In today’s globalized society, the world is more connected than ever. This year’s public health epidemics, such as Ebola and Zika, and the extensive media coverage they received, drive home the fact that infectious diseases have vast global implications. Given the risk, infectious disease prevention should factor into efforts to build healthy communities.

Recently, Abt Associates hosted a discussion concerning this topic titled “Global Health Security Threats: Are We Prepared?” The two panel forum was part of the organization’s Bold Thinkers Series, and featured prominent leaders in the field of global health and security preparedness. Throughout the exchanges, two familiar themes emerged: the importance of strengthening health systems, and the importance of empowering local leaders and communities. Both are key aspects of AcademyHealth’s mission to make health care and research better.

The first, and perhaps the most prominent, of these lessons is the importance of strong health systems and institutions – something AcademyHealth and its members are working towards every day. Without necessary resources, health systems and institutions remain ineffective against outbreaks. Interventions, particularly successful ones based on evidence, require robust health systems and strong governmental institutions to support them. Furthermore, investing in a strong health system has been shown to have positive impacts on citizens’ well-being and contribute to economic growth within a country. Weak health systems, on the other hand, contribute to delays in timely responses to outbreaks and can create unnecessary obstacles to coordinating effective interventions.

However, as several speakers emphasized, investments must occur on a large scale – global, horizontal investments – rather than only at a national level. An integrated, globalized health system and response is essential to creating efficient and effective interventions. Without taking into account the “bigger picture,” an infectious disease epidemic in one region is overlooked as being a real threat to the global population.

A second lesson that rose to the surface is the importance of empowering vulnerable communities to be agents of their own health. This echoes local lessons on the importance of patient and consumer engagement in the research process. On the front lines, community engagement gives greater legitimacy to interventions and empowers local leaders to better understand and respond to their situations. Creating relationships between global organizations and local leaders is important in order to shed light on cultural and social contexts that allows responders create successful health interventions.

For instance, speakers often referenced some of the lessons learned during the West African Ebola crisis. Understanding the culture and beliefs of patients in areas affected by the outbreak in Sierra Leone became crucial to building trust between aid workers and the community. During the crisis, local leaders and health coordinators worked to incorporate regional religious traditions with biohazard compliant burials. Fostering this relationship of trust also allowed responders to overcome social and cultural communication barriers that allowed aid workers to administer lifesaving drugs to patients.

By better understanding the local context in which health emergencies occurs and integrating local experts, context is then fed back into the health system. This cycle further strengthens a state’s institutions – creating better health interventions and responses that create cost savings and do not strain health systems.

Some international organizations have already begun implementing these strategies into their own interventions. The Bill and Melinda Gates Foundation has started to invest in strengthening local institutions and organizations into their emergency response planning in order to “help communities prepare for and cope with future shocks.” The World Health Organization has also advocated the importance of forging relationships with local and national organizations who are interested in seeing positive results. The Red Cross has used anthropologists’ cross-cutting perspective to develop and support health interventions and evaluations in Western Africa during the Ebola crisis which has helped create more community based interventions.

Stronger health systems, government institutions, and better community engagement can all continue to positively impact the fight against infectious disease. As infectious disease crises continue to be exacerbated by urbanization, climate change, and conflict, lessons from previous failures and victories will be more important than ever. From the global to the local, policies affecting health and the performance of the health system should be informed by the best and most relevant evidence available. That’s the best way to effectively improve health and health care both at home and abroad. 

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