Professor Ilona Kickbusch says that health security needs to be integrated into the post-2015 Sustainable Development Goals and development agenda.

In a letter to the Lancet published this week, Director of the Institute’s Global Health Programme, Professor Ilona Kickbusch, and three other experts called for a Sustainable Development Goal (SDG) on health security.

Global health security risks, including epidemics and antimicrobial resistance, cannot be further neglected. Despite the importance of efforts to build stronger and more resilient health systems in the aftermath of Ebola, a more comprehensive, coherent, and effective framework is needed to deal with the full set of health security risks that we face at the local and global levels.

Here is the full text of the letter:

We must use the window of political opportunity for decisive action and enlightened leadership that the Sustainable Development Goals (SDGs) provide to address a key set of local and global risks of our time—global health security risks. The increasing recognition of global health security needs to be integrated into the post-2015 development agenda and SDGs. We propose to add global health security as SDG18. This new SDG could be formulated as, “Take appropriate action to reduce the vulnerability of people around the world to new, acute, or rapidly spreading risks to health, particularly those threatening to cross international borders”.

As in the case of Ebola, it is clear that a risk to one person, community, or nation is a risk to all people, communities, and nations. It is in the wise self-interest of each nation to ensure that every country has a strong, viable, and capacity-rich public health system. While this approach is a necessary component of global health security, it is not sufficient to address the full range of health security risks and the lack of appropriate responses. WHO has defined the provision of global public health security as the “activities required...to minimize vulnerability to acute public health events that endanger the collective health of populations living across geographical regions and international boundaries”.1 Achievement of a coherent and effective approach to global health security will need clarity about the roles, responsibilities and resources of states, regional intergovernmental organisations, global intergovernmental organisations, national security sectors, civil society organisations, and other non-state associations, such as major foundations.

The Ebola epidemic could not have been completely prevented, but it could have been far better managed than it has been so far. While the epidemic is persisting and poses the challenge of getting to “patient zero”, the epidemic also offers an opportunity to learn, revise, and reinvigorate the global public health system to be more effective than it is now, thus improving global health security. Global health security however, must not simply mean that developed countries impose management of health security on developing countries, mainly to protect themselves. Health security needs should be met through a whole-of-government approach that addresses the failures and exposed deficits in global health capacity and governance. Such a universal approach lies at the centre of the SDGs. A SDG focused on global health security could serve as a catalyst for more effective, efficient, and accountable public health provision than exists at present at local, national, and international levels.

There is still time for negotiators to define SDG18 more precisely and to bring stakeholders on board—during SDGs negotiations at the UN, at the 2015 World Health Assembly, at the G7 meetings, and upcoming meetings of the BRICS, the African Union, and other regional bodies.

Just as there will be other Ebola epidemics, there will be other global health security crises. For example, the challenge of antimicrobial resistance—another major global health security challenge that has been neglected at our peril—could also be integrated. Risk portends certainty, and the opportune time to establish a coherent and effective global health security framework is now.

We declare no competing interests.