Public health researchers work to build a global response to outbreaks

Dr. Jorge Saavedra, left, and Jose Szapocznik.
By Janette Neuwahl Tannen

Dr. Jorge Saavedra, left, and Jose Szapocznik.

Public health researchers work to build a global response to outbreaks

By Janette Neuwahl Tannen
Professor José Szapocznik and Dr. Jorge Saavedra are working with world leaders to foster a global treaty that would guide nations on how to respond to disease outbreaks and prevent pandemics.

Four years ago, public health professor José Szapocznik saw the need for a worldwide coalition that could help contain disease outbreaks and prevent major pandemics.

Since then, Szapocznik’s goal has become much more prescient.

Just two months after Szapocznik spoke to the AIDS Health Care Foundation about the issue, the current COVID-19 pandemic began. Szapocznik and 20 other public health leaders published an article in The Lancet Public Health calling for a global framework and treaty that could help every nation prevent, prepare, and respond to outbreaks and pandemics in a more systematic way. Nations that did not comply could face equitable and just sanctions, while poorer countries could be provided funding to comply with pandemic prevention protocols. These methods of mutual assurance, according to Szapocznik, will help countries know that their peers are doing all that is needed to prevent outbreaks from becoming pandemics.

“If we are going to prevent pandemics, we need a different global governance architecture that has these functions,” explained Szapocznik, who also is chair emeritus of the Miller School of Medicine Department of Public Health Sciences. “And to have an effective mechanism, this body needs to monitor what’s going on in different countries and be able to verify the data independently.”

Toward that aim, with support from the AIDS Health Care Foundation (AHF), Szapocznik worked with Dr. Jorge Saavedra, executive director of the AHF Global Public Health Institute at the University of Miami, and sought guidance from Dr. Julio Frenk, University president and global public health expert, to form the Panel for a Global Public Health Convention in early 2021. Now, Szapocznik serves as the head of its secretariat, which includes Saavedra and three University of Miami graduates of the public health master's degree program.

The panel’s work got a major boost in December, when in response to its advocacy and that of many other international groups, the World Health Organization (WHO) declared it would set up a body to start negotiating such an agreement or treaty. And this week, an intergovernmental body of the WHO had its first meeting in Geneva, Switzerland, to draft a convention or an agreement to prevent pandemics. Meanwhile, the United States is calling on the WHO to strengthen its international health regulations by the end of May.

Szapocznik, along with a growing number of global public health experts, is working to make the agreement a reality. With many of the same goals as the article in the Lancet, the 10-member panel now meets monthly to advocate for a global treaty. It includes a range of world health experts, like its chair, Barbara M. Stocking, former chief executive of OxFam Great Britain, recent past president of Murray Edwards College at the University of Cambridge, and chair of the 2015 WHO-appointed Ebola independent panel; Laura Chinchilla, former president of Costa Rica and current vice-president of the World Leadership Alliance-Club de Madrid; Jane Halton, former secretary of the Department of Finance and the Department of Health in Australia and former president of the World Health Assembly, which governs the WHO; John Dramani Mahama, former president of Ghana; and professor Maha El Rabbat, who was the first female Egyptian minister of health and population and is currently executive director of the Middle East and North Africa Health Policy Forum.

With the pandemic’s three-year anniversary approaching, the novel coronavirus is still spreading throughout the world, spawning variants in its wake. Szapocznik points to a patchwork of policies about containing the virus, along with vaccine access that differs throughout the world, as the problems. These varied responses now have caused nearly six million deaths that could have been prevented, he indicated; plus, economies of many nations were harmed, he added. Having a global treaty could help the world to contain outbreaks—through transparency, coordination, global monitoring of data, sharing of vaccine manufacturing knowledge, and accountability, Szapocznik suggested.

“Equity is needed not only in the distribution of common goods, like vaccines and medications, but in the financing needed to prepare poor countries to respond effectively when an outbreak occurs,” the public health professor said. “No single country can prevent the impact of a pandemic because viruses do not recognize borders.”

Another impetus for the treaty: while the WHO is a vital resource for providing scientific guidance and supporting countries’ preparation for preventing pandemics, it cannot both support nations and simultaneously hold them accountable for their actions, Szapocznik said.

Still, a treaty or agreement will not come without tough negotiations. While nations such as Chile and many in Europe fully support the idea, and with the United States warming up to it, others—such as Brazil and China—have been opposed to such a move.

“Everyone is focused on helping themselves now, but no country will be able to fully bounce back until we dramatically reduce transmission around the world to prevent new, more harmful variants from emerging,” Szapocznik said. “Some countries aren’t willing to look at the bigger picture, but we all have to cooperate if we are going to prevent the next pandemic.”