The Role of Civil Society in Pandemic Preparedness - Innovation in Global Health Governance - page 109

world can imperil the livelihoods of people an ocean away, that infectious pathogens
can encircle the globe in a matter of days in the age of international travel, and
that the public's fearful reaction can deliver the final blow to an already crippled
economy. this should have underlined the urgent need to strengthen the global
capacity for disease surveillance, increase reporting transparency, and improve
regional cooperation (Fao and oIe 2005a).
Public health authorities did try to increase the control of microbes in the
aftermath of SarS. Yet it remains doubtful that the critical lessons that SarS should
have taught have been internalised. Despite the critical need for a stronger global
public health infrastructure, the international community continued to under-invest
in an efficient and effective global system of outbreak surveillance and response
(evans et al. 2004). a virus is most lethal where the target population is already
immuno-compromised by disease, malnutrition, and poor sanitation, or where the
health infrastructure is unable to contain it. It is impossible to estimate the extra
impact of avian influenza on cramped refugee camps, on famine-stricken areas, on
sprawling slums lacking clean water and medical facilities, or on the 33.2 million
people living with HIv/aIDS (Garrett 2005a; wHo 2005).
So how can one prepare, in the context of inadequate global health care, for a
pandemic far deadlier and far more difficult to control than SARS, one that would
indiscriminately affect every sector of society (osterholm 2005)?
Global Governance versus microbial Globalisation
Global collaboration is the only way to fight epidemics in the age of globalisation:
a global disease requires a global health policy and global governance framework
that involves a multiplicity of actors—including national governments, international
agencies, private and corporate actors, and civil society (aginam 2004). avian
influenza, by its nature, lies at the complex interface between farming practices,
livestock trade, food safety, and public health security (Fao and oIe 2005a). this
section therefore explores the overlapping layers of the global health architecture
to underscore the need for participatory processes, multi-stakeholder consultations,
cross-sectoral linkages, and local engagement in the transnational pandemic plans,
starting with the Un. 7
International Coordination of Preparedness Planning
although it was relatively localised and contained, the shock of the asian tsunami
in December 2004 exposed the poor shape of the Un's inter-agency coordination.
It also prompted critical review of the Un's role in national preparedness plans in
different countries—and a far more immediate response to avian influenza.8 8
The World Health Organization (wHo) is the default agency when it comes to
health-related issues. 9 but the complexity of avian influenza makes it necessary
to engage other actors that are better placed to address the zoonotic or security side of