Correspondence
We must use the window of political opportunity for decisive action and enlightened leadership that the Sustainable Development Goals (SDGs) provide to address a key set of local and global risks of our time—global health security risks. The increasing recognition of global health security needs to be integrated into the post-2015 development agenda and SDGs. We propose to add global health security as SDG18. This new SDG could be formulated as, “Take appropriate action to reduce the vulnerability of people around the world to new, acute, or rapidly spreading risks to health, particularly those threatening to cross international borders”. As in the case of Ebola, it is clear that a risk to one person, community, or nation is a risk to all people, communities, and nations. It is in the wise self-interest of each nation to ensure that every country has a strong, viable, and capacity-rich public health system. While this approach is a necessary component of global health security, it is not sufficient to address the full range of health security risks and the lack of appropriate responses. WHO has defined the provision of global public health security as the “activities required...to minimize vulnerability to acute public health events that endanger the collective health of populations living across geographical regions and international boundaries”. 1 Achievement of a coherent and effective approach to global health security will need clarity about the roles, responsibilities and resources of states, regional intergovernmental organisations, global intergovernmental organisations, national security sectors, civil society organisations, and other non-state associations, such as major foundations. www.thelancet.com Vol 385 March 21, 2015
The Ebola epidemic could not have been completely prevented, but it could have been far better managed than it has been so far. While the epidemic is persisting and poses the challenge of getting to “patient zero”, the epidemic also offers an opportunity to learn, revise, and reinvigorate the global public health system to be more effective than it is now, thus improving global health security. Global health security however, must not simply mean that developed countries impose management of health security on developing countries, mainly to protect themselves. Health security needs should be met through a whole-of-government approach that addresses the failures and exposed deficits in global health capacity and governance. Such a universal approach lies at the centre of the SDGs. A SDG focused on global health security could serve as a catalyst for more effective, efficient, and accountable public health provision than exists at present at local, national, and international levels. There is still time for negotiators to define SDG18 more precisely and to bring stakeholders on board—during SDGs negotiations at the UN, at the 2015 World Health Assembly, at the G7 meetings, and upcoming meetings of the BRICS, the African Union, and other regional bodies. Just as there will be other Ebola epidemics, there will be other global health security crises. For example, the challenge of antimicrobial resistance— another major global health security challenge that has been neglected at our peril—could also be integrated. Risk portends certaint y, and the opportune time to establish a coherent and effective global health security framework is now. We declare no competing interests
*Ilona Kickbusch, James Orbinski, Theodor Winkler, Albrecht Schnabel [email protected] Global Health Programme, Graduate Institute for International and Development Studies, Geneva CH 1211, Switzerland (IK); Balsillie School of International Affairs, Wilfrid Laurier University, Waterloo, ON,
Canada (JO); Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (JO); and Geneva Centre for the Democratic Control of Armed Forces, Geneva, Switzerland (TW, AS) 1
For the Sustainable Development Goals see https:// sustainabledevelopment.un.org/ sdgsproposal
WHO. The world health report 2007—a safer future: global public health security in the 21st century. http://www.who.int/whr/2007/ overview/en/index.html (accessed March 3, 2015).
The Theory of Everything and a neglected tropical disease: a Hawking legacy The success of the film The Theory of Everything and the Oscar awarded to Eddie Redmayne for his portrayal of Professor Stephen Hawking reflects the legacy of a brilliant physicist and the ability to overcome a severe life-long disability. An unsung legacy of the Hawking family are the achievements of Frank Hawking, Stephen’s father who featured in the film. What does not emerge is Frank Hawking’s professional stature. Between 1939 and 1973, Hawking published at least 28 papers on filariasis 1 working latterly at the National Institute for Medical Research. Frank Hawking was the pioneer of the development of the drug diethylcarbamazine (DEC) now the basis of the preventive chemotherapy outside Africa; 2 he recorded the global distribution of the disease and established the basis of the phenomenon of periodicity.3,4 Filariasis is one of the world’s most disabling conditions and the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to eliminate the disease by 2020 was initiated in 2000 based on donated drugs and supported by morbidity control. The programme is active in 60 endemic countries and 500 million treatments have been distributed annually in recent years. The cumulative number of treatments to date is approaching 5 billion.5,6 To date the number of individuals spared the risk of chronic lymphoedema and
Reimschuessel/Splash News/Corbis
We need a sustainable development goal 18 on global health security
Published Online March 6, 2015 http://dx.doi.org/10.1016/ S0140-6736(15)60301-4
For more on GPELF see http:// www.who.int/lymphatic_ filariasis/disease/en/
Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/
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We must use the window of political opportunity for decisive action and enlightened leadership that the Sustainable Development Goals (SDGs) provide to address a key set of local and global risks of our time—global health security risks. The increasing recognition of global health security needs to be integrated into the post-2015 development agenda and SDGs. We propose to add global health security as SDG18. This new SDG could be formulated as, “Take appropriate action to reduce the vulnerability of people around the world to new, acute, or rapidly spreading risks to health, particularly those threatening to cross international borders”. As in the case of Ebola, it is clear that a risk to one person, community, or nation is a risk to all people, communities, and nations. It is in the wise self-interest of each nation to ensure that every country has a strong, viable, and capacity-rich public health system. While this approach is a necessary component of global health security, it is not sufficient to address the full range of health security risks and the lack of appropriate responses. WHO has defined the provision of global public health security as the “activities required...to minimize vulnerability to acute public health events that endanger the collective health of populations living across geographical regions and international boundaries”. 1 Achievement of a coherent and effective approach to global health security will need clarity about the roles, responsibilities and resources of states, regional intergovernmental organisations, global intergovernmental organisations, national security sectors, civil society organisations, and other non-state associations, such as major foundations. www.thelancet.com Vol 385 March 21, 2015
The Ebola epidemic could not have been completely prevented, but it could have been far better managed than it has been so far. While the epidemic is persisting and poses the challenge of getting to “patient zero”, the epidemic also offers an opportunity to learn, revise, and reinvigorate the global public health system to be more effective than it is now, thus improving global health security. Global health security however, must not simply mean that developed countries impose management of health security on developing countries, mainly to protect themselves. Health security needs should be met through a whole-of-government approach that addresses the failures and exposed deficits in global health capacity and governance. Such a universal approach lies at the centre of the SDGs. A SDG focused on global health security could serve as a catalyst for more effective, efficient, and accountable public health provision than exists at present at local, national, and international levels. There is still time for negotiators to define SDG18 more precisely and to bring stakeholders on board—during SDGs negotiations at the UN, at the 2015 World Health Assembly, at the G7 meetings, and upcoming meetings of the BRICS, the African Union, and other regional bodies. Just as there will be other Ebola epidemics, there will be other global health security crises. For example, the challenge of antimicrobial resistance— another major global health security challenge that has been neglected at our peril—could also be integrated. Risk portends certaint y, and the opportune time to establish a coherent and effective global health security framework is now. We declare no competing interests
*Ilona Kickbusch, James Orbinski, Theodor Winkler, Albrecht Schnabel [email protected] Global Health Programme, Graduate Institute for International and Development Studies, Geneva CH 1211, Switzerland (IK); Balsillie School of International Affairs, Wilfrid Laurier University, Waterloo, ON,
Canada (JO); Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (JO); and Geneva Centre for the Democratic Control of Armed Forces, Geneva, Switzerland (TW, AS) 1
For the Sustainable Development Goals see https:// sustainabledevelopment.un.org/ sdgsproposal
WHO. The world health report 2007—a safer future: global public health security in the 21st century. http://www.who.int/whr/2007/ overview/en/index.html (accessed March 3, 2015).
The Theory of Everything and a neglected tropical disease: a Hawking legacy The success of the film The Theory of Everything and the Oscar awarded to Eddie Redmayne for his portrayal of Professor Stephen Hawking reflects the legacy of a brilliant physicist and the ability to overcome a severe life-long disability. An unsung legacy of the Hawking family are the achievements of Frank Hawking, Stephen’s father who featured in the film. What does not emerge is Frank Hawking’s professional stature. Between 1939 and 1973, Hawking published at least 28 papers on filariasis 1 working latterly at the National Institute for Medical Research. Frank Hawking was the pioneer of the development of the drug diethylcarbamazine (DEC) now the basis of the preventive chemotherapy outside Africa; 2 he recorded the global distribution of the disease and established the basis of the phenomenon of periodicity.3,4 Filariasis is one of the world’s most disabling conditions and the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to eliminate the disease by 2020 was initiated in 2000 based on donated drugs and supported by morbidity control. The programme is active in 60 endemic countries and 500 million treatments have been distributed annually in recent years. The cumulative number of treatments to date is approaching 5 billion.5,6 To date the number of individuals spared the risk of chronic lymphoedema and
Reimschuessel/Splash News/Corbis
We need a sustainable development goal 18 on global health security
Published Online March 6, 2015 http://dx.doi.org/10.1016/ S0140-6736(15)60301-4
For more on GPELF see http:// www.who.int/lymphatic_ filariasis/disease/en/
Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/
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