PAHO Dominican-born Director Carissa F Etienne
VANCOUVER, Canada (CMC) — The Pan American Health Organization (PAHO) has called on Caribbean countries to take action and make the necessary investments to make their health systems stronger and more resilient.
“Preparedness requires more than emergency plans and simulation exercises,” said PAHO Director Dr Carissa F Etienne in addressing the 4th Global Symposium on Health Systems Research here.
“It means strengthening core aspects of health systems, from human resources and access to medicines, to health information systems and even legal measures to support public health action,” added Dr Etienne, who was born in Dominica.
Etienne’s remarks were made before an audience of more than 2,000 experts at the symposium that was co-sponsored by Health Systems Global, PAHO, the World Health Organization, the Alliance for Health Policy and Systems Research, the Canadian Society for International Health, Canada’s International Development Research Centre, and the Canadian Institutes of Health Research.
Investing in health systems resilience is “considerably more cost-effective” than financing emergency response, and is likely to better protect people’s health and well-being in both emergencies and normal times, said Etienne.
“Fragile health systems increase the vulnerability of populations to external risks that impact health and well-being, health protection, and ultimately social and economic development,” she said.
“Again and again we see this through epidemics of H1N1 influenza, chikungunya and Zika virus; through earthquakes in Chile and Ecuador; hurricanes in Haiti and the Bahamas; and through the effects of climate change on health,” she added.
In September, health leaders from PAHO member countries endorsed a new framework for efforts to ensure that health systems are more resilient in future health emergencies.
The “Resilient Health Systems” framework notes that more than 98 million people in the Americas, including the Caribbean, were affected by disasters between 2004 and 2014; that the recent chikungunya epidemic sickened more than 1.6 million people; and the Zika epidemic had such a serious health impact that the WHO declared it a “public health emergency of international concern”.
To ensure that health systems are prepared for such emergencies, the framework calls for integrated action and increased investments in disaster preparedness, risk reduction, and response; disease surveillance and outbreak management; and health system strengthening and universal health.
“We know that a fragmented approach is not enough,” said Etienne during a panel discussion on resilient health systems. “We need to address both traditional disaster and disease risks, as well as longer-term internal and external risks that affect the ability of health systems to respond well in both normal times and during health emergencies.”
To be effective, PAHO said efforts to build strong, resilient health systems must be based on evidence from research in a range of areas.
“Evidence generated must ensure that health-care delivery systems of the future are of better quality, are universally accessible, and are more transparent, democratic, and responsive,” Etienne said, adding that the central goal of this research should be to identify the characteristics of resilience in health systems.
She said the results could lead to the development of “stress tests” that can assess health systems’ response capacity and identify weaknesses that need to be addressed.
Getting started on this kind of research is especially urgent, because the process of building resilient health systems will take time, Etienne said.
“Building health systems with the right attributes does not happen overnight. It requires long-term political, social, and economic stability, and a broad commitment from countries to invest in health and development,” she said. “We must work together to find solutions.”