International Cooperation Aims to Boost Public Health Systems

A community health worker in a village in Senegal examines a patient who has recovered from a bout with malaria

By Charlene Porter
IIP Staff Writer

27 September 2011

Washington — The United States and the World Health Organization (WHO) are moving to a higher level of cooperation, combining resources to help other countries boost their public health infrastructure for the good of their own people and the rest of the world.

In New York September 19, the two parties signed what is formally called a “memorandum of understanding” to help developing countries improve their public health capabilities and create better adherence to the International Health Regulations (IHR). President Obama expressed his commitment to the endeavor when he addressed the U.N. General Assembly.

“We must come together to prevent, detect and fight every kind of biological danger,” Obama said in his September 21 speech.

The United States and the WHO have a long record of cooperation and mutual support in working together to contain infectious disease outbreaks, expand vaccination coverage and decrease infant and child mortality rates. This agreement elevates that cooperation to a “whole-of-government approach,” according to an official in the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR).

“It’s about any event that may have a negative impact on international public health,” said Dr. Jose A. Fernandez, the acting deputy director of the ASPR Division of International Health Security. “Radiological releases, chemical spills, food-borne outbreaks and pandemic influenza would all be examples” of events that have the potential to move rapidly across borders and harm individuals with no regard for nationality.

The regulations took on an expanded form in recent years after sudden outbreaks of severe acute respiratory syndrome (SARS) and avian influenza caused major public health scares and proved how transportation and globalization can put disease on a fast track.

One-hundred-ninety-four nations are signatories to the IHR, but Fernandez says many nations need some assistance to upgrade their disease identification, surveillance and response capabilities.

The United States has been training and assisting medical professionals in the developing world for some time. Notably, the U.S. Centers for Disease Control and Prevention (CDC) maintains a network of Global Disease Detection Centers throughout the world to work directly with countries and the WHO to bolster capacities for disease surveillance and response. The U.S. Navy medical research unit in Cairo brought in teams of specialists from many African countries during the avian influenza scare to provide training in detection of the disease.

“The [Department of Defense] labs alone have provided an enormous amount of support generally to countries and institutions,” Fernandez said. But the newly signed memorandum of understanding reaches for new levels in “successfully improving, enhancing and protecting global health security.”

This new level of commitment to the International Health Regulations comes as the Obama administration is implementing its Global Health Initiative, which strives to invest in the most effective health care programs. Fernandez said helping countries build greater capability to meet the responsibilities of the IHR is compatible with the Obama initiative.

“When we do these capacity-building activities, there has to be country ownership, it has to be sustainable, and that means it needs to address day-to-day public health needs,” Fernandez said.

The WHO is striving to upgrade the capabilities of all nations to assess, notify and respond to infectious disease threats, and is working toward achieving that level of competence by 2012.