A series of public health emergencies and concerns have called into question whether countries have the most effective institutional arrangements for their national public health agencies (NPHAs) – the government bodies often tasked with coordinating responses to these emergencies. For example, during the COVID-19 pandemic, uncertainty over jurisdiction sometimes led to confusion and hampered the response. Other governance issues are also important for these agencies, from how they are funded to staff recruitment and retention. Many countries had to rapidly scale up their public health workforce in the middle of the COVID-19 pandemic, but that demand declined equally as rapidly following the end of the pandemic’s acute phase. These sorts of challenges impact all functions and all levels of these agencies.
Countries are increasingly aware of the need to strengthen NPHA. This is reflected in efforts across the globe to realign NPHAs and make them more fit for purpose. To inform these ongoing policy processes, the Alliance for Health Policy and Systems Research is partnering with the WHO Health Emergencies Programme (WHE) to generate policy-relevant learning and convene a national public health agency learning network.
To kick off this initiative, a consultation meeting was held in Singapore in early May, hosted in collaboration with Singapore’s interim Communicable Diseases Agency (iCDA). Policy-makers and researchers from 11 countries (representing six low- and middle-income countries and five high-income countries) attended the consultation alongside representatives from WHO regional offices, the Africa Centres for Disease Control and Prevention (Africa CDC), the United States Centers for Disease Control and Prevention (US CDC), the International Association of National Public Health Institutes (IANPHI), Resolve to Save Lives and the Johns Hopkins Bloomberg School of Public Health.
The three-day meeting reflected on experiences from NPHA reforms from different settings. Welcoming the participants to Singapore, Prof Vernon Lee from the Singapore Ministry of Health emphasized the need for continuous learning: “Singapore did generally well in many aspects in our response to COVID-19, but we realized that we need to enhance our preparedness planning and response to be agile and operationally ready, which is one of the reasons we are setting up a new Communicable Diseases Agency.”
Africa CDC’s Dr Haftom Taame also underscored the need to get the relationship right between NPHAs and the rest of government, especially when considering the degree of autonomy they should have. “The focus should on technical and scientific independence, which – with good relations with government – can then be adopted and implemented”, he suggested.
Other panels and presentations focused on country experiences responding to epidemics and pandemics and applying lessons learned from these emergencies to improve the performance of NPHAs. On the final day, countries presented and discussed research questions to inform the way ahead.
The Alliance and WHE will now work with country teams of policy-makers and researchers from a range of countries, including those who participated in this first meeting. This two-year collaboration will continue the conversation at the Eighth Global Symposium on Health Systems Research in Nagasaki, Japan, in November 2024 and document findings to inform how these national institutions can be better organized to protect the health and well-being of their people.