Parliament’s role in strengthening health security preparedness
Global health crises impact all segments of society, and no community in our world is fully protected against them. Recent public-health emergencies of international concern (PHEICs)1 include the ongoing COVID-19 pandemic, the 2018–20 Ebola epidemic in the Democratic Republic of the Congo, the 2015–16 Zika virus epidemic, the 2014-16 Ebola outbreak in West Africa and the 2009 H1N1 pandemic. Each of these examples underscores how a public-health crisis can lead to significant health and economic losses and deprive people of opportunities.
There have been at least six pandemics since the 1918 Spanish Influenza pandemic, including COVID-19. Each of these has been a zoonosis (a disease caused by germs that spread from animals to people). Without preventive strategies, more pandemics are possible.5 Yet there is no way to know when the next health emergency will strike, whether it is a PHEIC, a pandemic or some other kind of disaster. For a zoonotic disease to emerge, for example, an easily transmitted pathogen simply needs to jump from animal to human. The likelihood of that occurring increases with climate change and closer contact between humans and wild and domestic animals.
In 2019, the 141st assembly of the Inter-Parliamentary Union, held in Belgrade between the 13th and the 17th of October, adopted by consensus the Resolution titled Achieving universal health coverage by 2030: The role of parliaments in ensuring the right to health. Article 31 of the resolution states “Also urges parliaments to address the political, social, economic, environmental and climate determinants of health as enablers and prerequisites for sustainable development, and to promote a multisectoral approach to health”.
Throughout 2020 and 2021, the COVID-19 pandemic subjected global and country emergency preparedness to a tough stress test. As the disease emerged and transmitted easily from person to person and country to country, it simultaneously overwhelmed the national capacities of many countries and resisted containment measures. As countries struggled to bring down their infection numbers, many experienced multiple waves of infection with high morbidity and mortality rates.
As emergency responses were deployed, the lack of preparedness was further highlighted. An overreliance on the capacity to react to emerging health risks resulted in strained health and financial systems. It also caused human suffering, disrupted work and education and reduced economic and commercial opportunity – thereby entailing further misery and chaos. Vulnerable groups were particularly hard hit, and existing inequalities worsened.
Parliamentarians can leverage their various roles and positions to advocate and lead and to bring about better emergency preparedness and health security. The parliamentary functions of law-making, oversight, accountability and budgetary approval, together with the individual opportunities that parliamentarians have as representatives and community leaders, should be put to use so that emergency preparedness becomes a priority and the devastating impact of COVID-19 and other health emergencies is never again repeated.
During the 144th Inter-Parliamentary Union Assembly held in Bali, Indonesia, between the 20th and the 24th of March 2022, IPU and WHO jointly launched the 34th Handbook for Parliamentarians on Strengthening health security preparedness: The International Health Regulations (2005).
This handbook aligns with and contributes to the implementation of the IPU resolution Achieving universal health coverage by 2030: The role of parliaments in ensuring the right to health and the WHO resolution Strengthening preparedness for health emergencies: Implementation of the International Health Regulations (2005). Both emphasize the importance of health security in attaining universal health coverage (UHC).
The International Health Regulations (2005) (IHR) are an instrument of international law conferring rights and obligations on their 196 States Parties. Their purpose is to prevent the international spread of disease and to enable a public-health response when risks arise that is proportional to the risk and avoids unnecessary interference with international traffic and trade.
Parliamentarians act collectively as a parliament but may also contribute individually as parliamentarians to the activities of their parliaments and their constituencies. Options for action to support health emergency preparedness and health security are as multifarious as the types of positions that parliamentarians can hold. The commonality is that all parliamentarians may serve their own communities and constituencies powerfully as influencers, leaders and advocates by supporting and protecting human health and economic security.
This handbook was created to enhance parliamentary contributions to health-security preparedness. It is designed to be used by parliamentarians and parliamentary staff as they consider important aspects of preparedness that need to be established or strengthened at all levels including communities. The handbook contains key questions that can help guide parliamentarians in their capacity-building efforts.