England’s outgoing chief medical officer, Professor Dame Sally Davies, has said that countries must work together to fight global health threats. Davies, who is set to become the first female Master of Trinity College Cambridge, warns that the UK must respond to global disease outbreaks quickly and adds that vaccination rates must be improved to prevent the resurgence of eradicated diseases.
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According to the Centers for Disease Control and Prevention (CDC), diseases can be transported from isolated locations to major cities in just 36 hours. Despite this, around 70 percent of countries are not fully prepared for a public health emergency.
“A threat in one corner of the world is a threat to anywhere else,” Davies explained. “We are only as strong as our weakest link when it comes to health.
“You only have to look at how infectious diseases can spread to understand that if [governments] are not able to cope in their own country, we will see them move across the world.
“For security in these countries and here at home, we should invest in those health systems in order to protect everyone. We are globally interconnected, if we do not attend to our global linkage we put ourselves at risk.”
It is the first time that Davies has dedicated her annual report to the issue of global collaboration to protect against disease outbreaks. As well as infectious diseases, her report discusses pollution, health misinformation, and antimicrobial resistance as areas also requiring international collaboration.
Over the past five years, money spent by the Department for International Development (DFID) has decreased as it was given a smaller portion of the aid budget.
According to the National Audit Office, 58 percent of the DFID’s budget was spent in the least developed countries in 2017, and 28 percent is now being spent by departments other than DFID such as the Department for Business, Energy and Industrial Strategy, the Foreign Office and the Home Office. Compared to 2013, allocations made to other government departments stood at 10 percent.
In response to these figures, the National Audit Office said that these new departments receiving funding do not embrace the DFID’s core principle of “leave no one behind.”
Davies believes that this stretch in spending in other departments could result in a less effective approach.
“DFID does an amazing job,” she said. “But what we’ve started to do more over the last few years is spend UK aid from other departments. They do a decent job… but we need to have a shared global health strategy with shared objectives that go through a number of government departments for investments to be enduring.”
Recommending investment into global health, Davies continued:
It is in our mutual interest. It creates a better world for us and for future generations. It helps to keep our population safe. We should invest in systems and solutions that contribute to making health more equitable, secure and sustainable. What we learn abroad will improve our NHS and support our domestic efforts to make sure no one in the UK is left behind.”
Professor Dame Sally Davies
Davies recalled the 2018 UK monkeypox outbreak, which was the first outbreak outside of Africa since 2003. The outbreak was controlled and managed by collaboration with the Nigerian Centre for Disease Control.
This same type of collaboration is also helping those in the Democratic Republic of Congo who are in the midst of an Ebola outbreak. The CDC has also written about its role in controlling a Dengue fever outbreak in Senegal.
In 2017, three former CDC Public Health Emergency Management Fellows headed up a national-level response to the outbreak in a collaboration between Senegal’s Public Health Emergency Operations Center (PHEOC) and a member of the PHEOC’s surveillance and epidemiology team to share their knowledge and expertise not only to orchestrate a rapid response team to the outbreak area, but also to educate health professionals about Dengue fever. The response included vector control measures such as large-scale dusting and targeted insecticide spraying.
Putting health threats before all else
In 2009, a Middle Eastern organization proved that even tense political differences (in this case between Israel and Palestine) can be put aside to control and prevent disease outbreaks.
The Middle East Consortium on Infectious Disease Surveillance (MECIDS), established in 2003, is a collaboration between Israeli, Jordanian and Palestinian health officials to share information and coordinate action against infectious disease outbreaks.
Dr. Assad Ramlawi, the director of primary care and public health for the Palestinian Authority Ministry of Health said:
“We have to exchange information and support each other. We have to be aware of what is going on in each country because disease and bacteria know no borders.”
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Infectious diseases know no boundaries
Davies’ report also calls on the visa system to become “quick, smooth, and affordable” so that people from low- and middle-income countries are able to study in the UK and share knowledge and expertise that could benefit the NHS and other countries around the world.
Professor of global public health at Edinburgh University Medical School Devi Sridhar said: “Across centuries, controlling infectious diseases has continued to bring countries together. Ultimately outbreaks are about humans – regardless of nationality, religion, or skin color – versus microbes, and the only way to defeat them is to work together.
Dame Sally Davies’ annual report is a powerful reminder of the major health challenges the UK continues to face, and the importance of UK investment in the larger global health system which all countries, rich or poor, depend on.”
Professor Devi Sridhar, Edinburgh University Medical School