Preface

It is an undeniable fact that the global community remains largely unprepared to conduct early pandemic identification interception and to subsequently mount a reliable pandemic response. This is clearly evident from our experiences from the recent COVID-19 pandemic, with its global death toll of over 7 million people.1 The pandemic has mercilessly exposed the frailty of communities around the globe, from local to national to international levels. However, as we delve into contemporary approaches and developments in global health security (GHS), we witness the global community's unwavering commitment to learn from these challenges and strengthen our collective response. This book offers a comprehensive analysis of the essentials of GHS and the strategies necessary to ensure robust leadership and systems-based approaches across nations. It examines the integrated efforts and developments by various governments, nongovernmental organizations, and other bodies, all working toward sustained investment to develop and implement rapid response mechanisms critical to ensuring a timely and effective response to mitigate the risks of future outbreaks or pandemics.

Global health (GH) security functions on a detect, prevent, respond, and recover2 continuum. These four pillars are not isolated entities but rather a framework of interconnected systems, procedures, and policies that aim to minimize exposure and strengthen operations at key administrative and governmental levels. They operate independently and concurrently, with some functions overlapping from one pillar to the next during an outbreak. This intricate design creates a mutually supportive and reinforcing system, enabling a coordinated global response to health threats. This, in turn, ensures that countries are adequately prepared to respond to and contain outbreaks within their borders. These are critical components of GH governance and a testament to our shared responsibility and the need for continuous development to ensure the health and well-being of individuals worldwide. Identifying emerging and re-emerging infectious diseases and their impact on GHS is particularly relevant, especially with increasing outbreaks in under-developed and under-resourced areas, as well as the existing frailty even within relatively developed regions of the globe. Due to these factors, effective GHS actions often present a formidable challenge that not infrequently exceeds local capabilities. Within the current collection of book chapters, authors highlight some common emerging and re-emerging infectious disease threats and the dynamic relationships that exist between the associated factors and the occurrence of such diseases. This includes a discussion of various strategies to mitigate the impact of emerging and re-emerging infectious diseases. These insights are highly relevant and can be effectively utilized to anticipate and respond to the challenges posed by emerging infectious diseases. The book also emphasizes the

<sup>1</sup> World Health Organization. WHO Coronavirus (COVID-19) dashboard > Deaths [Dashboard]. World Health Organization 2023 data.who.int, https://data.who.int/dashboards/covid19/deaths

<sup>2</sup> Carlin EP, Moore MS, Shambaugh E, Karesh WB. 2021. Opportunities for Enhanced Defense, Military, and Security Sector Engagement in Global Health Security. EcoHealth Alliance.

critical role of vaccines in GHS, making a compelling case for vaccine interventional equity and appropriateness, advocating for a more secure global health landscape. Additionally, it provides essential insights into the public health attributes of armed conflict, its impact on individual and population health, and the spread of communicable diseases across various countries.

As the world grapples with the devastating impact of the COVID-19 pandemic, it becomes evident that the functions required to optimize GHS are beyond the capacity of any single government or sector. This also underscores the urgent need to re-establish a pandemic response committee around the globe, complete with international mechanisms for very close, joint, coordinated action. Therefore, we must not only renew our commitment to intercontinental and intergovernmental policies, programs, and engagement but also recognize the imperative of collective action. It is a shared responsibility to address the pillars of GHS—to detect, prevent, respond, and recover from health threats. With climate change, globalization, and various wars and conflicts, epidemics and pandemics are bound to occur more frequently. Consequently, the evolution of these pillars is not only critical but also a call to action for all of us to meet the ever-changing health landscape and ensure preparedness for future health crises.

## **Allincia Michaud MD, MPH and Stanislaw P. Stawicki MD, MBA, FACS, FAIM** Department of Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA

## **Ricardo Izurieta MD, DrPH, MPH**

College of Public Health, University of South Florida, Tampa, Florida, USA

Section 1 Introduction

## **Chapter 1**
