Table 1

Health security challenges and proposed solutions in the Asia-Pacific region

ChallengeProposed solutions
Retaining political commitment
  • Improve education and risk perception of leaders in all relevant sectors, as well as the wider community

  • Health security to be given standing priority

  • Regional funding mechanisms to sustain core activities

  • Establish mechanisms to ensure lessons from EID outbreaks are critically reviewed and acted on

Weak health systems
  • Increased domestic investment in health systems (in general)

  • Coordinated international assistance to build local capacity

  • Commitment to universal health coverage

Limited EID surveillance and reporting
  • Conduct comprehensive assessments using the IHR monitoring and evaluation framework

  • Invest in basic quality-assured laboratory infrastructure

  • Maintain functional national/regional reporting systems

Subnational vulnerability not considered; all MEF tools rarely used
  • JEE assessment to consider subnational vulnerability; optimise the use of all MEF tools

  • Encourage local engagement to consider risks and identify workable solutions that will increase ‘all hazard’ resilience

Misalignment of international donor and local priorities
  • International donor support should align with local priorities and strengthen health systems in general

  • Discourage programme-specific investment that does not build sustainable local capacity

Emergency infrastructure are expensive to maintain and often underused
  • Disaster risk reduction and preparedness infrastructure should be designed for continuous use and training

  • Develop models where high-level containment facilities (laboratory or clinical) can be scaled up or down as required

Poor linkage of human, animal and environmental surveillance data
  • Ensure cross-sectorial linkage; integrate IHR with OIE’s Evaluation of Performance of Veterinary Services to improve livestock and wildlife disease surveillance

  • Encourage One Health collaboration at Regional and National levels, specifically among public health officials

  • Increase awareness of environmental determinants of disease

‘Silos’ within WHO and between WHO, OIE and FAO
  • Increase linkage between different WHO programmes, for example, between Health Emergencies, Health Systems and Communicable Diseases

  • Strengthen functional forums that link WHO, OIE and FAO activities relevant to EIDs and AMR

All hazards not uniformly relevant
  • Allow small countries to rank the relevance of different hazards since all specified hazards may not be applicable

  • Encourage/provide access to regional resources where appropriate; recognise as adequate

  • AMR, antimicrobial resistance; EID, emerging infectious disease; FAO, Food and Agriculture Organization; IHR, International Health Regulations; JEE, joint external evaluation; MEF, monitoring and evaluation framework; OIE, World Organisation for Animal Health; One Health, referring to human and animal disease.