Diplomatic Pouch / January 5, 2015
By Larry Luxner
West Africa’s Ebola crisis and the threat of the virus spreading to Europe and the United States has catapulted global health to the top of the Pentagon’s priority list, say U.S. military and civilian officials who addressed a conference in Washington last month.
“When we launched the Global Health Security Agenda in February, our intent was to help all countries meet international health regulations within a period of five years,” said Holly Wong, principal deputy assistant secretary for global affairs at the U.S. Department of Health and Human Services (HHS). “We had no idea what was going to happen with the Ebola outbreak in West Africa. That, more than anything else, has made the case that global health security needs to be at the top of every political agenda around the world.”
Wong was one of three speakers during a panel on global health security at the 2014 annual meeting of AMSUS, the society of federal health professionals. The Dec. 2-5 event, held at the Walter E. Washington Convention Center, brought together hundreds of U.S. federal government health officials as well as guests from as far away as the Netherlands, Senegal and Saudi Arabia.
“HHS is largely and predominantly a domestic health policy organization focused on taking care of Americans,” said Wong, who previously worked at the Inter-American Development Bank and was also vice-president of the International AIDS Vaccine Initiative. “But you can’t focus on the health of Americans without taking into account the health of people in other countries, and issues that can cross borders. That’s largely why, over the last several years, we’ve put together a global health strategy for the department.”
The strategy’s three goals, Wong told her AMSUS audience, are to protect and promote the health and well-being of Americans; to provide leadership and technical expertise abroad, and to advance U.S. interests in international diplomacy and security through global health action.
“It’s not a matter of us saying, ‘we should be helping other countries’ or ‘we can teach them how to do things.’ It’s also important for us to be learning from those other countries,” Wong said. “Vaccines, drug trials or other innovations discovered elsewhere are all things Americans can benefit from. And by working in health policy, it’s often very possible to make diplomatic advances or gains with countries that may not be our allies. This gives us an entrée into diplomatic discussions that are difficult to have.”
As such, she said, the U.S. government launched a Global Health Security Agenda (GHSA) last February. The agenda’s stated mission is “to attain a world safe and secure from global health threats posed by infectious diseases, where we can prevent or mitigate the impact of naturally occurring outbreaks, and intentional or accidental releases of dangerous pathogens.”
Since its establishment, said Wong, 44 countries agreed to become partners in GHSA, whose U.S. government partners include the Pentagon, HHS, the Atlanta-based Centers for Disease Control and Prevention, the U.S. Department of Agriculture, the State Department, the Food and Drug Administration and the U.S. Agency for International Development.
“Given the ability of viruses and ill people to travel, we all remain vulnerable. Part of that is the recognition that no country can achieve global health security on its own,” said Wong. “Most countries are not compliant or fully capable of meeting international health regulations.”
Wong noted that the SARS outbreak 11 years ago caused $30 billion in economic losses in only four Asian countries. The U.S. anthrax attacks of 2001 infected only 22 people and killed just five — but cost more than $1 billion to clean up. And the H1N1 “swine flu” epidemic of 2009 killed 284,000 people during its first year alone, while AIDS spread silently for decades.
“We’ve been trying to make sure everyone working on Ebola isn’t focused just on the immediate response,” she said. “We are looking to build longer-term thinking, not only in the three or four affected countries but in all countries throughout the region, to make sure they have the capacity to detect problems like Ebola, and be able to respond effectively.”
This rapid-response capability is more crucial than ever, said Dr. David J. Smith, deputy assistant secretary of defense and chief of the Pentagon’s Force Health Protection & Readiness division.
“For the last six months, we’ve been immersed in the Ebola crisis, but we’re also monitoring other potential threats,” said Smith, who has participated in various humanitarian missions involving the USS Mercy hospital ship. He’s also helped victims of an earthquake in Ecuador, and served 14 months in Afghanistan.
“From a Department of Defense perspective, we have to be more vigilant than ever, and this is the primary reason we have a bio-surveillance laboratory network around the world,” he said, noting the presence of labs in Cairo, Lima, Nairobi, Bangkok and now in Tbilisi, Georgia. “Whether we’re talking about bird flu, SARS, HIV or 100 other diseases, we recognize the security threats and spillover effects from the breakdown in health systems. The Ebola crisis has clearly heightened our awareness and concern.”
Smith said the benefits of U.S. engagement in global health security are “irrefutable.”
“Every time another nation is able to support itself against a medical disaster, it means the United States is safer. We’ve also seen that extremism can be cultivated in countries unable to manage natural disasters. A more medically capable world makes for a safer United States. This is the basic agenda of the GHSA. Our health efforts are a vital component of humanitarian and disaster response efforts,” he said, citing the 2004 tsunami that struck Indonesia and the 2010 earthquake that ravaged Port-au-Prince, Haiti, as prime examples.
The panel’s final speaker was Brig. Gen. Johannes de Graaf, surgeon-general of the Armed Forces of the Netherlands. He said the focus of global health must eventually shift to one that promotes healthy lifestyles through diet, exercise and stress prevention.
“Global health security is so much more than the absence of illnesses. It’s also about social economic processes and institutions, the environment, hygienic food, good government and education,” the Dutch official said.
De Graaf that “the Ebola crisis in West Africa is more than a health threat. The social and economic impact of this disease will continue long after the crisis has been dealt with. Ebola is in itself a development crisis, and as such needs an integrated response focused on poverty.”