Contributions of the New Framework for Essential Public Health Functions to Addressing the COVID-19 Pandemic (original) (raw)
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Journal of Global Health
Background The Coronavirus Disease 2019 (COVID-19) pandemic takes variable shapes and forms in different regions and countries. This variability is explained by several factors, including the governance of the epidemic. We aimed to identify the key attributes of governance in response to the COVID-19 pandemic and gain lessons for an effective response to public health emergencies. Methods We employed a mixed-methods design. We mapped the attributes of governance from well-established governance frameworks. A negative binomial regression was conducted to identify the effect of the established governance measures on the epidemiology of the COVID-19 pandemic. We used publicly available data on COVID-19 cases and deaths in countries around the world. Document review was conducted to identify the key approaches and attributes of governance during the pre-vaccine era of the response to the COVID-19 pandemic. We conducted a thematic analysis to identify key attributes for effective governance. Results The established governance measures, including generation of intelligence, strategic direction, regulation, partnership, accountability, transparency, rule of law, control of corruption, responsiveness, effectiveness, efficiency, equity, ethics, and inclusiveness, are necessary but not sufficient to effectively respond to and contain the COVID-19 pandemic. Additional attributes of national governance were identified: 1) agile, adaptive, and transformative governance; 2) collective (collaborative, inclusive, cooperative, accountable, and transparent) governance; 3) multi-level governance; 4) smart and ethical governance: sensible, pragmatic, evidence-based, political, learner, and ethical. Conclusions The current governance frameworks and their attributes are not adequate to contain the COVID-19 pandemic. We argue that countries need agile, adaptable, and transformational, collaborative, multi-level, smart and ethical governance to effectively respond to emerging and re-emerging public health threats. In addition, an effective response to public health emergencies depends not only on national governance but also on global governance. Hence, global health governance should be urgently renewed through a paradigm shift towards universal health coverage and health security to all populations and in all countries. This requires enhanced and consistent global health diplomacy based on knowledge, solidarity, and negotiation.
Hindsight is 2020? Lessons in global health governance one year into the pandemic
Nature Medicine
I t has now been just over one year since the first two cases of coronavirus disease 2019 (COVID-19) were confirmed in two Chinese nationals staying at a hotel in York, England, on 31 January 2020 (ref. 1). On 26 January 2021, the death toll from COVID-19 in the United Kingdom had surpassed 100,000 and there were reportedly over 30,000 daily cases of the disease, with an estimated 1 in 10 people going on to experience the enduring effects of 'long COVID' (Official UK Coronavirus Dashboard, https://coronavirus.data.gov. uk/details/deaths). The global death toll has just reached 2.1 million (World Health Organization (WHO) COVID-19 Dashboard, https://covid19.who.int). The global death toll had reached almost 2.5 million by 23 February 2021. However, around the world, a varied picture has emerged (https:// covid19.who.int and refs. 2,3). Countries such as China, Taiwan, New Zealand and Australia have managed to eliminate or get close to elimination of their epidemics caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) relatively well 2,3. Others such as Hong Kong, South Korea, Singapore, Finland and Norway have managed to control it at low levels. Sadly, both the United States and the United Kingdom are still battling high numbers of daily cases, tens of thousands of deaths, and an exhausted health workforce and overstretched health services 4,5. As the virus proliferated across the globe, it also revealed critical vulnerabilities in our global and national health governance systems that have resulted in inadequate outbreak responses 6,7. In this Perspective, we explore what is now known about the virus and identify key lessons learned about the WHO and national governance and the impact on pandemic preparedness and response.
The Challenge of Pandemic Governance for Low- and Middle-Income Countries after COVID-19
Think Global Health (an initiative of the Council on Foreign Relations), 2022
The global health mantra is familiar—countries can only effectively prepare for and respond to pandemics through cooperation. COVID-19 provides little evidence that state behavior has heeded this slogan. During the most severe global crisis in decades, multilateralism failed, and nationalism prevailed.
Changing roles in global health governance following COVID-19
Background: The Global Health Governance (GHG) response to the COVID-19 pandemic has been criticized, particularly regarding vaccine management, and changes in the roles of GHG actors have been recommended. Aim: To investigate the perception of experts regarding changes in the roles of different GHG actors following the COVID-19 pandemic. Methods: This study used a 3-round Delphi survey to collect data from 30 global health experts between May and December 2022. The GHG roles investigated were stewardship, production of guidelines and policies, promotion of solidarity and collaboration, and management of global health challenges. Social network analysis was performed and collected data was converted into a 1-mode network. Degree centrality and Eigenvector centrality were calculated using the UCINET 6.757 modelling programme. Results: There were variations between the current and future roles in degree centrality and eigenvector centrality for the 19 GHG actors in each of the 4 functions investigated. For stewardship, WHO, governments and the World Bank had the highest degree centrality and eigenvector centrality during both the current and future periods. In terms of production of guidelines and policies, WHO maintained the highest current and future eigenvector centralities, while research agencies, UNICEF and Gavi upheld their current eigenvector centrality measure. For the promotion of solidarity and collaboration, WHO had the highest centrality measures, followed by UNICEF, governments and Gavi. Regarding the function "management of global health challenges", WHO lost its position to UNICEF as the most central, while UNDP, FHI 360 and research agencies were predicted to have a more central role in the future. Conclusion: The findings position WHO as the current and future top actor in stewardship, production of guidelines and policies, and promoting solidarity and collaboration, and UNICEF as the upcoming most central actor in managing global health challenges. Governments were major actors in all GHG functions except for managing global health challenges. Funding actors were central in all GHG functions, indicating finance as an important factor in obtaining a central role in GHG. Research organizations received a high centrality rating, indicating their importance in GHG.
Challenges and Lessons Learned in the Implementation of Government Policies during COVID-19 Pandemic
International Journal For Multidisciplinary Research, 2023
Subnational governments, such as Local Government Units (LGUs), are currently faced with a health crisis that entails significant economic, social, and budgetary ramifications. In order to address the consequences of the COVID-19 pandemic, the Local Government Unit of Malita Davao Occidental has implemented various interventions through its Municipal Inter-Agency Task Force (MIATF) on Emerging Infectious Diseases. Results revealed emerging (8) themes as follows: limited access to healthcare services and medical providers; capacity and training needs; cultural and socioeconomic gaps; poor communication and information dissemination; improve overall healthcare system; empower the Local Government Units; communication strategies; the holistic and sustainable development programs and needs. The purpose of this study was to identify the challenges and lessons learned of the MIATF in the implementation of government policies during the COVID-19 pandemic using qualitative method.
International Journal of Health Governance
PurposeAs the coronavirus disease 2019 (COVID-19) continues to spread across countries, it is becoming increasingly clear that the presence of pre-existing noncommunicable diseases (NCDs) dramatically increases the risk of aggravation in persons who contract the virus. The neglect in managing NCDs during emergencies may result in fatal consequences for individuals living with comorbidities. This paper aims to highlight the need for a paradigm shift in the governance of public health emergencies to simultaneously address NCD and noncommunicable disease (CD) pandemics while taking into account the needs of high-risk populations, underlying etiological factors, and the social, economic, and environmental determinants that are relevant for both CDs and NCDs.Design/methodology/approachThe paper reviews the available global frameworks for pandemic preparedness to highlight the governance challenges of addressing the dual agenda of NCDs and CDs during a public health emergency. It proposes...
The main challenges in pandemic management: understanding global health security's current obstacles
The COVID-19's pandemic highlights the urgency of a global health security and infectious diseases agenda, as well as a need to effectively exercise the health governance mechanisms available or to be devised by the international community. This article seeks to identify and briefly discuss the main challenges pandemic's governance faces today, as to contribute to all efforts to address this need. They are four: the crisis of WHO as the main agent of global health governance; the limits of the international cooperation initiatives for development of national capacities in public health so far; international patent law and the obstacles to universal access to healthcare; and the restrictions to human mobility and the disrespect to human rights in times of health crisis. As an analysis method, extensive academic literature, official documents, and journalistic clippings are used in order to instruct the hypothesis proposed. Therefore, this paper is an analytical effort to bring the issue of global health security closer to the field of International Relations and Social Sciences, valuing the construction of a sustainable and comprehensive approach to global health and pandemic response.
Governing the Pandemics: Moving towards an Assertive Institutional Environment
Journal of Global Health, 2021
The global coronavirus pandemic has taken the world by surprise. Though such a pandemic was anticipated, it has hit countries with force, which both national and international health institutions were unprepared for. Known as COVID-19, this newly emerging virus exhibits high transmissibility, an alarming fatality rate, and few proven medical countermeasures, all of which pose a challenge to its governance. The enormity of the situation caused by COVID-19 is putting global institutions to the test with regards to governance during pandemics. The Viewpoint calls for revision of the international guidelines and national approach towards an assertive institutional environment for pandemic governance. An assertive institutional environment is about the actors stepping back to take decisions as an external viewer for the welfare and security of humanity and their ecology nationally and globally. It is not about having proactive policy response with predictable concrete events but rather drawing attention to potentially relevant developments on an everyday basis recognizing the prevailing uncertainty, unpredictability, and availability of resources with strong leadership. This requires stronger international cooperation, adequate foresight, enhancing social solidarity, and optimizing resources with strong leadership and effective communication.