Last year, I spent an inspiring and humbling day at the Hagadera refugee camp, part of the Dadaab camp complex in eastern Kenya. After an early start in Nairobi, the UN transport plane dropped us at the airstrip near the Kenya-Somalia border around 7am, following the 45-minute twice-weekly flight.
Met by the International Rescue Committee (IRC) jeep, logo emblazoned on its side, we were escorted with an armed guard through the maze of narrow streets and windy tracks to the UN compound.
The purpose of the trip was to explore how Public Health England (PHE) could collaborate better with IRC, the huge humanitarian aid organisation now led by David Miliband. Accompanied by the head of the IRC team in Kenya and her senior staff, I was shown around the health facilities in Hagadera, the camp that IRC has been designated by the UN to run.
Over the years of their existence, the six camps within the complex – home to several million refugees – have developed as communities with their own economies, schools and transport arrangements.
Over the past few years PHE has provided a public health response to a range of emergency situations, including the floods in Thailand and Pakistan, nuclear tragedy in Japan, and the Philippines typhoon. From these experiences we have learnt that our impact will be even more effective and safer if linked, when appropriate, to a partner aid organisation – one with extensive on-the-ground presence like the outstanding IRC.
We are now complementing this association by strengthening our ties with the Department for International Development (DFID), and developing a framework for emergency deployment.
International public health work is all about partnerships. Since that visit to Dadaab, we have enhanced our generic links with IRC – now of great value in PHE’s efforts in West Africa to support the WHO and national governments in the Ebola outbreak – and we have a specific initiative around public health governance in Hagadera.
Interestingly, the original purpose (and first part) of the Kenya visit was not connected to IRC, but was in response to a request from the Kenya government for support and advice around setting up their new national public health institute (NPHI). This piece of work was in collaboration with the International Association of National Public Health Institutes (IANPHI), and PHE now has several other projects with IANPHI around development of NPHIs, including in Uganda.
The newly published PHE global health strategy, developed through discussion and engagement with many stakeholders, sets out our approach to global health and provides a framework for our international engagement over the next five years.
In the document we describe how the mandate for our global health work comes from the Government’s forward-thinking Health is Global strategy, as well as from PHE’s leading role around implementation of the WHO International Health Regulations (IHR). The strategy identifies five strategic priorities which will be the focus of our global health work:
- Improving global health security and meeting responsibilities under the International Health Regulations – focusing on antimicrobial resistance, mass gatherings, extreme events, climate change, bioterrorism, emergency response, new and emerging infections, cross-border threats, and migrant and travel health
- Responding to outbreaks and incidents of international concern, and supporting the public health response to humanitarian disasters
- Building public health capacity, particularly in low and middle income countries, through, for example, a programme of staff secondments and global health initiatives
- Developing our focus on, and capacity for, engagement on international aspects of health and wellbeing, and non-communicable diseases
- Strengthening UK partnerships for global health activity
In developing the strategy we have drawn on PHE’s expertise and assets, our responsibilities to the UK public, PHE’s relationship with other government departments and international organisations. We have also considered how our global health work will be organised, as well as funding and commercial issues.
Although a key part of PHE’s overseas work will remain around matters of global health security, such as responding to large international infectious disease outbreaks, we plan to expand our contributions to the public health development agenda: that is, supporting other countries in building up their public health systems and capabilities.
As the second largest national public health organisation in the world, we have a huge amount to offer – with results that benefit humanity, protect the UK population and provide wonderful learning opportunities for staff.
PHE is committed to improving the health of the people around the globe. Earlier this year Duncan Selbie, PHE’s Chief Executive, joined me on a visit with the Department for International Development to Pakistan, exploring how we can work with the Pakistan government around building their disease surveillance systems.
We are also involved in projects and staff secondments to the Caribbean, South Africa and Vietnam. To provide guidance and scrutiny of our global health work, we have established a new Global Health Committee, reporting to the PHE Board and chaired by Professor Sian Griffiths, a PHE non-executive director. In addition, we have the inspiration and global health wisdom of our PHE chairman, Professor David Heymann.
Over time, we will learn and improve the coordination, prioritisation and implementation of PHE’s global health work. Although a small international public health team provides central management, we will be setting up a cross-PHE delivery group to ensure inclusion and oversight, and want to involve members of the broader public health system across England in our work. Only by connecting PHE’s domestic and international activities will we fulfil our global responsibilities, and make the most of the opportunities that international engagement provides. The global health strategy gives us a framework and direction to undertake such work, and I look forward to more people joining PHE’s efforts to implement the strategy.
Read Anthony's personal blog at https://medium.com/@AKessel
Homepage image: Somali school in Dadaab, Kenya refugee camp, licensed under public domain via Wikimedia Commons