JICA Ogata Research Institute


Knowledge Reports

No.4 Progress in the Global Framework for Infectious Disease Control in over the Past Thirty Years; What Did We Achieve and Where Are We Going?

In the past 30 years, the accelerating spread of emerging or reemerging infectious diseases resulted in outbreaks in which originating countries could not contain infections within their territory. Given the challenges facing limited number of organizations tasked to handle increased global devastation caused by these numerous infectious diseases, there has been progress during the late 20th century and the early 21st century toward a revised framework for global infectious disease control, including innovative measures to cope with more frequent pandemics.

The progress in the framework includes the establishment of UNAIDS, the Global Fund, and new public-private partnerships, such as the STOP Tuberculosis partnership. Although these new entities/organizations had a significant impact on targeted infectious diseases control through the provision of abundant funds and globally unified strategies for developing countries, there were disadvantages to these disease specific (so-called vertical) approaches that led to a shift to horizontal approaches to strengthening health systems. Additionally, there have been innovative changes in programmatic components of infectious disease control, such as the introduction of the concept of “global health security” and the revision of the International Health Regulations. The concept of “global health security” has linked the concept of health security to a global strategy for the prevention of communicable diseases across national borders, though there are persistent discrepancies between developed and developing countries in their understanding of the concept, which hampered international collaboration during the COVID-19 pandemic.

Despite this general progress and new initiatives, international aid failed to strengthen health systems in developing countries, which might have subsequently led to limited capacities for infectious disease control as well. These situations collectively resulted in difficulty controlling the Ebola virus outbreak in West African countries in 2014.

These tragic experiences led to the proposal of several important initiatives to prevent future pandemics, including reforms of WHO and the preparation of emergency funding mechanisms. The most important points, which strongly relate to the current pandemic of COVOD-19, were 1) focusing on resilience to strengthen health system and 2) a better understanding of the significance of community involvement. Conceptual debates on how to develop resilient health systems have continued, with discrepancies between developed and developing countries’ understanding of the concept exacerbated during the COVID-19 pandemic. It is therefore important to focus on developing practical road maps for the establishment of resilient health systems that are applicable to each country based on its context and prioritize “building trust” within countries and among international society.

Keywords: Infectious disease, International Health Regulations, Global Health Security, Resilient Health Systems, COVID-19


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