including desk reviews, in-depth interviews with key informants and analysis of the pooled data. Result Based on the assessment of the three main functions of the IHR framework (prevention, detection, and response), Yemen showed a demonstrated or developed capacity to detect outbreaks, but nevertheless limited or no capacity to prevent and respond to outbreaks. Conclusion This study shows that there has been poor implementation of IHR in Yemen. Therefore, urgent interventions are needed to strengthen the implementation of the IHR core capacities in Yemen. The study recommends 1) raising awareness among national and international health staff on the importance of IHR; 2) improving alignment of INGO programs with government health programs and aligning both towards better implementation of the IHR; 3) improving programmatic coordination, planning and implementation among health stakeholders; 4) increasing funding of the global health security agenda at country level; 5) using innovative approaches to analyze and address gaps in the disrupted health system, and; 6) addressing the root cause of the collapse of the health services and overall health system in Yemen by ending the protracted conflict situation.

WHO Emergency Powers for Global Health Security

2019 ◽  
pp. 152-186
Author(s):  
Christian Kreuder-Sonnen
Keyword(s):  
Influenza Pandemic ◽  
International Health ◽  
H1n1 Influenza ◽  
World Health ◽  
Health Security ◽  
Emergency Powers ◽  
First Case ◽  
Health Organization ◽  
Emergency Measures

Chapter 6 analyzes two consecutive cases of exceptionalism in the World Health Organization (WHO). In the first case study, it explains how the WHO’s assumption of emergency powers in the 2003 SARS crisis led to their legal normalization. To confront the SARS outbreak, the WHO resorted to unprecedented emergency measures infringing on states’ sovereignty. Building on arguments of functionality, the WHO managed to create a broad consensus on the general appropriateness of such measures. They were thus enshrined in the new International Health Regulations in 2005 and came to their first reuse in the second case: the adoption of emergency powers during the H1N1 influenza “pandemic” in 2009. Due to a very mild course of the outbreak, however, this time it incited a societal backlash against the WHO. The emergency measures were delegitimized as excessive and futile, forcing the WHO to accept a procedural containment of its emergency powers.

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