The COVID-19 pandemic has exposed the inadequacy and fragility of the global health infrastructure. The consequences have been devastating. However, in every adversity there lies an opportunity. The lessons learned from the ongoing pandemic are an opportunity to revise and reinforce the public health care system, especially in the rural areas.

In a research titled “Global Public Health Convention for the 21st Century”, the Panel for a Global Public Health Convention (GPHC) has outlined 10 recommendations on how the world can better prevent and prepare for future pandemics by adopting a robust global public health convention. GPHC panel is an independent group of global experts from diverse disciplines such as public health, public policy, medicine, diplomacy and economics. It was officially launched on April 26 this year.

The 10 key recommendations are:

1. Greater authority for a global governing body: “The governance structure for a global public health system should grant necessary authority to one or more agencies, such as the WHO, to coordinate pandemic prevention, preparedness, and response globally, including across regions and countries.”
2. Improved ability to respond to pandemics: “The global public health system (and its governing agency or agencies) should possess the capability to flexibly and rapidly respond to, instil protections for, formulate interventions against, and mobilise and deploy resources for, a range of possible public health security threats and scenarios such as infectious disease outbreaks and pandemics... This flexibility includes the capacity to meet the diverse needs of countries at any given stage of an infectious disease outbreak or pandemic.
3. Single source for technical expertise: “An effective global public health security system requires a singular body with technical expertise in pandemic prevention, preparedness, response, and recovery. This agency should represent the authoritative source for information, expertise, and technical proficiency. The agency should be the single authoritative guide in case of emerging and re-emerging infectious disease outbreaks—the role that WHO is currently authorised to serve.”
4. Objective evaluation system for national core public health capacities: “The capacity of objectively evaluating countries on their progress in achieving requirements and of providing or coordinating remediation for identified deficiencies should be built into a governing framework for a global public health system.”
5. More effective enforcement mechanisms: “An effective global public health security convention requires a governing body (or bodies) to enforce the framework.... Enforcement mechanisms can include incentives for participation, penalties for non-compliance, or both.” 
6. Autonomy: “The conventions governing body (or bodies) should possess independent decision making powers and be insulated from undue political interference. The body should have the ability to make decisions in the best interest of global health, rather than in the interests of individual stakeholders.” 
7. Independent and sustainable funding: “An effective global public health security framework requires a sustainable financing system that protects the governing body (or bodies) from political influence, possible retribution, or the threat of inconsistent funding....Sustainable financing means perennial investments in all stages of infectious disease containment—especially prevention-related activities, before outbreaks occur.”
8. Representativeness: “The governing framework must possess a high degree of transparency and accountability. The governing structure must be adequately representative of all countries. It should also include other relevant stakeholders from civil society, the public health sector, the private sector, and academia, among others.”
9. Investment from multiple sectors: “A formal pandemic prevention, preparedness, and response system (including governing bodies) must involve multiple sectors at all levels of governance and action.... The public health sector alone is not enough to effectively prepare the world for a pandemic, nor does it typically have enough influence within countries to gather adequate national support.
10. Commitment: “For a global health security convention to be effective, all relevant parties participating in the system must understand the threat posed by pandemic infectious diseases; accept the gravity of this threat; acknowledge their own responsibility in contributing to effective prevention, preparedness, and response; show a commitment to these efforts...”

(Source: Lancet Public Health, Published Online May 5, 2021)

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA