The pursuit of health is a political choice, as is the pursuit of better integration between health and disaster risk reduction – and to achieve both we need all sectors of the government and stakeholders represented and involved
There are strong links between the global health agenda and the imperative to implement disaster risk reduction. Yet, historically, much of the coordination between the global health agenda and the agenda of prevention has been limited to emergency response planning. That response is undoubtedly critical to saving lives after a disaster. But much greater benefits can be attained through reducing risks before they become deadly, costly disasters. This became evidently clear at the height of the Covid-19 pandemic.
Both fields champion prevention first, and the need for this approach is growing as countries face more extreme and unpredictable weather events due to climate change, and the threat of a new pandemic remains.
This is why the Political Declaration of the United Nations General Assembly on the Midterm Review of the Sendai Framework for Disaster Risk Reduction – adopted unanimously by all member states – stresses “the need to enhance coordination, coherence and integration between disaster and health risk management systems, including at the local level”.
It is important to recognise and build on the commonalities between the health sector and disaster risk reduction, especially regarding shared goals, risks and methods.
The Sendai Framework for Disaster Risk Reduction 2015–2030 seeks to reduce disaster losses in lives, livelihoods and health. Among its seven targets, the first two focus on reducing disaster mortality and reducing the number of affected people. This aligns the framework’s objectives directly with the health-related Sustainable Development Goals, particularly SDG 3.
The average annual number of deaths and missing persons from disasters decreased from 1.77 per 100,000 people between 2005 and 2014 to 0.82 between 2012 to 2021. We can attribute this positive trend to the expansion of early warning systems. However, these numbers do not include deaths from the Covid-19 pandemic – and adding them would make the Covid-19 pandemic the deadliest disaster in the last 100 years.
Reducing the risk of pandemics is included as a biological hazard in the Sendai Framework, because when it was negotiated in 2015, the World Health Organization and UN member states – having experienced Ebola, severe acute respiratory syndrome and Middle East respiratory syndrome – strongly advocated for including such outbreaks among the multi-hazards the world will face. Indeed, the WHO’s 2019 Health Emergency and Disaster Risk Management Framework cites the proactive management of risks. Despite this mutual recognition of shared risks, the Covid-19 pandemic tragically caught most countries off guard, with unclear working arrangements between the disaster and health sectors to address this common risk. We failed to prevent or be prepared.
Beyond the threat of future pandemics, there is also a cause for collaboration to reduce the direct and cascading impacts of disasters. This includes building the resilience of health facilities and critical infrastructure and reducing the risk of disease outbreaks in the aftermath of disasters, which cause significant morbidity and mortality among affected populations.
Aside from the fact that both the global health agenda and the agenda of disaster risk reduction advocate for investing in prevention, both also adopt a ‘people-centred’ approach and use many of the same methods to assess and address risks. As a result, there are many practical areas for sharing lessons learned and good practices.
Examples include crafting policies and regulations to finance and incentivise prevention, collecting and managing risk and impact data, designing and executing multi-hazard risk assessments, and developing and evaluating risk communication efforts, to name a few.
To achieve common goals, address common risks, and make the best use of resources and tools, countries must adopt multi-sectoral and all-of-society risk governance structures, with all sectors of the government and stakeholders, including non-governmental actors – particularly representatives of the most vulnerable – represented and involved. This approach is at the heart of the Sendai Framework. It makes sense in a world where every risk is connected and all impacts are cascading.
That said, creating such an inclusive and multi-sectoral approach requires political commitment. Indeed, the best examples came during the Covid-19 pandemic when the heads of state and government established governance structures that brought together all relevant ministries to coordinate containment and response efforts.
We need to see such risk governance arrangements adopted more permanently to better anticipate and mitigate all current and future risks. The health sector can serve as a model. Guidance is available in the 2016 Bangkok Principles for the Implementation of the Health Aspects of the Sendai Framework and the WHO’s Health Emergency and Disaster Risk Management Framework. Furthermore, in humanitarian crises, where responding to health emergencies is often a top priority, disaster risk reduction should be a standing agenda item for humanitarian country teams and inter-cluster coordination, following the guidance of the UN Office for Disaster Risk Reduction’s checklist for Scaling up Disaster Risk Reduction in Humanitarian Action 2.0.
We have a crucial opportunity now to cement this integration: the negotiations between WHO member states on a global accord on pandemic prevention, preparedness and response. This groundbreaking accord has the potential to ensure that the important lessons of the Covid-19 pandemic are not lost and will be used to prevent future disasters at the scale we experienced.
The pursuit of health is a political choice – and so is the pursuit of better integration between health and disaster risk reduction. Countries must take this up as a political priority to prevent future disasters and avoid reinventing the wheel the next time a global crisis occurs.