Unpacking the Global Health Security Strategy: Surveillance, Sustainability, and “One Health” Approach

President Joe Biden announced the release of a  U.S. Global Health Security Strategy (GHSS). The synopsis of the new plan states, “The new Global Health Security Strategy articulates a whole-of-government, science-based approach to strengthening global health security.” The plan is further explained as a necessary approach to mitigate harm from future pandemics while partnering with 50 countries. 

In the aftermath of the COVID-19 pandemic, government officials can leverage the tragic impacts of a pandemic to obtain more power. The devastating attacks on September 11, 2001, caused fear and panic, which led to legislation that was presented as a solution to prevent future attacks. The Patriot Act was presented as that solution. This legislation allowed for warrantless searches and seizures. The legislation was a violation of the First and Fourth Amendments and was renewed multiple times until it finally expired in 2020. 

Building the infrastructure to protect against future pandemics is a useful goal, but the methods must be examined closely. The GHSS document contains the word “surveillance” 52 times. One excerpt reads: “Countries establish and maintain functional national surveillance systems with rapid data and information sharing across public health levels; among surveillance systems, laboratory networks, and clinical care facilities. Surveillance is conducted across human, animal, and environmental health sectors, as well as regionally and globally.”

This is a guiding document, not legislation that overtly grants particular powers to any agency. However, as a guiding document, it can lead to unilateral decision-making among agency heads to serve that goal. That is the basis of the Chevron defense, a court precedent that has allowed federal agencies to make decisions when they don’t explicitly have the power to do so. That precedent may be overturned, as the Supreme Court has a Chevron defense case on the docket. 

An instance of this is the FCC voting to grant themselves authority over every facet of the internet in the name of curbing digital discrimination. That was one aspect of the Infrastructure Investment and Jobs Act. The legislators who passed that resolution did not sign off on the FCC powers that the agency itself determined necessary to address digital discrimination. 

Surveillance systems can be voluntary and aren’t inherently an overreach of power. The main question to consider is how this guiding document may be used to reach a goal that includes protecting against pandemics that may be caused by climate change or animal-based agriculture. The Avian flu is one of the latest concerns that causes more government oversight of farming practices. The government provides indemnity payments so farmers with infected birds can cull their whole flock when one asymptomatic bird tests positive for Avian Flu. These policies prevent the spread of the Avian Flu, but also cause egg shortages. 

The CDC has listed recommendations that all poultry operations “should take” to prevent Avain Flu outbreaks. Among those recommendations are “Thoroughly clean and disinfect equipment and vehicles entering and leaving the farm. Include tires and undercarriage. Do not borrow equipment or vehicles from other farms and do not lend yours. Keep your poultry flock isolated from outside environments. Prevent flocks from contacting wild birds and water sources that might be contaminated by wild birds.”

The Global Health Security Strategy has several common keywords of concern. Focus on zoonotic diseases is a focus on farming practices. Focus on climate is a focus on minimizing beef production to reduce carbon emissions. The document contains the phrase “one health” 15 times, describing a holistic approach to resolving health issues by considering how animals, humans, and plants affect each other. Climate shows up in the document 28 times. 

One health is an understandable approach. When making policies are advocating for changes to impact global health, the economy and resources available should all be part of the implementation of such strategies. Descriptions of what “one health” means vary based on scientific and agricultural knowledge as well as political beliefs. 

The U.N. didn’t make any statements regarding the reduction of meat consumption at COP28, but did say carbon emissions from cattle should be reduced by 25%. The term “one health” is being used by researchers to say that meat consumption must be reduced for purposes of climate change and reducing zoonotic diseases. One research article is titled “A just transition in animal agriculture is necessary for more effective and equitable One Health outcomes.” The article states, 

“Planning and supporting just transitions is essential if we are to successfully transform our food systems. Time is short, and there is a great deal at stake – from the climate, to biodiversity, to human health. Prompt action to start planning a just transition away from large-scale meat production and consumption can benefit One Health outcomes and help ensure a more just and sustainable future for all.”

The Global Health Security Strategy states, “The Feed the Future (FTF) initiative supports research to identify innovative approaches to improve animal health, including the development of novel vaccines and diagnostics, as well as strengthens local capacity by equipping animal health laboratories, training the next generation of animal health scientists, and improving farm biosecurity.”

Further in the document, it states, “FTF also recognizes that the health of livestock is intrinsically tied to the health of people, including access to healthy diets, and the health of ecosystems, and thus collaborates with others across the U.S. interagency to support One Health approaches that improve human health, address zoonotic diseases, promote natural resource management, and build efficient, climate-resilient food systems, in line with PREPARE.”

The U.N. refers to “one health” as an important mission. The Food and Agriculture Organization of the United Nations has a page tracking progress on sustainable development goals (SDG) related to agriculture. It states, “The world’s smallholder farmers produce around one-third of the world’s food, contributing substantially to agrifood systems and economies worldwide. However, their labour productivity continues to lag behind that of larger-scale producers, with more pronounced differences in higher-income countries.”

Within this mission is a goal to increase the productivity of small farms. This happens as small farmers frequently go under as corporate farming enterprises continue to increase in number and size. The FAO also intends to partner with organizations to reach these goals. Among the partnerships is with the Bill and Melinda Gates Foundation. The Highwire previously reported about a Gates-funded vaccine patch that includes a brief history of human rights abuses from Gates-funded projects. 

The event held by the Center for Strategic and International Studies (CSIS), which discusses the new Global Health Security Strategy, states that the event was “made possible by the generous support of the Bill and Melinda Gates Foundation.” That event included a discussion with Stephanie Psaki, the Global Health Security Coordinator, and former Senator Richard Burr. Psaki is the younger sister to the former Biden administration press secretary, Jen Psaki. 

Senator Richard Burr was the subject of a ProPublica exposé regarding his support of the pharmaceutical industry. Another ProPublica report discusses the former senator’s stock sale, which was done with insider knowledge about the COVID-19 pandemic. During the event, Burr suggested Resillience as a private company that could “fill in the gaps” for manufacturing and to make sure China doesn’t control the market. 

Resilience’s board features Sue Desmond-Hellman, former CEO of the Bill and Melinda Gates Foundation, alongside Scott Gottlieb, ex-FDA director and Pfizer board member. Mark McClellan, another former FDA director, serves as an advisor. As previously reported, there is a revolving door between pharmaceutical companies and regulatory agencies tasked with industry oversight. 

The Global Health Security Strategy doesn’t outline specific strategy details but focuses on more significant goals of health, food security, and disease mitigation. It focuses on concepts of preventing zoonotic diseases and moving to change activities that harm the climate. Furthermore, the strategy says the U.S. government will “implement a range of activities to reduce the risk for zoonotic disease spillover through improved biosurveillance and biosecurity measures for those working with animals.”

The public’s desire for a comprehensive plan addressing economic and environmental concerns is widely acknowledged. However, the lack of specific details in the report regarding the proposed course of action raises questions, especially in light of past failures in pandemic strategy.