When it comes to emerging trends in international development and public health in 2024, global health security (GHS) is at the top of the list. It’s also at the heart of mitigating the impacts of present global health issues while preparing for those to come. True GHS means that there are strong systems and frameworks in place to prevent and respond to global health threats—threats such as the COVID-19 pandemic, tuberculosis (TB), and HIV/AIDS.

As much of the world emerges from many of the pressures of the COVID-19 pandemic, it is important to keep the lessons we learned in mind as we work towards GHS for all. COVID-19 highlighted that the future of GHS requires a vision that addresses interrelated health care across countries and continents.

The current picture of GHS is governed and driven by many arms, including policy, governance, and health economics; infections of pandemic potential and pandemic preparedness; antimicrobial resistance; and climate change and health. The convergence of these priorities describes in brief the complexity of future health priorities.

Looking back at the events of the pandemic, we can see that overall, countries were not prepared to respond to the multitude of health, logistical, and economic impacts that fall under these GHS arms. Going forward, we need to better understand how to “health proof” our world, ensuring that we are better equipped to deal with future threats.

As we move into the new year, keeping GHS at the forefront of every aspect of our work is essential, and health system strengthening is essential to ensure global stability.

Policy and Health Economics

Policy and public health economics are vital to strengthening GHS, but dealing with pandemics or other health threats does not always fit perfectly into current policies. Being able to assign a number or a percentage to the impact that pandemics and infections of pandemic potential can have is essential to advancing the GHS agenda. In tandem with taking advantage of the power of public health economics, policies need to be designed to respond flexibly to ‘trigger events’, which could range from future pandemics and environmental disasters to wars.

When the next health threat occurs, policies already need to be in place that will facilitate the rollout of disaster management guidance and response in tandem with collaboration across borders. Current international health policy is focused on movement control, closing borders, quarantines, and economic shutdown in an attempt to contain disease.

We need a shift in policy to create early warning systems, prevention, and treatment capacity that transcend borders. As we saw during the pandemic, we, in our individual countries, do not live in a vacuum, so regional and cross-border policies are essential to mitigate the impacts of the next health threat.

The Next Pandemic and Data Systems

Although COVID-19 may have been a shock to many, it was a repeat of the 1918 influenza pandemic, and in terms of tackling infections of pandemic potential, we should be framing them as when the next pandemic occurs, not if.

In building up a strong GHS framework that will respond to the next pandemic, the One Health approach should be the central point. One Health approaches take into account the three intertwined components of human, animal, and environmental health, with the goal of achieving optimal health outcomes for all three.

Infections of pandemic potential come from a number of vectors, including domestic and wild animals, so those working to predict and prepare for future pandemic threats also need to be in close contact with the animal health professionals both in the clinical and laboratory spaces. This collaboration will only serve to strengthen GHS through early warning and preparedness systems.

Part of the One Health approach hinges on the availability and accessibility of good data to monitor current outbreaks, predict future ones, and analyse past problems and solutions. The need to build integrated data systems both in surveillance and in clinical settings is vital to get a more holistic picture of the state of a disease at any given point in time.

Building these mega-data systems sounds simple in principle, but in reality, is quite difficult. Countries have their own standards of practice and operating systems, and in many instances, cost is a barrier to replacing these. It is essential that legacy data be integrated into centralised systems, when possible, because data can be used to warn and prepare the general public before a potential health threat, and subsequently inform the public during an event and give them predictions about what is to come.

Data centralisation and integration needs to be done across the board at the country-level. This type of centralisation is being focused on for diseases like COVID-19 because of its current relevance, but must be done for other threats, like HIV/AIDS or tuberculosis, to really build a strong framework for enhanced GHS going forward.

The Climate Issue

Ultimately, the intersection between climate change and health is at the heart of GHS. Our changing climate is shifting where infectious diseases occur, how they spread, and how effectively and efficiently they’re able to spread once introduced into the general population. Additionally, climate change contributes to an increase in environmental disasters that in turn create humanitarian crises and can displace large populations, further fueling infectious disease spread.

As of now, we can’t know how much climate change is going to impact global health, but we do know that it will and that we need to prepare in advance. This means making combatting climate change central to GHS-focused work going forward.

The Dream GHS Picture

In a perfect world, GHS looks like the open exchange of vital monitoring and clinical data and the preparedness of health systems to respond to future threats swiftly and efficiently. Needless to say, a few stumbling blocks remain.

Central data warehousing of large datasets is beyond the scope of most LMICs at this time, so data is being kept at a regional level which presents problems when it comes time to share said data.

Along the same vein, data cannot move across borders—in many cases the free exchange of data is being prevented or declined. We need to work towards data diplomacy, in which data itself is held in diplomatic terms where it can be accessed and shared.

This type of collaboration requires policy changes, not at the country level, but at the WHO or even United Nations level. Ultimately, these changes won’t happen overnight, which is why it’s essential to utilise a stepwise approach, starting country by country and hopefully scaling up in order to see greater change.

Health proofing our world won’t be easy, but it’s essential to improving GHS and preparing for the future threats that are sure to come. The capabilities, tools, and data are all within our reach. Now it’s just a matter of gathering the right people, and ensuring lasting support for a stronger, more flexible, more responsive GHS framework that is built to last.

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