Health security and limitation of fundamental rights in Colombia during the COVID-19 pandemic

At the beginning of 2020 the World Health Organization declared COVID-19 a pandemic. The governments of the world issued regulations that, to stop the virus, implied the limitation of rights by ordering confinements, stopping non-essential activities and paralyzing the economy. In Colombia since March 2020 the authorities issued regulations whose result was the limitation of rights. The purpose of this text is to review whether said regulation and its effects on rights have been respectful of the Colombian Constitution from March 2020 to March 2021. The conclusion is that rights were unconstitutionally limited during the pandemic in an unconstitutional way. © 2022, Universidad de Talca. All rights reserved.

Non-traditional Security: A Risk-Centric View

As described in Saha and Chakrabarti (South Asian Survey 28(1):111-132, 2021: 112), "COVID-19 has firmly established itself as the single largest security disrupter of this century in the non-traditional sense. It has necessitated a recalibration of securitisation framework.…" The impact of the COVID-19 pandemic certainly illustrates the transnational nature of today's security landscape. Similarly, events such as the WannaCry cyber-attack, global terrorism, serious and organized crime, disease vectors, and natural disasters create challenges that affect both global and national security interests. Such events are shaping the security calculus across dimensions such as health security, economic security, food security, and energy security emerging as interrelated concepts that characterize the security landscape as complex. The increased transnational flow of people, goods, money, and information as products of "globalization” has also changed the security landscape in terms of the "globalization” of risks. This transnational/transborder nature of security challenges our traditional views of national security characterized by state-based, military dimensions. The non-traditional security calculus thereby emerges as part of the security landscape that can often have significant national security impacts through the implications associated with systemic risks. Outstanding scholarly work has been presented on the topic of non-traditional security through the lens of International Relations and Contemporary Security Studies (e.g., see Collins, Contemporary security studies. Oxford University Press, Oxford, 2013). This chapter presents non-traditional security through a risk-centric lens and explores the notion of systemic risk as part of the security calculus. COVID-19 will be used as an illustrative example of a shock to societal systems that reveals systemic risks, vulnerabilities, and impacts across the non-traditional security domains. © Springer Nature Switzerland AG 2022.

Does health securitization affect the role of global surgery?

Aim: More and more frequently outbreaks of infectious diseases force the international community to urgent health action and lead to an increasing security focus on global health. Considering the limiting character of resource allocation, all other medical conditions must compete with the top spot of health security matters, as we currently see with the outbreak of COVID-19. Surgery is an integral part of universal health offering life-saving therapy for a variety of illnesses. Amidst the increasing nexus of infectious diseases and health security and in the view of Public Health Emergencies of International Concern (PHEIC), is there a risk of global surgery falling behind? Subject and Methods: While the global undersupply of surgical care is well recorded, contextual explanations are absent. Our research introduces the constructivist concept of securitization according to the Copenhagen School to explain the structural handicap of global surgery and by that presents a structural explanation. We investigate the securitizing potential of surgical diseases in comparison to infectious diseases. Results: Surgical conditions are non-contagious without the risk for disease outbreaks, hardly preventable and their treatment is often infrastructurally demanding. These key features mark their low securitizing potential. Additionally, as PHEIC is the only securitizing institution in the realm of health, infectious diseases have a privileged role in health security. Conclusion: Surgery substantially lacks securitizing potential in comparison to communicable diseases and by that is structurally given an inferior position in a securitized health order.

Multisectoral action towards sustainable development goal 3.d and building health systems resilience during and beyond COVID-19: Findings from an INTOSAI development initiative and World Health Organization collaboration.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. As the world faces global health crises such as pandemics, epidemics, climate change and evolving disease burdens and population demographics, building strong and resilient public health systems is of critical importance. The need for an integrated approach to building health system resilience; the widening of inequalities; and fears of vulnerable populations being left behind are critical issues that require Supreme Audit Institutions (SAIs) enquiry as independent public oversight bodies. Each country has a Supreme Audit Institution with a remit to audit public funds as an effective, accountable, and inclusive institution. Government audits are key components of effective public financial management and Good Governance. SAIs contribute to the quality of government engagement and better state-society relations through their work. As SAIs provide independent external oversight and contribute to follow up and review of national targets linked to the Sustainable Development Goals (SDGs) in their respective countries, they can play an important role in national recovery efforts. WHO and INTOSAI Development Initiative (IDI) have been collaborating in facilitating SAIs' audits of strong and resilient national public health systems linked to the national target of SDG 3.d in 40 countries across Africa, Americas, Asia and Oceania between 2021 and 2022. This paper aims to convey key lessons learned from the joint multisectoral collaboration for facilitating the 3.d audits that can contribute to building health systems resilience in ongoing recovery efforts. The collaboration included facilitation of the audits through professional education and audit support using a health systems resilience framework. The 3.d audits are performance audits and follow IDI's SDG Audit Model (ISAM). Following the ISAM implies that the SAI should focus on a whole-of-government approach, policy coherence and integration, and assess both government efforts at 'leaving no one behind' and multi-stakeholder engagement in implementing the chosen national SDG target linked to 3.d. WHO's Health Systems Resilience team has supported IDI and SAIs by delivering training sessions and reviewing working papers and draft reports of the SAIs from a health systems resilience perspective. IDI has provided the technical expertise on performance audits through its technical team and through in-kind contributions from mentors from many SAIs in the regions participating in the audit. In the 3.d audit, SAIs can ask how governments are acting to enhance capacity in some or all of the following, depending on their own national context and risk: forecasting, preventing and preparing for public health emergencies (PHEs) and threatsadapting, absorbing and responding to PHEs and threatsmaintaining essential health services in all contexts (including during emergencies/crises). The audits are expected to highlight current capacities of health systems resilience; the extent to which a whole-of-government approach and policy coherence have been utilised; and government efforts related to multistakeholder engagement and leaving no one behind in building health systems resilience related to progressing towards achieving the national target linked to 3.d by 2030. An overall positive achievement noted was that undertaking a complex health audit in the middle of a pandemic is possible and can contribute to building health systems resilience and recovery efforts. In their review of audit plans, draft summaries, and other work by the SAIs, both WHO and IDI have observed that SAIs have used the training and supplementary materials and applied various parts of it in their audits. This collaboration also demonstrates key considerations needed for successful partnership across multisectoral partners at global, regional and national levels. Such considerations can be applied in different contexts, including socioeconomic and health system recovery, to ensure whole-of-society and whole-of-government action in building health systems resilience and monitoring and evaluation to maintain and accelerate progress towards the national target linked to SDG3.d, health security and universal health coverage (UHC), as well as broader socioeconomic development.

The launch of the EU Health Emergency Preparedness and Response Authority (HERA): Improving global pandemic preparedness?

The crowded global health landscape has been joined by the European Union Health Emergency Preparedness and Response Authority (HERA). HERA will assume four broad areas of responsibility: horizon scanning for major health threats; research and development; support for capacity to manufacture drugs, vaccines, and equipment; and procuring and stockpiling key medical countermeasures. In this Health Reform Monitor article, we outline the reform process and describe HERA's structure and responsibilities, explore issues that arise from the creation of this new organisation, and suggest options for collaboration with existing bodies in Europe and beyond. The COVID-19 pandemic and other infectious disease outbreaks have shown the need to treat health as a cross-border issue, and there is now a broad consensus that greater direction and coordination at the European level is needed. This ambition has been matched with a considerable increase in EU funding to tackle cross-border health threats, and HERA can be used to deploy this funding in an effective manner. Yet this is contingent upon clearly defining its role and responsibilities vis-à-vis existing agencies to reduce redundancies.

A reflection on the NHS, health security, and refugees

In 2021 a sudden influx of refugees arrived in the UK from Afghanistan, at a time when the British public were being encouraged to access healthcare services to obtain COVID-19 vaccinations. This report examines the successes and failures of care provision in the NHS across the country, in particular Wolverhampton, whereby refugees accessed healthcare provision in a local Primary Care Network. The report considers the author's personal experiences while working within the local Primary Care Network, in addition to published research, in the context of health security. Furthermore, it highlights recommended improvements within the NHS to provide aid to the vulnerable, while preserving the system set out to create health security.

Health Diplomacy in the CARICOM Region

In today's globalized world, with high connectivity and interdependence on other nations, the germs can cross borders within minutes making the Caribbean region more vulnerable. The paramount role of health diplomacy is increasing day by day, especially with the recent COVID-19 pandemic. In 2007, the Caribbean region formulated the "Port of Spain Summit Declaration”, a unique, comprehensive policy addressing chronic non-communicable diseases with a high-level commitment from the head of the states. Health diplomacy is not something new to the region as it has developed many regional initiatives for collective action against HIV/AIDS, other infectious diseases in the past decades but never had a dedicated centre to further the concept or conduct more research. This chapter examines various challenges in the region and emphasizes the region's role in addressing its needs on global platforms to negotiate for more assistance and robust policies to safeguard peace, health, and development. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Critical appraisal of the Coronavirus preparedness among countries using the global health security index

Introduction: This critical study was aimed to investigate the utility of the Global Health Security Index in predicting the current COVID-19 responses. Material and Methods: Number of infected patients, deaths, incidence and the death rate per 100,000 populations related to 55 countries per week for 26 weeks were extracted. The relationship of GHSI scores and country preparedness for the pandemic was compared. Results: According to the GHSI, the incidence rate in most prepared countries was higher than the incidence rate in the more prepared countries, and which was higher than the incidence rate in the least prepared countries. However, Prevention, Detection and reporting, Rapid response, Health system, compliance with international norms and Risk environment, as well as Overall, the incidence and death rate per 100,000 people have not been like this. Conclusion: Due to mismatch between the GHSI score and fact about COVID-19 incidence, it seems necessary to investigate the factors involved in this discrepancy. © 2022, Published by Frontiers in Health Informatics.

Securitising infectious disease outbreaks: The WHO and the visualisation of molecular life

Following its exceptional response to the 2003 severe acute respiratory syndrome (SARS) outbreak, the World Health Organization (WHO) gained new powers to securitise infectious disease outbreaks via the revised 2005 International Health Regulations (IHRs) and the ability to declare a Public Health Emergency of International Concern (PHEIC). This article investigates the declaration of a PHEIC in relation to the 2009 H1N1 flu pandemic, the 2014-16 Ebola outbreak, and the ongoing COVID-19 pandemic. It argues that the securitisation of these outbreaks was dependent upon global surveillance networks that utilised genetic technologies to visualise the molecular characteristics and spread of the pathogen in question. Genetic evidence in these cases facilitated the creation of a securitised object by revealing the unique and 'untypable' nature of the H1N1 and SARS-CoV-2 viruses and made visible the widespread prevalence of Ebola across the population of West Africa. The power of this evidence draws from a societal perception of science as producing objective 'facts' about the world that objectivise their objects of concern and empower political actors in the implementation of their security agendas. As a result, scientific evidence provided by genetic technologies now plays a necessary and indispensable role in the securitisation of infectious disease outbreaks.

Lack of Alignment Between WHO Joint External Evaluation and State Party Self-Assessment Scores Undermines Utility as Evaluation Tools for the Department of Defense.

The International Health Regulations 2005 (IHR) set standards for countries to detect and respond to public health threats such as COVID-19. The US Department of Defense engages with partner nations to build IHR-related health security capacities. In this article, we compare 2 elements of the IHR Monitoring and Evaluation Framework to determine if they align in a useful way. The version of the State Party Self-Assessment Annual Reporting (SPAR) tool used for this study is a self-assessment of 13 capacities, while the Joint External Evaluation (JEE) requires collaboration with international subject matter experts to evaluate 19 capacities. The SPAR indicators are scored separately from 0% to 100%, whereas the JEE uses a rank-ordered scale from 1 to 5 for variable numbers of indicators in each capacity. Using 2018-2019 data from the World Health Organization, we quantitatively and qualitatively evaluated the alignment of the SPAR and JEE scoring systems, using paired t tests for related capacities and 3 approaches to matching the scales. Whether using a simple, evenly divided scale for the SPAR or downscaling the SPAR scores to match with lower JEE scores, the paired t tests indicate that the JEE and SPAR scoring systems are not aligned. Many of the capacities in the JEE and SPAR are defined differently, pointing to one of the reasons for the discordance. We discuss implications for revision of the JEE and SPAR assessment tools along with ways in which the scores might be used for planning global health engagement capacity-building activities.

COVID-19 and the EU's Ability to Manage and Prevent Health Crises

This chapter addresses the implications for European Union (EU) cooperation of the coronavirus pandemic. In doing so, it assesses the EU's ability to manage and prevent health crises more broadly. The chapter first discusses the EU's limited competences in the health field and outlines the legal framework for cross-border health threats. The analysis then examines the initial response to the pandemic from January to early autumn 2020, including a late start, subsequent collapse of cooperation and finally a more concerted approach emphasising solidarity. In conclusion, the chapter touches upon an emerging reform agenda enabling the EU institutions to better respond to and prevent similar crises in the future. Attention is drawn to aspects beyond preparedness and response, such as socio-economic factors, inequalities and weak health systems. Finally, the chapter underlines human impact on ecosystems and the climate as factors contributing to accumulated health risks and changing disease patterns. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022, corrected publication 2022.

Gamification and policy compliance: Results from an online vignette experiment in the context of social distancing for public health security

The commonly applied strategies for promoting compliance with public health and safety policies can be inefficient and coercive, posing a need to examine novel motivational strategies to aid in this endeavor. Gamification, which aims to foster engagement and intrinsic motivation towards mundane activities and behaviors, is one of the vanguard design approaches among behavioral change support systems. Despite the increasing interest in gamification, the corpus lacks studies on its effects on policy compliance. Therefore, this study examines the relationships between gamification design types, gameful experience, and policy compliance in the social distancing context (during COVID-19) using a vignette-based online experiment (n=937). Based on the results, gameful experience mediates the positive relationships between achievement and progression-based, competitive, and immersive gamification and policy compliance, while social gamification is not associated with gameful experience. The results provide evidence of gamification's potential as a non-coercive method of helping people follow policies. © 2023 IEEE Computer Society. All rights reserved.

The European Health Union and the protection of public health in the European Union: Is the European Union prepared for future cross-border health threats?

The Covid 19 pandemic has cast traditional health protection issues in a new light due to their cross-border significance with far-reaching consequences for almost all areas of social life and places health protection in the European Union in a broader context that goes beyond the national consideration of necessary measures at EU Member State level. The pandemic has made it clear that the responsibility for public health remains in principle with the EU Member States and that the competences of the European Union under Article 168 TFEU are – with a few exceptions – generally limited to supporting, coordinating and assisting tasks. This article examines whether the European Union is adequately prepared for future pandemics and other cross-border health threats based on its responsibilities under the current system of competences between the EU and its Member States in the area of health policy under article 168. The article concludes with some suggestions for discussion and consideration. © 2023, The Author(s).

Covid-19 Detection and Classification using Transfer learning with XGboost

The 2019 new corona virus (COVID-19), with a genesis phase in China, has dispersed apace amid individuals subsisting in distinct nations and is rising toward about twelve lakh cases in the balance as per the intuition of the European center for Health Security and Communicable diseases and ECDC. There is a foreordained figure of COVID-19 trial caskets attainable in medical centers because of the escalating cases in day-to-day life. In this way, it is important to execute a programmed location framework as a snappy elective conclusion alternative to forestall COVID-19 transmitting between peoples. In this examination, three disparate Convolutional neural system- based models (XGBOOST/LIGHTGBM, Inception-ResNetV2 and InceptionV3) have been put forward for the whereabouts of coronavirus and pneumonia contaminated convalescent by harnessing thoracic radiographic screening. Receiver Operating Characteristics (ROC) investigations and disordered networks by those tripartite models are bestowed and deteriorated by exploiting 5-superimpose traverse accredit. Contemplating the demonstration outcome obtained, it is perceived that the pre- prepared XGBOOST/LIGHTGBM model accouters the most upraised characterization execution with 98.6% exactness amongst the other two propounded models (96% correctness for InceptionV3 and 85% exactness for Inception-ResNetV2). © 2023 IEEE.

AI Based Directory Discovery Attack and Prevention of the Medical Systems

The medical system has been targeted by the cyber attackers, who aim to bring down the health security critical infrastructure. This research is motivated by the recent cyber-attacks happened during COVID 19 pandemics which resulted in the compromise of the diagnosis results. This study was carried to demonstrate how the medical systems can be penetrated using AI-based Directory Discovery Attack and present security solutions to counteract such attacks. We then followed the NIST (National Institute of Standards and Technology) ethical hacking methodology to launch the AI-based Directory Discovery Attack. We were able to successfully penetrate the system and gain access to the core of the medical directories. We then proposed a series of security solutions to prevent such cyber-attacks. © 2022 Creative Commons.

Global health governance responds to COVID-19: Does the security/access divide persist?

This paper evaluates global health responses to the COVID-19 pandemic through the 'two regimes of global health' framework. This framework juxtaposes global health security, which contains the threat of emerging diseases to wealthy states, with humanitarian biomedicine, which emphasises neglected diseases and equitable access to treatments. To what extent did the security/access divide characterise the response to COVID-19? Did global health frames evolve during the pandemic?Analysis focused on public statements from the World Health Organization (WHO), the humanitarian nonprofit Médecins Sans Frontières (MSF), and the American Centers for Disease Control and Prevention (CDC). Following a content analysis of 486 documents released in the first two years of the pandemic, the research yielded three findings. First, the CDC and MSF affirmed the framework; they exemplified the security/access divide, with the CDC containing threats to Americans and MSF addressing the plight of vulnerable populations. Second, surprisingly, despite its reputation as a central actor in global health security, the WHO articulated both regime priorities and, third, after the initial outbreak, it began to favour humanitarianism. For the WHO, security remained, but was reconfigured: instead of traditional security, global human health security was emphasised - collective wellbeing was rooted in access and equity.

Moving from assessments to implementation: promising practices for strengthening multisectoral antimicrobial resistance containment capacity.

BACKGROUND: Antimicrobial resistance (AMR) poses a global threat to human, animal, and environmental health. AMR is a technical area in the Global Health Security Agenda initiative which uses the Joint External Evaluation tool to evaluate national AMR containment capacity. This paper describes four promising practices for strengthening national antimicrobial resistance containment capacity based on the experiences of the US Agency for International Development's Medicines, Technologies, and Pharmaceutical Services Program work with 13 countries to implement their national action plans on AMR in the areas of multisectoral coordination, infection prevention and control, and antimicrobial stewardship. METHODS: We use the World Health Organization (WHO) Benchmarks on International Health Regulations Capacities (2019) to guide national, subnational, and facility actions that advance Joint External Evaluation capacity levels from 1 (no capacity) to 5 (sustainable capacity). Our technical approach is based on scoping visits, baseline Joint External Evaluation scores, benchmarks tool guidance, and country resources and priorities. RESULTS: We gleaned four promising practices to achieve AMR containment objectives: (1) implement appropriate actions using the WHO benchmarks tool, which prioritizes actions, making it easier for countries to incrementally increase their Joint External Evaluation capacity from level 1 to 5; (2) integrate AMR into national and global agendas. Ongoing agendas and programs at international, regional, and national levels provide opportunities to mainstream and interlink AMR containment efforts; (3) improve governance through multisectoral coordination on AMR. Strengthening multisectoral bodies' and their technical working groups' governance improved functioning, which led to better engagement with animal/agricultural sectors and a more coordinated COVID-19 pandemic response; and (4) mobilize and diversify funding for AMR containment. Long-term funding from diversified funding streams is vital for advancing and sustaining countries' Joint External Evaluation capacities. CONCLUSIONS: The Global Health Security Agenda work has provided practical support to countries to frame and conduct AMR containment actions in terms of pandemic preparedness and health security. The WHO benchmarks tool that Global Health Security Agenda uses serves as a standardized organizing framework to prioritize capacity-appropriate AMR containment actions and transfer skills to help operationalize national action plans on AMR.

Healthcare policies, precautionary measures and outcomes of mass gathering events in the era of COVID-19 pandemic: Expedited review.

With the onset of the COVID-19 pandemic in early 2020, several countries suspended or restricted mass gathering (MG) events to mitigate the risk of superspreading events. Prohibiting MGs aimed to lessen the likelihood of highly infectious persons coming into close contact with many others. Now that the world has opened its doors wide and removed most of precautionary measures, many questions arise. In this review, we aimed to summarize the current evidence regarding the policies and regulations that were implemented for the safe return of MG events. Besides, we highlighted the impact of the return of MG events during 2021 on the trajectory of COVID-19 spread. Canceling MG events can carry religious, societal, economic, and public negative consequences necessitating the safe return of these events. The experience with the COVID-19 pandemic was the foundation for the recommendations for the safe conduction of MG events during the pandemic by international public health bodies. When policymakers adequately applied precautionary measures and strategic approaches, we witnessed the safe holding of huge MG events without aggravating the COVID-19 situation or increasing the number of new cases beyond the capacity and readiness of the national healthcare system.

The intersectionality of health (in)security: Healthcare, disposable workers, and exposure within Brazil's pandemic politics

Brazil has suffered severe consequences from the Covid-19 pandemic, currently ranking second globally in terms of total fatalities, with more than 682,000 lives lost. This article critically outlines how a ‘health security' framework overlooks processes of intersectionality and the varying impacts of the virus on different segments of society, or what we term health insecurity. We organize our analysis around three aspects of the pandemic that have become salient in Brazilian society, namely access to healthcare, disposable workers, and exposure to the virus, and delineate the intersectional impact of gendered inequality, neoliberal ideologies, and racial hierarchies within these three themes. Our methodology employs media and scholarly interpretations of Covid-19, and other secondary empirical and statistical data, to outline the virus's impacts on differently positioned bodies throughout Brazilian society. Our main findings reveal that during the pandemic, women's labor and health concerns have been undervalued, exploitative working conditions have been exacerbated, and Afro-Brazilians have been put in situations of higher exposure to the virus in both public and private spaces. This article underscores the need to better examine how public health, systems of oppression and exclusion, and (in)security overlap with each other. © The Author(s) 2023.