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Global Health Security Agenda | Strengthening Health Security Across the Globe: Progress and Impact of U.S. Government Investments in the Global Health Security Agenda - 2019 Annual Report

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Infectious disease threats anywhere — whether natural, accidental, or deliberate — pose significant risks to global health, security, and the economy. The novel coronavirus (SARS-CoV-2/COVID-19) pandemic and recent outbreaks of Ebola in the Democratic Republic of the Congo1 are poignant reminders that the work to achieve global health security is urgent.

The May 2019 Global Health Security Strategy2 highlighted the U.S. Government’s determination to advance global health security capacity both at home and abroad, including through an ongoing commitment to the Global Health Security Agenda (GHSA). The United States helped launch the GHSA in 2014 — initially as a five-year commitment — with a coalition of countries envisioning a world safe and secure from the threat of infectious diseases. The initiative was renewed in 2018 for a second five-year phase from 2019-2024, known as “GHSA 2024.” GHSA is a multisectoral, multilateral effort of nearly 70 countries in partnership with the private sector, civil society, and international organizations. It works to build countries’ capacity to prevent, detect, and respond to infectious disease threats.3 GHSA 2024 works to accelerate implementation and compliance of the International Health Regulations (IHR 2005), a legally binding instrument adopted by 194 World Health Organization (WHO) Member States to strengthen country-level capabilities needed to prevent, detect, and respond to public health emergencies for greater global health security.

The United States has served on the GHSA Steering Group that has guided the effort since its inception in 2014. Within GHSA 2024, the United States leads efforts on sharing our experiences, lessons learned, and technical expertise with partners around the world. In addition, the United States has provided financial resources as part of its commitment to GHSA to support partner countries improving their ability to address infectious disease threats. As noted in the 2019 Global Health Security (GHS) Index,I, 4 a high-level report by the Global Preparedness Monitoring Board (GPMB),5 the World Economic Forum Global Risks Report,6 as well as other reports, no country is fully prepared for an infectious disease threat and “the world requires determined political leadership to prepare for health threats at national and global levels.”7 The United States is a leader in efforts to strengthen partner country capacities in health security, increase international support for global health security, and ensure a homeland prepared for, and resilient against, health threats.

As of August 5, 2020, COVID-19 has killed more than 700,000 people and has infected more than 18 million in 188 countries globally.8 As we have seen with the COVID-19 pandemic, disease outbreaks have the ability to overwhelm entire health systems and, in addition to the loss of life, can cause worldwide economic disruptions. While COVID-19’s total global economic impact is still to be determined, we know the world economy as a whole lost an estimated $93-107 billion in productivity, in addition to substantial death and disability from the 2003 SARS and 2014-15 Ebola epidemics.9,10,11 These effects highlight the need for every country to prioritize investments in health security and in building capacity to stop infectious disease threats at their source.

Beyond traditional health security risks, additional factors including urbanization; environmental changes; political instability; public activities that involve mass gatherings; travel; trade; and violent conflicts can increase the opportunities for pathogens to spread. These risks, combined with the continued possibility of deliberate or accidental release of pathogens, justify why the global community must adopt a whole-of-society, multisectoral approach to combat these threats.