Global Health Institute

By Zachary Fritz

On Tuesday, January 29, 2020, Georgetown’s Conversations in Global Health class hosted Dr. Rebecca Katz, Georgetown Professor and the Director of the Center for Global Health Science and Security, to reflect upon her professional journey in global health and discuss one of the most pressing issues in global health security: the novel coronavirus in China. In addition to sharing her vast experience as a global health security consultant to the U.S. State Department and a leading figure in academia, Dr. Katz provided a unique yet measured perspective regarding the potential implications of declaring a Public Health Emergency of International Concern (PHEIC), the importance of the International Health Regulations (IHR), and the main difficulties of global health diplomacy.

Much of the discussion with Dr. Katz centered around global health preparedness and the proper implementation of the IHRs to the coronavirus outbreak. When asked about the current state of global preparedness, I found Dr. Katz’s emphasis on political willingness and communication to be insightful into her beliefs regarding the areas for potential improvement in coordinating global health security. Furthermore, her comments seemed to indicate the importance of capturing the fluctuating interest of policymakers in creating global health policies. This attention on politics is particularly important to the coronavirus outbreak given China’s negative global health reputation from the SARS outbreak. One of the most salient points of controversy is whether or not to declare the novel coronavirus outbreak a PHEIC. Katz compared the present situation in China with the hesitancy to declare a PHEIC in the Ebola epidemic in western Africa, explaining that the IHR defines it as an outbreak that has the potential to cross international borders. While issuing it earlier has immense benefits for the affected population if the outbreak expands, a pre-mature declaration has significant consequences as affected nations’ industrial supply chains are disrupted by travel and trade restrictions and other nations enact restrictive and stigmatizing immigration policies. In my opinion, the tentativeness indicates that global health emergencies are evaluated primarily through a political lens, as the signal matters as much as the treatment of the epidemic. The decision has significant implications on the political weight of the IHR and what exactly should constitute a PHEIC (e.g. regional versus global terminology).

Dr. Katz expressed her expectation that PHEIC for coronavirus will likely be declared in the next week since it has fulfilled the legal definition of crossing international borders. While I understand that such a decision would be validated according to a strict IHR interpretation, I believe that the declaration should not be issued until either the fatality rate spikes significantly or there is person-to-person transmission outside the country of origin to limit the negative political consequences until absolutely necessary. Furthermore, I think it would also be useful to distinguish between regional international threats and global international threats in future IHR reviews. 

Dr. Katz measured analysis and careful diction toward complex global health issues, such as the novel coronavirus, demonstrate the importance of proper communication and language skills toward her success in global health security. From our discussion with Dr. Katz and along with “Defining Health Diplomacy (Links to an external site.)," I was reminded of the necessity of taking a coordinated and international approach to combat global health crises through employing a variety of global health experts from foreign service agents to academics, such as Dr. Katz, in an era of globalization with increased probabilities of epidemics and pandemics. 

Zachary Fritz (C‘21) is a third-year undergraduate at Georgetown University studying Biology of Global Health and Science, Technology, and International Affairs with a concentration in Global Health.

By Meera Parikh

On Tuesday, the Conversations in Global Health class hosted Dr. Rebecca Katz, professor and the Director of the Center for Global Health Science and Security at Georgetown University. While she currently works on the intersection between global health, technology, and security, she spent her undergraduate years studying political science and economics at Swarthmore University. However, after developing an infection while volunteering in India, Katz found herself studying Brucella melitensis instead. “When you have a rare infection, you have to become your own expert,” Dr. Katz cited as her sudden interest in the bacteria. As she simultaneously pursued a Masters in Public Health at Yale University in Infectious Disease Epidemiology, Dr. Katz personally experienced disease at the patient level. This was one of many seemingly coincidental events in her career path. 

As she researched more about Brucella, she found a lot of literature about bioweapons—this was because Brucella was a possible bioterrorism agent in the 1950s. She began thinking about the intersection between disease and technology, which lead her to develop a thesis proposal about public health and national security. At the time, most Ph.D. programs were not interested in her research, however she was finally offered a spot at Princeton University. And then another coincidence occurred. On September 10, 2001, Dr. Katz turned in her thesis on public health security, one day before America’s security faced a major threat. Suddenly, the ideas she presented in her paper became issues of national concern. In 2004, Dr. Katz began consulting for the Department of State, while concurrently conducting global health security research at the George Washington University. Four years ago, she moved her research team to Georgetown University, where she currently works.

While listening to Dr. Katz’s career path, I began to wonder, does the job that I will have in five or ten years exist yet? How do I plan for the future, when so many people stumble into their careers through a combination of chance and life experience? In the fleeting moment that I considered these ideas, the conversation shifted to 2019-nCoV, the novel Coronavirus. 

In response to the question “Are we better prepared to deal with pandemics?” Dr. Katz offered a simultaneously optimistic and ominous response: “Yes, but not enough.” She explained that while we have improved infrastructure and adherence to the International Health Regulations, it is impossible to keep up with nature. China has revised their disease surveillance systems and been more transparent about the 2019-nCoV than they were with SARS, but there are still critical questions about the pathogen that are unanswered. The scary, yet fascinating thing about the outbreak is that it is both an issue of the present and the future, and we need to keep both in mind as we develop interventions. After the WHO failed to declare the 2019 Ebola outbreak a public health emergency of international concern (PHEIC) in time, I thought that they would not do the same with this outbreak. But after hearing Dr. Katz elaborate on the political, social, and economic implications of declaring a PHEIC, I realized how nuanced the pandemic response is. I see the same ideas echoed in her recommendations for Global Health Diplomacy in which public health and policy experts must work together to determine the best interventions. Global health issues have no borders, so it takes an international, interdisciplinary team to solve them. Despite all the chaos and fear that pandemics cause, there are researchers, like Dr. Katz, who do their best to prepare for them. And while my career probably won’t follow a linear trajectory, I too can prepare for the unpredictable.

Meera Parikh (NHS ‘22) is a second-year undergraduate student studying Global Health.