Measuring and Motivating Global Health Security: Lessons From Taiwan

Measuring and Motivating Global Health Security: Lessons From Taiwan

In 2012, I had the privilege of working with Taiwan’s Department of Health, assessing its public health emergency preparedness programs. It quickly became obvious that preparedness for epidemics was a top priority for good reason: In 2003,Taiwan was hit hard by the global SARS epidemic, suffering nearly 700 infections and 200 deaths—and losing nearly half a percentage point of its Gross Domestic Product. Since SARS, Taiwan has worked hard to develop its preparedness capacities.

Though it doesn’t have full membership in global institutions like the World Health Organization (WHO) and initiatives such as the Global Health Security Agenda (GHSA), Taiwan has found ways to incorporate the priorities and principles of these efforts into its preparedness work. On October 19, 2016, Taiwan published a complete multi-sectoral Global Health Security Assessment, conducted by a six-person External Assessment Team from the UPMC Center for Health Security (the “Center”) in June 2016. The assessment used the WHO’s new International Health Regulations (IHR) Joint External Evaluation (JEE) tool. The JEE Tool provides a standard metric by which countries and regions can assess their current baseline capacities and measure future progress toward full development of IHR capabilities to prevent, detect, and respond to public health threats, whether they are naturally occurring, deliberate, or accidental.

As a member of the Taiwan JEE assessment team, I can attest to the value of the whole process. First, in a world that seems to be in a continual state of emergency, JEE assessments afford participants a rare opportunity to step back and receive from their peers an honest accounting of their strengths and weaknesses for preventing, detecting, and responding to a range of health security threats, such as human and zoonotic disease outbreaks, radiation and chemical emergencies, and food safety events. Second, since the assessments take a multi-sectoral approach, participants must bring together different stakeholders, which can be an important first step towards building strong, working relationships between agencies.

These benefits are not unique to our experiences in Taiwan. At a symposium that the Center organized, individuals involved in JEE assessments in Bangladesh, Ethiopia, Tanzania, Pakistan, and the US spoke to the perceived value of the process and reported similar benefits to what my colleagues and I observed in Taiwan.

Word of the JEE’s value is spreading. Reportedly, WHO now has a backlog of countries and regions that have requested JEE assessments. This is a welcome development. After more than 10 years of stalled progress on the implementation of the International Health Regulations (IHR), it is encouraging to see a new wave of enthusiasm for global health security. Now we must sustain this momentum to ensure that all countries are able to assess their capacities and make the necessary improvements to ensure that epidemics no longer pose significant threats to society.