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The World Health Organization (WHO), governments, financial institutions, development partners, and health agencies from across the world have committed to accelerate strengthening and implementation of capacities required to cope with disease outbreaks and other health emergencies. A significant threat to global health security is the number of national health systems that are weak, fragmented and under-funded. Only about one third of countries in the world have the ability to assess, detect and respond to public health emergencies. Ebola, Zika, yellow fever and other recent outbreaks have exposed these weaknesses at national, regional and international levels.

Renewed commitment to health system strengthening in-line with the International Health Regulations (2005) is needed, especially in vulnerable countries. The true power of health systems is their ability to deliver timely, quality health services to those in need in a comprehensive way and on an adequate scale. These systems are especially important during emergencies, when access to quality essential health services can be severely compromised, participants at a three day meeting  on âÂÂAdvancing Global Health Security: From Commitments to ActionsâÂÂ, . The meeting brought together 250 participants from 52 countries representing 28 different organizations.

The meeting highlighted the critical importance of flexible preparedness planning, community strengthening and engagement, information sharing, strengthening of intersectoral collaboration of national and international partnerships, and the critical role that governments and technical partners play in financing and implementing them. Investing in these systems requires strong ownership and supportive leadership at the highest levels.
The meeting in Bali is the second high-level WHO meeting to advance global health security. The first meeting took place in Cape Town, South Africa in July 2015. Since then, considerable preparedness strengthening activities have taken place and been implemented, especially in vulnerable countries.âÂÂFortifying health security in todayâÂÂs world must be a key priority of governments, multilateral agencies, development banks, and non-government organizations the world over. What matters most is maintaining the momentum and turning that into real, tangible results,â Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region said at the end of the meeting. Speaking at the opening of the event, Dr Matshidiso Moeti, WHO Regional Director for Africa, said âÂÂthe bedrock of outbreak and emergency preparedness and response is a functioning, resilient national health system â with the financing, human resources, infrastructure, information and supply management systems capable of detecting and responding to public health events.

A significant advancement since the Cape Town meeting is the WHO joint external evaluation (JEE) process, which is one of four components of the new WHO IHR Monitoring and Evaluation Framework. The WHO JEE process helps to identify strengths and weaknesses in national health systems and in other sectors which play a key role in health emergency preparedness and response.The results of the WHO JEE is shared publicly and will support the country and its partners in developing a national action plan linked to the national budget and planning cycles, anchored in the health system and supporting its implementation in the country.The JEE process reflects the underlying principles of the strategic framework for emergency preparedness that was fine-tuned at the Bali meeting,  including  transparency, accountability, multisectorality, partnership, sustainability, and alignment. Key to the Bali framework is the building of robust health systems in order to achieve universal health coverage (UHC) by methods that are efficient, country-focused, transparent and accountable, and strengthening and maintaining the effectiveness of global health security as a global public good.WHO has also created an open-access web platform called the Strategic Partnership Portal (SPP) to help identify country needs, gaps and partner activities to ensure resources are used more efficiently, without duplication. Training on how to use the SPP, mandated by WHO Member States and supported by health partners, has been rolled out in several high-risk countries in Africa, with planned expansion to other WHO Regions in 2016.”