National Legislation, Policy, & Financing

• Aldis W. (2008). Health security as a public health concept: a critical analysis. Health Policy and Planning, 23(6), 369-75. 
  • Confusions surrounding the concept of ‘health security’ are leading to the breakdown of communication and collaboration on several important global public health initiatives, such as global communicable disease surveillance under the World Health Organization’s International Health Regulations (IHRs). This paper explores the origins – and more importantly, some of the consequences – of these confusions. This paper also proposes some steps to relieve the present state and to assure continued global cooperation moving forward.
• Barnett DJ, Balicer RD, Lucey DR, et al. (2005). A Systematic Analytic Approach to Pandemic Influenza Preparedness Planning. PLoS Medicine, 2(12), e359.
  • This policy paper offers phase-specific insights into pandemic influenza planning by using the Haddon matrix to bridge injury-prevention epidemiology with global infectious disease preparedness and response. In the process, this analytic tool sheds light on opportunities for prevention, mitigation, and consequence management strategies to address a global public health threat.
• Bell E, Tappero JW, Jafari H, et al. (2017). Joint External Evaluation—development and scale-up of global multisectoral health capacity evaluation process. Emerging Infectious Diseases, 23(S1), S33-39.          
  • The Joint External Evaluation (JEE), a consolidation of the World Health Organization (WHO) International Health Regulations 2005 (IHR 2005) Monitoring and Evaluation Framework and the Global Health Security Agenda country assessment tool, is an objective, voluntary, independent peer-to-peer multisectoral assessment of a country’s health security preparedness and response capacity across 19 IHR technical areas. This paper describes the development of the JEE, the process, and reviews results from 52 completed JEEs.
• Brattberg E, Rhinard M. (2011). Multilevel Governance and Complex Threats: The Case of Pandemic Preparedness in the European Union and the United States. Global Health Governance, 5(1), 1-21.
  • The scale of dangers posed by influenza pandemics, combined with a series of actual outbreaks, has led policymakers in both the European Union (EU) and the United States (US) to frame the issue as a security threat and to call for extraordinary action. Drawing upon securitization theory and traditional implementation theory, this article compares the extent to which the EU and US have turned words into action on pandemic preparation. The findings show that increasingly securitized rhetoric following the H5N1 and H1N1 outbreaks has indeed been followed by new policies, structures, and operational capacities. As such, the article provides preliminary evidence that securitizing a public policy problem can increase political leverage over administrative processes of implementation.
• Broom J, Broom A, Bowden J. (2017). Ebola outbreak preparedness planning: a qualitative study of clinicians’ experiences. Public Health, 143, 103-08.
  • This study examines the experiences of frontline healthcare professionals in an Australian hospital during the 2014–15 Ebola outbreak in West Africa. A special focus is given to participant views on information, training and preparedness, to inform future outbreak preparedness planning.
• Calain P. (2007). Exploring the international arena of global public health surveillance. Health Policy and Planning, 22(1), 2-12.
  • This paper explores external factors influencing political commitment to comply with the 2005 International Health Regulations (IHR) and illustrates the adverse effects generated by a number of selected challenges.
• Chandra A, Acosta J, Howard S, et al. (2011). Building Community Resilience to Disasters A Way Forward to Enhance National Health Security. Rand Health Quarterly. 
  • Community resilience has become a key policy issue at federal, state, and local levels, including in the National Health Security Strategy. This article shares details that provide a roadmap for federal, state, and local leaders who are developing plans to enhance community resilience for health security threats and describes options for building community resilience in key areas.
• Chas E. (2014). Global Agenda, Local Health: Including Concepts of Health Security in Preparedness Programs at the Jurisdictional Level. Biosecurity and Bioterrorism, 12(6), 318-24.
  • This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda (GHSA). Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.
• Cordova-Villalobos JA, Macias AE, Hernandez-Avila M, et al. (2017). The 2009 pandemic in Mexico: Experience and lessons regarding national preparedness policies for seasonal and epidemic influenza. Gac Med Mex, 153, 93-101. 
  • This report describes the Mexican experience during the 2009 influenza pandemic and the lessons that this experience provides to public health preparedness for future pandemics. Mexico was the first country to notify the World Health Organization of an outbreak of what later became the first influenza pandemic of the 21st Century, caused by the virus A(H1N1). Before this event, Mexico had a national pandemic influenza preparedness plan, which included seasonal influenza vaccination, stockpiles of personal protection equipment and strategic drugs, and risk communication strategies. During the epidemic, the national public health laboratory network and case surveillance systems were strengthened together with surge capacities for intensive care and delivery of antiviral drugs. Risk communication was conducted for people to comply with implemented measures regarding social distancing.
• Currie J, Grenfell B, Farrar J. (2016). Beyond Ebola. Science, 351(6275), 815–16.
  • Liberia was declared Ebola-free in January of 2016. A new case was identified shortly after this announcement, but it was nevertheless clear that the West African epidemic had moved on to a more hopeful phase. This manuscript discusses lessons can be drawn from the Ebola crisis to help the international community to prepare for and respond to the next global epidemic.
• European Union. (1998). Decision No 2119/98/EC. 
  • Legislation that set up a network for epidemiological surveillance and control of communicable diseases in the European Community.
• European Union. (2009). Article 152 (5) EC, Public Health.
  • The European Community can now adopt measures aimed at ensuring – rather than merely contributing to – a high level of human health protection. Article 152 (formerly Article 129) of the EC Treaty now has a wider scope. Among the areas of cooperation between member states, Article 152 lists not only diseases and major health scourges but also, more generally, all causes of danger to human health, as well as the general objective of improving health. The Council may also adopt measures setting standards for organs and substances of human origin, blood and blood derivatives. Veterinary and plant-health measures directly aimed at protecting public health are now adopted under the co-decision procedure.
• Frenk J, Moon S. (2013). Governance Challenges in Global Health. NEJM, 368(10), 936-42.
  • This article defines and discusses the importance of good global governance for health. Briefly, it outlines the major challenges to such governance; describes the four necessary functions of a global health system as the (i) production of global public goods, (ii) management of externalities, (iii) mobilization of global solidarity, and (iv) stewardship; and discusses policy implications.
• Garoona JP, Duggan PS. (2008). Discourses of disease, discourses of disadvantage: A critical analysis of National Pandemic Influenza Preparedness Plans. Social Sciences and Medicine, 67(7), 1133-42.
  • Analysis of national pandemic preparedness plans has revealed that plans often pay little attention to the needs and interests of the disadvantaged. This paper investigates those findings via critical discourse analysis of the same plans as well as World Health Organization guidance documents. Among the six discourses that emerge from the analysis, the scientific, political, and legal dominate the social, cultural, and ethical. This order delineates a specific regime of truths within which the lives, needs, and interests of the disadvantaged are neglected. Unless pandemic preparedness plans recognize their discursive construction, implementation of the policies and practices they prescribe run the risk of further disadvantaging populations likely requiring the greatest protection.
• Gostin LO,  Ayala AS. (2017). Global Health Security in an Era of Explosive Pandemic Potential. J Natl Sec Law & Policy, 9, 1-24.
  • This article makes the case for fundamental reform of the international system to safeguard global health security. More specifically, the authors build on the action agenda offered by four international commissions formed in the wake of the Ebola epidemic and discuss how this agenda would safeguard the global population against future infectious disease threats.
• Gostin LO, Sridhar D. (2014). Global Health and the Law. NEJM. 370(18), 1732-40.
  • Global health law is not an organized legal system, with a unified treaty-monitoring body, such as the World Trade Organization. However, there is a network of treaties and so-called “soft” law instruments that powerfully affect global health, many of which have arisen under the auspices of the World Health Organization (WHO). Global health law has been defined as the legal norms, processes, and institutions that are designed primarily to attain the highest possible standard of physical and mental health for the world’s population. Global health law can affect multiple spheres, ranging from national security, economic prosperity, and sustainable development to human rights and social justice. Each global health problem is shaped by the language of rights, duties, and rules for engagement used in the law.
• Gostin LO, DeBartolo MC, Friedman E. (2015). The International Health Regulations 10 Years on: The Governing Framework for Global Health Security. The Lancet, 386, 2222–26.
  • Fundamental revisions to the International Health Regulations (IHR) in 2005 were meant to herald a new era of global health security and cooperation. Yet, 10 years later, the IHR face criticism, particularly after the west African Ebola epidemic. In this article, the authors review the International Health Regulations’ performance and future.
• Gostin LO, Katz R. (2016). The International Health Regulations: The Governing Framework for Global Health Security. The Milbank Quarterly, 94(2), 264-313.
  • A lack of progress on IHR implementation has led Member States to launch independent programs with strikingly similar aims. The United States established the Global Health Security Agenda (GHSA), partnering with approximately 50 countries to accelerate progress towards global capacity to prevent, detect, and respond to biological threats. The United States has committed to support up to 30 countries in developing these capacities, and the 2015 G7 Summit pledged to double that number. As the IHR face probing questions and parallel initiatives are developed, the authors of this article review their historical origins, their performance, and their future.
• Hanvoravongchai P, Adisasmito W, Chau PN, et al. (2010). Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries. BMC Public Health, 10(1), 322.
  • This study presents the results from a rapid situation analysis of health system and pandemic preparedness in six countries of the Asia-Pacific region prior to the H1N1/2009 epidemic. Taiwan had extensive experience with the SARS outbreak, with over 300 confirmed cases. Viet Nam, Thailand, and Indonesia also had SARS cases and, together with Lao PDR and Cambodia, have had human Avian Influenza cases. Pandemic preparation in these countries has contributed to improvement in health system surveillance, laboratory capacity, monitoring and evaluation and public communications, but preparation for pandemic mitigation in countries with low health system resources is still rather limited.
• Heymann DL, Chen L, Takemi K, et al. (2015). Global health security: the wider lessons from the west African Ebola virus disease epidemic. The Lancet, 385(9980), 1884-1901.
  • Following the Ebola virus disease outbreak in West Africa, the Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. This article captures their contributions to describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future.
• Hoffman SJ. (2010). The evolution, etiology and eventualities of the global health security regime. Health Policy and Planning, 25(6), 510-22.
  • This analysis aims to provide an understanding of the evolution, etiology and eventualities of the global health security regime. This is essential for national and international health policy makers, practitioners and academics to know where and how to act in preparation for future challenges.
• Holmberg M, Lundgren B. (2015). Framing post-pandemic preparedness: Comparing eight European plans. Global Public Health, 13(1), 99-114. 
  • This paper compares the pandemic preparedness plans from eight European countries published after 2009. Special attention is paid to how pandemic preparedness is framed and how pandemic influenza in general is narrated in the plans.
• Ijaz K, Kasowski E, Arthur RR, et al. (2012). International Health Regulations—What Gets Measured Gets Done. Emerging Infectious Diseases, 18(7), 1054.           
  • The degree to which achieving IHR compliance will result in global health security is not clear, but what is clear is that progress against the threat of epidemic disease requires a focused approach that can be monitored and measured efficiently. Ijaz and colleagues developed concrete goals and metrics for 4 of the 8 core capacities with other US government partners in consultation with WHO and national collaborators worldwide. The intent is to offer an example of an approach to implementing and monitoring IHR for consideration or adaptation by countries that complements other frameworks and goals of IHR. Without concrete metrics, IHR may waste its considerable promise as an instrument for global health security against public health emergencies.
• Inglesby T, Fischer JE. (2014). Moving Ahead on the Global Health Security Agenda. Biosecurity and Bioterrorism, 12(2), 63-65.
  • A review of the issues on this agenda makes clear how serious these challenges are. And a look at who is doing some of the leading work on these issues shows how important it will be to identify international best practices, to form new international collaborations, and to encourage countries from around the world to offer their expertise and resources where they are needed.
• Kamradt-Scott A. (2016). Achieving Global Health Security: The Implementation of International Health Regulations Strategic Security Analysis. Geneva Centre for Security Policy.
  • The spread of infectious diseases and antimicrobial resistance remains one of the most challenging collective action problems confronted worldwide. Effective health security relies on each country doing their part in building and maintaining certain core capacities in disease surveillance and response as outlined in the International Health Regulations (IHR). Thus far, most countries have not met these obligations. For some governments, a key challenge to meeting the IHR obligations is resource scarcity; while for others, noncompliance is politically motivated. Currently, there are insufficient penalties to dissuade countries from doing the wrong thing. New measures are needed to discourage non-compliance and encourage health system strengthening.
• Katz R, Sorrell EM, Kornblet SA, et al. (2014). Global Health Security Agenda and the International Health Regulations: Moving Forward. Biosecurity and Bioterrorism, 12(5), 231-38.
  • The launch of the Global Health Security Agenda (GHSA) in February 2014 capped over a decade of global efforts to develop new approaches to emerging and reemerging infectious diseases—part of the growing recognition that disease events, whether natural, accidental, or intentional, threaten not just public health, but national, regional, and global security interests. In 2005, the United States, along with other Member States of the World Health Organization (WHO), adopted the revised International Health Regulations (IHR). The IHR conferred new responsibilities on WHO and the global health community to coordinate resources for capacity building and emergency response, and on the now-196 States Parties to develop the core capacities required to detect, assess, report, and respond to potential public health emergencies of international concern. Both GHSA and the IHR aim to elevate political attention and encourage participation, coordination, and collaboration by multiple stakeholders, while leveraging previously existing commitments and multilateral efforts. GHSA and the IHR are platforms for action; how efforts under each will complement each other remains unclear. Mechanisms that measure progress under these 2 overlapping frameworks will aid in focusing resources and in sustaining political momentum for IHR implementation after 2016.

• Public health legal preparedness begins with effective legal authorities, and law provides a key foundation for public health practice in the United States. Laws not only create public health agencies and fund them, but also authorize and impose duties upon the government to protect the public’s health while preserving individual liberties. This paper describes the evolution and status of essential legal authorities for public health preparedness, focusing on health care system surge capacity, the Pandemic and All-Hazards Preparedness Act, and the implementation of the International Health Regulations.
  Kamoie, B, Pestronk, RM, Doney, M. et al (2008). Assessing laws and legal authorities for public health emergency legal preparedness. Journal of Law, Medicine & Ethics, 36(S1), 23-27.

• The revised International Health Regulations (IHR [2005]) conferred new responsibilities on member states of the World Health Organization, requiring them to develop core capacities to detect, assess, report, and respond to public health emergencies. Many countries have not yet developed these capacities, and poor understanding of the associated costs have created a barrier to effectively marshaling assistance. The work and tool presented here was developed for making preliminary estimates of fixed and operating costs associated with developing and sustaining IHR core capacities across an entire public health system. This tool lays the groundwork for modeling the costs of strengthening public health systems from the central to the peripheral level of an integrated health system, a key step in helping national health authorities define necessary actions and investments required for IHR compliance.
  Katz R, Haté V, Fischer JE, et al. (2012). Costing framework for international health regulations (2005). Emerging Infectious Diseases, 18(7), 1121-27.
• Kayman, H., Ablorh-Odjidja A. (2006). Revisiting Public Health Preparedness: Incorporating Social Justice Principles Into Pandemic Preparedness Planning for Influenza. Journal of Public Health Management and Practice, 12(4), 373-80.
  • This article reviews the history between public health and social justice, provides a brief review of pandemic preparedness planning efforts, discusses the importance of and makes recommendations for incorporating principles of social justice in the development of pandemic preparedness plans, and highlights some of the challenges faced by public health in effectively and equitably meeting its charge to protect the nation’s health.
• Kickbusch I, Szabo MMC. (2013). A new governance space for health. Global health action, 7(1), 23507.
  • This article aims to set out the transnational and cross-cutting nature of governance in the global public health domain along three political spaces: global health governance, global governance for health, and governance for global health. The reform and strengthening of governance institutions in all three dimensions, as well as their interface, is critical to keep global health firmly on the political agenda, to strengthen action on the determinants of health, and to ensure that governance is accountable and transparent to those who have a stake in its viability and legitimacy.
• Kluge H, Martín-Moreno JM, Emiroglu N, et al. (2018). Strengthening global health security by embedding the International Health Regulations requirements into national health systems. BMJ Global Health, 3(S1), e000656-63.
  • The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert, and response. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. 
• Kutzina J, Sparkesa SP. (2016). Health systems strengthening, universal health coverage, health security and resilience. Bulletin of the World Health Organization, 94(1), 2.
  • Global and national initiatives focused on health systems strengthening, universal health coverage, health security, and resilience suffer when these terms are not well understood or believed to be different ways of saying the same thing. This article aims to facilitate understanding and highlight key policy considerations by identifying critical attributes of each concept and emphasizing the distinction between ends and means in health policy.
• Liu B, Sun Y, Dong Q, et al. (2017). Strengthening core public health capacity based on the implementation of the International Health Regulations (IHR) (2005): Chinese lessons. IJHPM, 4(6), 381-86.
  • This article discusses the importance of implementing the International Health Regulations (IHR) in our highly mobile, interdependent, and interconnected world and describes the steps, measures, and related experiences of implementing the IHR in China.

• Liberia is a country that arguably borne the largest brunt of the 2014 Ebola Virus disease (EVD) outbreak, with the highest number of fatalities of all countries since the outbreak began in March 2014. Though significant progress has been made in halting the spread of the disease, declarations by the World Health Organization that the country was “Ebola-free” have been cut-short by detection of new cases, raising concerns that the country and greater region are still in ongoing danger during the post-pandemic phase of the outbreak. More importantly, the unprecedented nature of the Liberian EVD outbreak provides a compelling case study exposing the fragilities of international responses to global public health emergencies. This commentary explores lessons learned from Ebola in Liberia and how they could affect the WHO, the International Health Regulations, and the future landscape of global health governance. 
• Mackey T. (2017). Lessons from Liberia: Global Health Governance in the Post-Ebola Paradigm. Global Health Governance, 11(2), 60-70.
• Manheim D., Chamberlin M., Osoba OA., et al. (2016). Improving Decision Support for Infectious Disease Prevention and Control Aligning Models and Other Tools with Policymakers’ Needs. Rand Corporation.
  • This report describes the characteristics, requirements, uses, applicability, and limitations of three classes of theory-based models (population, microsimulation, agent-based simulation) and two classes of statistical models (regression-based and machine-learning), as well as several complementary non-modeling decision-support approaches. The report then aligns all of these tools and approaches with a set of real-world policy questions. Finally, based on a review of published literature, an assessment of the different models and non-modeling approaches, and recent experiences, the authors recommend nine best practices for using modeling and decision-support tools to inform policymaking.
• Marks-Sultan G, Tsai FJ, Anderson E, et al. (2016). National public health law: a role for WHO in capacity-building and promoting transparency. Bulletin of the World Health Organization, 94(7), 534-39.  
  • A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries’ legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law – from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper, the authors propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. 
• McInnes C, Lee K. (2006). Health, security and foreign policy. Review of International Studies, 32(1), 5-23.
  • This article examines the emerging relationship between foreign and security policy, and global public health. It argues that the agenda has been dominated by two issues – the spread of selected infectious diseases and bioterrorism – but that this is a narrow agenda could be broadened to include a wider range of issues. The authors offer two examples for expanding the agenda: health and internal instability, and illicit activities. They also argue that the relationship between global health, and foreign and security policy has prioritized the concerns of the latter over the former.
• McKenzie A, Abdulwahab A, Sokpo E, et al. (2016). Creating the Foundation for Health System Resilience in northern Nigeria. Health systems and reform, 4(2), 357-66.
  • This article draws on the experience of work undertaken in northern Nigeria over the course of the last 10 years. A multidisciplinary team worked across the health system, addressing issues of governance, finance, institutional management, community systems support, access and accountability, and service delivery. This experience provides lessons for efforts elsewhere on how to strengthen health systems during and after emergencies and in situations affected by conflict.
• Mensua A, Mounier-Jack S, Coker RJ. (2009). Pandemic influenza preparedness in Latin America: analysis of national strategic plans. Health Policy and Planning, 24(4), 253-60.
  • Fifteen national plans were identified and retrieved from 17 of the Latin American countries surveyed. Latin American countries demonstrated different degrees of preparedness, and that a high level of completeness of plans was correlated to a country’s wealth to a certain extent. Plans had several strengths, however, gaps remained, including the organization of health care services’ response; planning and maintenance of essential services; and the provision of containment measures such as the stockpiling of necessary medical supplies including vaccines and antiviral medications. In addition, some inconsistencies and variations which may be important, such as in border control measures and the capacity to contain outbreaks, exist between country plans—issues that could result in confusion in the event of a pandemic.
• Moon S, Sridhar D, Pate MA, et al. (2015). Will Ebola change the game? Ten essential reforms before the next pandemic. The Lancet, 386(10009), 2204-21.
  • The Ebola epidemic raised a crucial question: what reforms are needed to mend the fragile global system for outbreak prevention and response, rebuild confidence, and prevent future disasters? To address this question, the Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine jointly launched the Independent Panel on the Global Response to Ebola. Panel members from academia, think tanks, and civil society have collectively reviewed the worldwide response to the Ebola outbreak. After difficult and lengthy deliberation, members concluded that major reforms are both warranted and feasible.
• Morhard R, Katz R. (2014). Legal and Regulatory Capacity to Support the Global Health Security Agenda. Biosecurity and Bioterrorism, 12(5), 254-62.
  • In February 2014, 27 nations, along with 3 international organizations, launched the Global Health Security Agenda (GHSA). The intent of GHSA is to accelerate progress in enabling countries around the world to prevent, detect, and respond to public health emergencies—capacities to be achieved through nine core objectives. This article describes the ways in which law may be integral to accomplishing elements of each of these nine objectives.
• Mounier-Jack S, Coker RJ. (2006). How prepared is Europe for pandemic influenza? Analysis of national plans. The Lancet, 367(9520), 1405-11.
  • An analysis of published national pandemic influenza preparedness plans from the European Union countries, the two acceding countries (Bulgaria and Romania), Norway, and Switzerland, were evaluated against criteria taken from a WHO checklist.
• Mounier-Jack S, Coker RJ. (2006). Pandemic influenza: are Europe’s institutions prepared?. The European Journal of Public Health, 16(2), 119-20.
  • 21 European national pandemic influenza plans were reviewed and analyzed. Preparation for surveillance, planning and coordination, and communication were satisfactory, but gaps remain in the maintenance of essential services, putting plans into action, and public-health interventions. Furthermore, few plans address the need for collaboration with adjacent countries, despite this being an acknowledged imperative. Similarly, plans for the timely distribution of available medical supplies were notably absent.
• Nicoll A, Brown C, Karcher F, et al. (2012). Developing pandemic preparedness in Europe in the 21st century: experience, evolution and next steps. Bull. World Health Organization, 90, 311-317.
  • This paper reports on the work of the ECDC (the EC and WHO’s Regional Office) in supporting the assessment, development and strengthening of pandemic planning and preparedness in WHO’s European Region in 2005–2009. It explains the initial problems encountered, the changes made to the assessment procedure with experience, the lessons learnt from the 2009 pandemic, and those aspects of pandemic preparedness that should be improved. Detail is limited, but additional information is available through a timeline and in pandemic preparedness web pages.
• Nkengasonga J, Djoudalbaye B, Maiyegun W. (2017). A new public health order for Africa’s health security. The Lancet Global Health, 5(11), e1064.
  • The authors of this comment argue that a new public health order should address two broad categories of barrier that have challenged the implementation of the 2005 IHR in Africa: health systems and systems for health. They elaborate on this point by discussing five key improvements to the health system.
• Osterholm MT. (2005). Preparing for the Next Pandemic. NEJM, (352), 1839-42.
  • This perspective piece outlines what is required to prepare for the next influenza pandemic. The author emphasizes the need to increase and fund vaccine research, as well as develop a public health blueprint to aid in the management of the first 12-24 months of a pandemic.
• Ross AGP, Crowe SM, Tyndall MW. (2015). Planning for the Next Global Pandemic. IJID, 38, 89-94. 
  • This editorial discusses many issues including priority emerging and re-emerging infectious diseases; the challenges of meeting international health regulations; the strengthening of global health systems; global pandemic funding; and the One Health approach to future pandemic planning. The authors recommend that the global health community unites to urgently address these issues in order to avoid the next humanitarian crisis.
• Sambala E, Manderson L. (2016). Ethical Problems in Planning for and Responses to Pandemic Influenza in Ghana and Malawi. Ethics and behavior, 199-217.
  • This report is a qualitative study in which 46 policymakers in Malawi and Ghana were interviewed on how they identified and resolved ethical problems regarding the planning for and response to pandemic influenza. Ethical problems involving conflicts of values and choices were raised in reference to the extent and role of resources and the nature of public health interventions. There is a need for an ethical framework within pandemic preparedness plans to avoid and resolve these problems.
• Schwartz J, Yen MY. (2017). Toward a collaborative model of pandemic preparedness and response: Taiwan’s changing approach to pandemics. Journal of Microbiology, Immunology and Infection, 50(2), 125-32. 
  • As newly emerging infectious diseases (EIDs) have become increasingly common, it has become clear that traditional response mechanisms have proven inadequate to the task of prevention and control. This paper explores whether enhanced cooperation with local government and community institutions can effectively supplement traditional state-centric public health epidemic responses. Using Taiwan as a case-study, the authors conclude that there are benefits of the whole-of-society approach. More specifically, enhanced cooperation resulted in a strengthened, holistic epidemic preparedness and response infrastructure. 
• Speakmana EM, Burris S, Coker RJ. (2017). Pandemic legislation in the European Union: Fit for purpose? The need for a systematic comparison of national laws. Health Policy, 121(10), 1021-24.
  • It is unclear what national pandemic governance exists in European Union Member States as it has not been mapped (i.e. identified and collated). Legal analysis and empirical evaluation of implementation and impact have therefore not been possible. The authors of this study propose comprehensive mapping to create the necessary comparative data for legal analysis assessing national legislation’s compliance with international obligations and ethical principles. Empirical research could evaluate its effectiveness in promoting cross-border coherence and robust emergency response.
• Suman M. Franz DR. (2015). Implementing the Global Health Security Agenda: Lessons from Global Health and Security Programs. Health Security, 13(1), 9-19.
  • Important lessons can be learned from other US government global health programs. This article reviews some of the strengths and challenges of the Global Health Initiative (GHI), the President’s Emergency Plan for AIDS Relief (PEPFAR), and the Nunn-Lugar Cooperative Threat Reduction (CTR) program’s Cooperative Biological Engagement Program (CBEP) to develop recommendations for implementing a unified global health security program in the United States.
• Trivedi KK, Dumartin C, Gilchrist M, et al. (2014). Identifying Best Practices Across Three Countries: Hospital Antimicrobial Stewardship in the United Kingdom, France, and the United States. Clinical Infectious Diseases, 59,  S170-78.
  • Rational antimicrobial use can be achieved through antimicrobial stewardship—a coordinated set of strategies designed to improve the appropriate use of antimicrobial agents. There are encouraging examples of antimicrobial stewardship programs from different parts of the world; however, the structure of these programs varies by hospital and country. In an effort to identify best practices in hospitals, the authors describe legislative requirements, antimicrobial stewardship program infrastructure, strategies and outcomes in the United Kingdom, France, and the United States.
• UK Department of Health & Social Care. (2015). Prevention and control of infections: code of practice. 
  • This policy document was published under the 2010-2015 Conservative and Liberal Democrat Coalition Government. It provides a brief overview of the consultation responses and the consequent changes to the revised Health and Social Care Act 2008 code of practice for the prevention and control of infection and related guidance.
• U.S. Department of Health and Human Services. (2012). North American Plan For Animal and Pandemic Influenza. Washington: DHHS.
  • This book discusses the North American Plan for Animal and Pandemic Influenza and outlines how Canada, Mexico, and the United States intend to strengthen their emergency response capacities as well as our trilateral and cross-sectoral collaborations and capabilities with the intent of ensuring a more coordinated response to future outbreaks of influenza pandemics.
• U.S. Department of Health and Human Services (2015). National Health Security Strategy and Implementation Plan 2015-2018. 
  • This iteration of the National Health Security Strategy provides strategic direction to ensure that efforts to improve health security nationwide are guided by a common vision, based on sound evidence, and carried out in an efficient, collaborative manner. It builds on knowledge of the progress made since 2009, as well as awareness of current gaps in national health security and the ever-shifting strategic landscape.
• Uscher-Pines L, Omer SB, Barnett DJ, et al. (2006). Priority Setting for Pandemic Influenza: An Analysis of National Preparedness Plans. PLOS Medicine, 3(10), e436.
  • Recognizing the potential severe impact of pandemic influenza, the World Health Organization (WHO) urges every country to develop or maintain an up-to-date national influenza preparedness plan, and provides guidance on plan content. WHO guidance focuses on numerous issues, from surveillance and communications to prioritization of vaccine. This study analyzes the national pandemic preparedness plans of 40 countries. Among these plans, there was a great deal of variation with respect to comprehensiveness, quality, and stage of completion.
• Wilson K, Lazar H. (2005). Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies. Institute for Research on Public Policy. 
  • Several emergency response problems highlighted in reports examining the SARS outbreak remain unresolved. In particular, there are important limitations in the current federal legislative framework to address emergencies, which impede the federal government’s ability to act at the early stage of an outbreak. They argue that legislative reform to provide the federal government with the freedom to act on an outbreak that is initially within the confines of only one province but is potentially of national concern should be a priority.
• World Health Organization. (2007). Ethical considerations in developing a public health response to pandemic influenza. Geneva: World Health Organization.
  • This document is meant to assist social and political leaders at all levels who influence policy decisions about the incorporation of ethical considerations into national influenza pandemic preparedness plans. The document focuses on priority setting and equitable access to resources, restriction of individuals’ movements as a result of non-pharmaceutical interventions (e.g., isolation, quarantine, limiting social gatherings, etc.), the respective obligations of healthcare workers and their employers and governments, and the obligations of countries vis-à-vis each other. The document also addresses the need for transparent and timely sharing of information to improve evidence-based policy design and facilitate public engagement in the decision-making process.
• World Health Organization (2009). IHR (2005): Toolkit for implementation in national legislation. Geneva: World Health Organization. 
  • The National IHR Focal Point was developed by the Secretariat of the World Health Organization (WHO) in response to requests for guidance on legislative implementation of the requirements concerning the designation or establishment and functioning of the National IHR Focal Point (NFP) under the 2005 International Health Regulations. This toolkit complements other related legal guidance on the role and assessment of national legislation for IHR implementation, including the legislative reference and assessment tool and compilation of examples of legislation.
• World Health Organization. (2010). Asia Pacific Strategy for Emerging Diseases. Geneva: World Health Organization. 
  • The Asia Pacific Strategy for Emerging Diseases (APSED) is a strategic framework for countries and areas of the region to strengthen their capacity to manage and respond to emerging disease threats. Building on the achievements of the original APSED (2005), the updated APSED is intended to further support progress towards meeting the obligations under the international Health Regulations (IHR, 2005) and consolidate gains already made in establishing collective regional public health security.
• World Health Organization. (2011). Pandemic influenza preparedness Framework. Geneva: World Health Organization. 
  • The objective of the Pandemic Influenza Preparedness Framework is to improve pandemic influenza preparedness and response, and strengthen the protection against the pandemic influenza. WHO intends to do this by improving and strengthening the WHO global influenza surveillance and response system (GISRS).
• World Health Organization. (2015). Building health security Beyond Ebola: Report of a High-Level Meeting. Geneva: World Health Organization. 
  • This report summarizes a high-level meeting between the World Health Organization and the Government of South Africa. The meeting focused on promoting health security, specifically aiming to (i) review the status of efforts to strengthen preparedness for Ebola virus disease, build IHR capacity, and strengthen health systems in Africa, (ii) reach a consensus on critical concepts, relationships and processes needed to strengthen capacity for health security preparedness at country level, (iii) provide input to the development of a high-level roadmap that includes implementation, and (iv) obtain specific commitments and identify the roles of partners, donors and relevant stakeholders.
• World Health Organization. (2017). Report of the Regional Assessment Commission on the status of implementation of the International Health Regulations (2005). Geneva: World Health Organization. 
  • This report provides an update on the progress of the functioning of the IHR-RAC in the Region in the context of resolution EM/RC62/R.3. It also presents the Commission’s recommendations to Member States and WHO for accelerating the implementation of IHR capacities in the context of the IHR monitoring and evaluation framework and the views of the Commission regarding the draft five-year global strategic plan to improve public health preparedness and response.
• World Health Organization. (2017). A Strategic framework for Emergency Preparedness. Geneva: World Health Organization. 
  • The purpose of this document is to provide a high-level, strategic, unifying framework that outlines what is needed for emergency preparedness. This framework builds on previous efforts, capitalizes on current opportunities, and gives direction for stronger investment in emergency preparedness across relevant sectors and at all levels. It also responds to a number of post-event reviews that have concluded that the world is inadequately prepared for different types of emergencies, and which have recommended strengthening emergency preparedness in countries and communities worldwide.