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April 26, 2023

Responding To: Georgetown Reflects on CUGH 2023: "Global Health at a Crossroads: Equity, Climate Change and Microbial Threats"

Global Response to Pandemics: Time to Reimagine Global Health

Bernard Owusu Agyare

"Imagination is not only the uniquely human capacity to envision that which is not, and, therefore, the foundation of all invention and innovation. In its arguably most transformative and revelatory capacity, it is the power that enables us to empathize with humans whose experiences we have never shared" - J.K. Rowling

After almost four years of virtual engagement, the Consortium of Universities for Global Health 2023 Conference (CUGH 2023) provided a unique in-person opportunity to deliberate on pertinent global health issues. This year’s theme, “Global Health at a Crossroads: Equity, Climate Change, and Microbial Threats,” was apt. Indeed, global health is at a crossroads considering the growing gap in all social determinants of health, climate change, and the increasing rate of epidemics and pandemics, particularly in the last decade. Two of the many great sessions at CUGH 2023 challenged me to reimagine a new global health paradigm.

The first was a plenary session on pandemic prevention, COVID-19, emerging infectious diseases, and other communicable diseases. Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Disease (NIAID); Thomas Inglesby, director of the Johns Hopkins Center for Health Security; Nicole Laurie, executive director of the Coalition for Epidemic Preparedness Initiative (CEPI) and former assistant secretary for preparedness and response in the Department of Health and Human Services (HHS); and other global health leaders led this discussion. The devastating impacts of the COVID-19 pandemic and the monkeypox outbreak served as contemporary global health security issues for this session.

Dr. Fauci shared 10 tips to guide future pandemic preparedness and response strategies. I found the third tip “global information sharing and collaboration” to be interesting yet crucially important, especially at a time when viral sovereignty is gaining traction. Gene sequences and other forms of infectious pathogen data sharing have become more linked with geopolitical and geoinstituitional competition. Considering that pathogens move across borders without passports, we need to reimagine a global health structure that sees scientific collaboration and data sharing as a global health “good.” Dr. Fauci also emphasized the need to address the longstanding system of inequity in health. In this regard, Dr. Laurie highlighted CEPI's role in facilitating the equitable distribution of vaccines globally and how the coalition seeks ways to incentivize global collaboration between scientists and researchers. During his turn, Dr. Inglesby noted that to prevent or effectively respond to Disease-X, a term coined by the World Health Organization (WHO) for an unknown future pandemic, national governments should demonstrate commitment to the Pandemic Treaty that is currently being negotiated.

The other thought-provoking session was “Reimagine Global Health in the 21st Century.” Although global health emerged in the last two decades to build and broaden perspectives on tropical medicine and international health, inequity and colonization have become its defining concepts over the years. Dr. Melissa Salm, a postdoctoral fellow with the Biosecurity Program at the Center for International Security and Cooperation, Stanford University, identified gaps in global health governance where low- and middle-income countries (LMICs) are not adequately engaged in global health discussions. Systemic asymmetry of power where local actors are not empowered to lead or take ownership of global health programs, asymmetry of funding, professional silos, and competition among global health actors are some of the problems that undermine the current global health architecture. It was posited that a new framework should be conceptualized to effectively address current global health realities.

In conclusion, I benefited immensely from the CUGH 2023 conference. The urgent need to reimagine global health into one that is truly equitable, collaborative, and decolonized was re-echoed. The conference sessions have challenged me to reflect on my role in bringing into reality this reimagined global health paradigm.

Bernard Owusu Agyare is a doctoral student in the global infectious disease program at Georgetown University.

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