DEEPENING COOPERATION and COORDINATION on HEALTH POLICY in the AMERICAS a New Approach to Health Emergencies
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JULY 2021 DEEPENING COOPERATION AND COORDINATION ON HEALTH POLICY IN THE AMERICAS A New Approach to Health Emergencies Inter-American Health Task Force White Paper Deepening Cooperation and Coordination on Health Policy in the Americas 1 JULY 2021 JULY 2021 TABLE OF CONTENTS Acronyms and Abbreviations ............................................................................................................................... 3 Executive Summary ............................................................................................................................................ 4 Figure 1. Summary of specific recommendations for health emergencies cooperation and coordination in the Western Hemisphere ................6 Introduction and Background ............................................................................................................................... 7 The Guiding Principle: "Health is the Greatest Wealth" ............................................................................................. 9 Purpose of the Task Force ................................................................................................................................... 9 Chapter 1: Setbacks in Regional Cooperation and Coordination in the Time of Covid-19 .............................................. 10 1.1. Inadequate Political Leadership, Coordination and Planning ................................................................................................................ 10 1.1.1. Weak Global Solidarity Undermines Regional Cooperation ............................................................................................................. 10 1.2. Challenges to Intragovernmental Coordination at All Levels ................................................................................................................ 12 1.2.1. Management Challenges .............................................................................................................................................................. 12 Chapter 2: Understanding the Crisis Along Four Axes ............................................................................................ 13 2.1. Data Accuracy, Timeliness, Availability, Transparency, Consistency, Completeness ............................................................................ 13 2.1.1 Surveillance: The Foundation for Prevention ................................................................................................................................... 13 2.1.2. Integrating Artificial Intelligence, Privacy, and Transparency in Pandemic Management .................................................................. 14 2.1.3. Timely Data Sharing and Open Access in the Era of Global Pandemics ............................................................................................ 15 2.1.4. The Importance of Genomic Sequencing to Covid-19 Response ...................................................................................................... 16 2.1.5. Regional Efforts to Gather and Share Data ..................................................................................................................................... 17 2.2. Noncompliance with the IHR ............................................................................................................................................................... 17 2.2.1. WHO's Work in Covid-19: Findings and Opportunities ..................................................................................................................... 17 2.2.2. Lack of Investment in IHR in Americas Region ............................................................................................................................... 20 2.2.3. A New Potential Framework Convention for Pandemic Preparedness and Response ........................................................................ 20 2.3. Lack of Equitable Access to Health Products and Services in the Time of Covid-19 .............................................................................. 21 2.3.1. Shortages of Medical Supplies ..................................................................................................................................................... 21 2.3.2. Access to Health Products in the Time of Covid-19: Business as Usual ........................................................................................... 22 2.3.3. Access Gaps Threaten the Regional Fight Against Covid-19 ........................................................................................................... 25 2.2.4. Collateral Effects of Covid-19 in Access to Health Care and Social Care ......................................................................................... 26 2.4 Misinformation, Disinformation, Conspiracy Theories: A War Against Multiple Forces ........................................................................... 27 2.4.1. Coordination and Cooperation are Essential to Deal with Disinformation ......................................................................................... 28 2.4.2. Vaccine Opponents ...................................................................................................................................................................... 29 Chapter 3: Why Focus on Enhancing Post-Covid-19 Cooperation and Coordination in the Western Hemisphere? ............. 30 3.1 Boosting Hemispheric Cooperation on Health Emergencies .................................................................................................................. 30 3.1.1 Shaping More Resilient Health Systems to Covid-19 and Other Health Crises .................................................................................. 31 3.1.2. The Underlying Principles for Sustainable and Lasting Cooperation in the Region ........................................................................... 32 Chapter 4: The Way Forward For Improving Regional Cooperation in Pandemic Preparedness and Response .................. 34 4.1 Specific Recommendations .................................................................................................................................................................. 34 Table 1. A new take on cooperation and coordination on health emergencies in the Western Hemisphere: Specific recommendations ............ 35 Glossary ......................................................................................................................................................... 42 References ..................................................................................................................................................... 46 2 Deepening Cooperation and Coordination on Health Policy in the Americas DIÁLOGO INTERAMERICANO | FEBREROJULY 20212018 ACRONYMS AND ABBREVIATIONS AI artificial intelligence CDC Centers for Disease Control and Prevention ECLAC Economic Commission for Latin America and the Caribbean EID emerging infectious diseases FIND Foundation for Innovative New Diagnostics GBV gender-based violence ICU intensive care unit IFIs international financial institutions IHR International Health Regulations IPPPR Independent Panel on Pandemic Preparedness and Response MDI misinformation and disinformation ML machine learning NCDs noncommunicable diseases OAS Organization of American States OECD Organization for Economic Cooperation and Development PAHO Pan American Health Organization PPE personal protective equipment R&D research and development RMNCH reproductive, maternal, neonatal, and child health services SDGs Sustainable Development Goals TFA Trade Facilitation Agreement TRIPS (Agreement on) Trade-Related Aspects of Intellectual Property Rights UNDP United Nations Development Program VOC variant of concern WHO World Health Organization © 2021, Inter-American Dialogue First Edition Printed in Washington, DC Cover photo: Tim Evanson / Flickr / CC BY-SA 2.0 / Edits: Made black and white, added blue tint, cropped / Original: bit.ly/3ld3sJ5 Layout: Kaitlyn Blansett / Inter-American Dialogue Industrias extractivas y regulaciones ambientales en el posconflicto: Preguntas clave para el nuevo gobierno Colombiano 3 JULY 2021 EXECUTIVE SUMMARY The Covid-19 pandemic has laid bare fundamental flaws Misinformation, disinformation, and conspiracy theories, in political leadership, coordination, and health policy which have spread widely, have contradicted, or dismissed integration in the Western Hemisphere. Moreover, the the warnings and advice of the scientific community. current geopolitical divides among governments in the region have undermined the few mechanisms in place for On the other hand, other factors have been used as an cooperation on health governance. The post-pandemic opportunity for health systems to be updated, including recovery would benefit from coordination and cooperation, the use of big data, artificial intelligence, and telemedicine. both between and within countries. Nevertheless, despite efforts by the Pan American Health Organization, health ministries, national statistics offices, Although national health systems, including those with multilateral organizations, agencies, and academic universal health care, were not well equipped to cope with institutions, among others, the challenge of harmonizing an epidemic of the magnitude of Covid-19, communities and combining such diverse data systems remains an across the Americas expected their governments to make