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HWA CHONG CONFLICT RESOLUTION & INQUIRY 2017

W O R L D H E A LT H O R G A N I S AT I O N

Dais introductions

Hou Boyang Head Chair Boyang is a Year 6 student in the Humanities Programme, and part of the Humanities and Current Affairs Society (HACAS).Boyang started his MUN journey at UNASMUN in 2012 and has been to several other MUNs since, including THIMUN (Singapore), SCMUN and SMUN. He also chaired HCCRI twice before. Furthermore, he enjoys reading on various topics, in particular history, something that he has been highly interested in since a young age. Boyang is also part of the Hwa Chong Taekwondo team and competed in the A division competitions last year. Boyang is honoured to be involved in the organizing and chairing of this year’s WHO and wishes all delegates the best of luck at the conference.

Tang Han Shin Vice-Chair Han Shin is a JC1 Malaysian scholar from Penang. He misses Penang food dearly and often sneaks to various food courts looking for prawn noodles and Char Kuey Teow. Food aside, he is currently a happy person studying under the Humanities Programme; very HP indeed. He debates in both Mandarin and English but seems to be more proficient in the former when it comes to employing attention diversion techniques in front of the adjudicators. These techniques have faithfully guided him through various MUN conferences such as RMUN 2016, NTUMUN 2016 and 2017, and occasionally earning him an award or two. He currently reads KI, H2 Math, History and Literature. He hopes to see invigorating debate and interaction among the delegates during the two days of HCCRI – high quality discourse, indeed, will recover all of his HP that is lost trying to survive block tests.

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Dragon Chew Vice-Chair Dragon is a JC1 student in the Humanities Programme, and a member of the students’ council. He has participated in conferences since 2015 and believes that the most important thing in MUN conferences are the people one interacts with, as well as the lessons that can be learnt. Dragon hopes that all delegates will have a fruitful conference!

Contact the chairs You may contact the Chairs of WHO at hccri2017+WHO@gmail.com.

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The World Health Organisation

The World Health Organization is a specialized agency of the United Nations that

primarily deals with international public health. It traces its roots to the Health

Organization, which was part of the league of nations. The constitution of the World

Health Organization had been signed by 61 countries on 22 July 1946, and the first

meeting of the World Health Assembly was concluded on 24 July 1948. Since its

creation, it has played a leading role in championing the improvement of public

healthcare for millions as well as combating deadly diseases. Its most notable

achievement thus far is generally agreed to be the eradication of the deadly smallpox.

Currently, its priorities include communicable diseases, in particular HIV, Malaria,

Tuberculosis, and the mitigation of the effects of non-communicable diseases

The WHO is governed by the World Health Assembly and the Executive board. Its

current Director General is Margaret Chan. The World Health Assembly is the supreme

decision-making body for WHO. It generally meets in Geneva in May each year, and is

attended by delegations from all 194 Member States. Its main function is to determine

the policies of the Organization.The Health Assembly appoints the Director-General,

supervises the financial policies of the Organization, and reviews and approves the

proposed programme budget. It similarly considers reports of the Executive Board,

which it instructs in regard to matters upon which further action, study, investigation, or

report may be required. The Executive Board is composed of 34 members technically

qualified in the field of health. Members are elected for 3-year terms. The main

functions of the Board are to give effect to the decisions and policies of the World

Health Assembly, to advise it and generally to facilitate its work.

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Implementation of Epidemic

Management Protocols

Overview of topic The word “epidemic” is derived from ancient Greek, and indeed it is something that

has plagued mankind throughout our long history. The plague of Athens, which

devastated the city state during the second year of the Peloponnesian war, is one of

the earliest recorded example of an epidemic. The term itself refers to the rapid spread

of infectious disease to a large number of people in a given population within a short

period of time, usually two weeks or less. One common point of confusion is the

difference between epidemics and pandemics. A pandemic is an epidemic of infectious

disease that has spread through human populations across a large region; for instance

multiple continents, or even worldwide.

Epidemics tend to have two types of outbreaks. One is the common type outbreak, in

which the affected individuals had an exposure to a common agent. If the exposure is

singular and individuals all develop the disease over a single exposure and incubation

course, it can be termed a common type outbreak

The other type of outbreak is the propagated outbreak. In a propagated outbreak, the

disease spreads from person to person. Affected individuals will transmit the disease to

others, widening the outbreak. Many epidemics, however, will have characteristics of

both common source and propagated outbreaks. For example, secondary person-to-

person spread may occur after a common source exposure. Epidemics can generally be

transmitted via a variety of ways, including the more common airborne transmission,

biological transmission, contact transmission, as well as more esoteric means such as

arthropod transmission and mechanical transmission.

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A number of devastating epidemics have hit the globe over the course of human

history. From lesser known yet lethal ones such as the Antonine plague and the Great

Plague of Vienna, to more famous ones such as the Black Death, the Ebola epidemic

and the Zika virus, the death toll inflicted upon mankind has been incalculable. In

recent years, several major epidemics have broken out, including the MERS crisis and

the West African Ebola outbreak. These examples, and the WHO’s role in them, will

now be examined in detail.

The Middle East respiratory symptom, MERS, was first identified in a patient in Saudi

Arabia in April 2012, and was eventually reported in 24 countries, leading to a total of

1905 cases and 677 deaths. The primary outbreak of MERS took place in Saudi Arabia,

where it led to the deaths of over 400 people. It was first transmitted from camels to

humans, and later transmitted between humans via close contact. A second major

outbreak of MERS took place in South Korea in 2015. It led to thousands being

quarantined and eventually several dozen deaths. In total, about 40% of those infected

died of the disease.

The WHO was primarily involved in working with clinicians and scientists internationally

to gather and share scientific data to better understand the virus and the disease it

causes, and to determine outbreak response priorities, treatment strategies, etc. It

coordinated the global health response to MERS together with affected countries and

international technical partners and networks. Its Director-General convened an

Emergency Committee under the International Health Regulations (2005) to advise her

as to whether this event constituted a Public Health Emergency of International

Concern (PHEIC) and on the public health measures that should be taken. Furthermore,

the WHO requested that Member States report to WHO all confirmed and probable

cases of infection with MERS-CoV together with information about their exposure,

testing, and clinical course to inform the most effective international preparedness and

response.

Another key example of WHO involvement in resolving an epidemic occurred during

the Ebola crisis. The West African Ebola outbreak is perhaps one of the most lethal

epidemics that has confronted the world in recent years. Although the disease was first

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identified in 1976, it did not come into public eye until the most recent outbreak in

2013, when it swept across the nations of Liberia, Sierra Leone and Guinea before

spreading to other countries around the world. Its mortality rate was extremely high, at

slightly above 70% in the West African countries. It eventually resulted in the deaths of

over 10000 people across the world. Other countries heavily affected by Ebola include

the African nations of Mali and Nigeria, and isolated cases were reported in the UK and

USA.

The WHO's response to the Ebola virus disease outbreak in West Africa had 3 phases.

Phase 1 focused on rapid response; phase 2 focused on increasing capacities, phase 3

focused on interrupting all remaining chains of Ebola transmission, and responding to

the other consequences.

The first phase, which took place from August to December 2014, involved the WHO

and partners focusing on rapid response via increasing the number of Ebola treatment

centres and patient beds, hiring and training teams in safe and dignified burials, as well

as strengthening social mobilization capacities.

In January 2015, WHO and its partners moved into Phase 2 (January – July 2015). In

this phase, emphasis was placed on Increasing capacities for case finding, increasing

capacities for contact tracing and community engagement. Such efforts as well as the

initiation of vaccine trials was credited with bringing the Ebola outbreak under control.

Phase 3 lasted from August 2015 to mid 2016, with the overarching goal to interrupt all

remaining chains of Ebola transmission. A series of measures were implemented,

including means such as enhancing the rapid identification of all cases, deaths, and

contacts, establishing and maintaining safe triage and health facilities, as well as

improving Ebola survivor engagement.

The efforts of the WHO, in addition to local governments and other international

agencies, eventually ended the crisis, and the WHO declared the emergency to have

ended on 29 March 2016.

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While the WHO has thus far been able to stop the spread of many epidemics, its

responses have been far from perfect. Errors and weaknesses within the organisation

such as poor on the ground organisation and initial slow response have led to many

unnecessary deaths, and it is now up to the delegates to work together to improve the

WHO’s capabilities and other aspects in order to further improve the WHO’s ability to

combat epidemics for years to come.

With specific regards to HCCRI, the dais reminds delegates that non-conventional

epidemics like those of tobacco or obesity should be shunned, while it is up to the

delegates’ discretion to include pandemics within the scope of consideration.

WHO Epidemic Management Programmes The International Health Regulations (IHR) is a 2005 agreement between 196 countries,

including all WHO Member States, to protect global health. Through IHR, countries

have agreed to build their capacities to detect, assess and report public health events.

WHO's work in coordinating IHR implementation is lead by the Department of Global

Capacities Alert and Response. Some of its areas of work are included below.

1. Global Outbreak Alert and Response Network (GOARN)

GOARN pools human and technical resources for rapid identification, confirmation and

response to outbreaks of international importance. WHO coordinates international

outbreak response using resources from GOARN.

2. Strategic Health Operations Centre (SHOC)

SHOC monitors global public health events around the clock, and facilitates

international collaboration during public health emergencies and daily operations.

SHOC also supports WHO regions and countries by providing technical support and

guidance in setting up their emergency operations centers. This helps countries meet

their IHR commitment to continuous surveillance and rapid detection of unusual health

events, and to communicate this information to WHO.

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3. Pandemic Influenza Preparedness (PIP) Framework

The PIP Framework brings together Member States, industry, other stakeholders and

WHO to implement a global approach to pandemic influenza preparedness and

response aiming to strengthen communication channels of influenza viruses with

human pandemic potential as well as to increase the accessibility of pandemic related

supplies to countries. It became effective on 24 May 2011 when it was unanimously

adopted by the Sixty-fourth World Health Assembly.

4. Global Influenza Surveillance and Response System (GISRS)

Global influenza virological surveillance has been conducted for over half a century and

GISRS monitors the evolution of influenza viruses and provides recommendations in

areas including laboratory diagnostics, vaccines, antiviral susceptibility and risk

assessment. GISRS also serves as a global alert mechanism for the emergence of

influenza viruses with pandemic potential.

Key issues

Detection and Confirmation In Guinea, it took nearly three months for health officials and their international

partners to identify the Ebola virus as the causative agent. By that time, the virus was

firmly entrenched and spread was primed to explode. Although a few scattered cases

had already been imported from Guinea into Liberia and Sierra Leone, these cases

were not detected, investigated, or formally reported to WHO. West African countries

like Guinea, which had never experienced an Ebola outbreak, were poorly prepared for

this unfamiliar and unexpected disease at every level, especially early detection of the

first cases. Clinicians had never managed cases of this nature or magnitude, nor had

any laboratory ever diagnosed a patient specimen.

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Detection of an outbreak relies on the ability of the responsible authority to recognise

an increase in disease cases significantly above the number normally expected. This

recognition is simpler if a routine surveillance system collects either summary or case-

based information on clinical and confirmed cases, which aids in the establishment of a

local outbreak (or epidemic) threshold. The attainment of a threshold value should be

considered as signalling an outbreak and should trigger specific responses. However, in

the absence of an effective surveillance system it may be difficult to detect small or

limited outbreaks. This failure of detection is directly complicit in causing epidemics to

become more widespread and potentially evolve into a global pandemic.

The power of early detection is obvious in Singapore’s preparedness against the 2009

H1N1 influenza pandemic. Prior to the “swine flu” outbreak in Singapore, there already

existed a disease surveillance system and influenza pandemic preparedness plan.

Known as the Disease Outbreak Response System (DORS), it is a five-colour alert

system that progresses from green to yellow, orange, red and black (DORS had been

raised to “alert orange” even before the first confirmed case). This system allowed for

precautionary health measures to contain the spread of the virus to Singapore such as

contact tracing, the issuing of Home Quarantine Orders (HQO), public health

advisories, treatment and vaccination. Of the 194 human cases, only 18 succumbed to

the virus. The death toll could have been higher if not for DORS.

Infrastructure for Epidemic Responses Infrastructure can be thought of in two respects. Primarily, that of healthcare facilities

and research for epidemic cures, and secondarily, that of, inter alia, roads and

communication networks to increase accessibility and serve as expedients in responses.

Both are integral for the successful implementation of epidemic management protocols

but this section shall touch mainly on the medical aspect - specifically the lack of

“treatment capacity”.

For example, during the West African Ebola Crisis, large treatment centres built in

Liberia stood empty, while in Sierra Leone, hospitals had no choice but to turn patients

away owing to a lack of treatment beds.This problem did not just stem from a lack of

pre-existing medical infrastructure in Sierra Leone but also the complexity of epidemics

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due to its transmission rates and cyclical nature. International response led by the US

poured resources in constructing medical facilities in Liberia but when they opened, the

number of new infections of Ebola virus disease being reported in Liberia had

dramatically fallen. However, it was only then did the Ebola virus began to proliferate in

Sierra Leone, something that was not considered before

The subsequent WHO report found that existing epidemic management protocols

were only applicable to certain countries and could not cover regions. Moreover, the

long response time of both local authorities in ascertaining the severity of the epidemic

and the international community in sending aid invariably contributed to the spreading

of the Ebola virus. Mechanisms to augur the aforementioned had to be developed.

Occupational Hazards and Shortage of Healthcare Workers

According to a 2013 WHO report, the world will be short of 12.9 million health-care

workers by 2035; today, that figure stands at 7.2 million. If this manpower shortage is

not addressed, it will have serious implications for the health of billions of people

across all regions of the world. This is highly applicable with regards to epidemic

management protocols given that healthcare professionals have received the relevant

training to care for patients as well as protect their own health and safety.

When the MERS-CoV erupted in South Korea in 2015, South Korea had the lowest

patient-to-nurse ratio among the Organization for Economic Cooperation and

Development nations, at 0.28 nurses per patient. The OECD average was 1.25. Then,

the hospital system extended to that of family members where they provided basic

care normally carried out by nursing staff. This has been since largely blamed for the

Mers spread, with many Koreans having contracted the virus while caring for their

family members at Mers-affected hospitals.

Yet, even when there are sufficient healthcare workers to manage the fallout, one

extension of existing protocols may be neglected - the inherent occupational hazard of

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coming into close contact with potentially contagious matter. In certain situations,

some doctors are thought to have become infected when they rushed, unprotected, to

aid patients who collapsed in waiting rooms or on the grounds outside a hospital.That

being said, investigations following the Ebola epidemic found that the vast majority of

infections in healthcare workers occurred in the community, and not in its treatment

facilities, which had an outstanding reputation for safety. Deficiencies in current

protocols have to be also explored should any implementation hope to be successful.

Factors influencing propagation of epidemics

Epidemics that are Endemic to Climes

Some of the worst epidemics include that of Malaria, and other variants such as Yellow

Fever, Zika, Chikungunya, which are transmitted by mosquitoes and commonplace in

warmer, tropical climates. The scary development is that global warming has led to

warming temperatures in cool, temperate regions that were once inaccessible to

mosquitoes. Another example, is the cholerae bacterium which thrive in warmer waters

and causes diarrhea so severe that it can kill within a week. Without improved

sanitation, rising global temperatures will increase deadly outbreaks. As such, epidemic

management protocols need to expand to include a more encompassing working

model.

High Population Mobility across Porous Borders

In the event of epidemic outbreaks, high population mobility exacerbates the existing

issue of controlling its spread. First, humans are a known pathogen carrier and by mere

virtue of movement, epidemics could potentially be spread. This is why when

outbreaks have been confirmed, certain transit areas utilise technology, such as infrared

scanners in the case of the H1N1 outbreak, to detect symptoms amongst travellers

before taking appropriate measures such as quarantines or admission into treatment

facilities.

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Secondly, cross-border contact tracing (the identification and diagnosis of people who

may have come into contact with an infected person) is difficult given that either

infected individuals have yet to be identified or there is no framework to do so.

Additionally, while populations readily cross porous borders, outbreak responders do

not, more often than not either lacking the authorisation or being too occupied with

domestic happenings.

Thirdly, the perennial issue of prolonging epidemics through a cycle of recovery and

infection. As the situation in one country began to improve, it may attract patients from

neighbouring countries seeking unoccupied treatment beds, thus reigniting

transmission chains. In other words, as long as one country experienced intense

transmission other countries remained at risk, no matter how strong their own response

measures had been. This was the case in the Ebola outbreak in Sierra Leone where

many people sought health care in neighbouring Liberia (which had only just recovered

from its own episode of Ebola).

Does the question simply lie in strengthening border security and restricting the free

flow of human traffic? In regions by which border control is virtually non-existent, that is

an important first line of defence against the admittance of pathogens into a country.

However, even with the relevant border measures in place, authorities still face the

inability in identifying infected individuals. This is ever the more applicable if we

consider situations in which epidemics have yet to be discovered. Lastly, there is also

the ethical consideration of actively denying patients medical attention for fear of

spreading the disease across borders.

Governmental Red Tape

One, there is the generic, typical governmental bureaucracy that pervades and

corrupts entire epidemic management protocols from the grassroots to the elephant

trees. Funds are not allocated to provide for healthcare infrastructure or health care

workers are not properly trained or paid. Governments refuse to comply with

international standards and assess the situation on the ground. They may even neglect

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confirmation or proper reporting and warnings to the WHO and other countries simply

due to a broken chain of command or non-existence response system.

Two, there is also another form of governmental resistance to the implementation of

healthcare responses or the establishment of protocols in the first place. This comes in

the form of legislature, or a lack of legislation guaranteeing health care coverage. For

example, in 2014, Global Fund and UNAIDS warned that Nigeria’s new anti-gay law

“could prevent access to essential HIV services for LGBT people who may be at high

risk of HIV infection, undermining the success of the Presidential Comprehensive

Response Plan for HIV/AIDS which was launched by President Goodluck Jonathan [of

Nigeria] less than a year ago”.

With regards to the HIV/AIDs epidemic (or actually pandemic), the stigma associated

with contracting this disease is often in conjunction with other forms of ostracism - such

as those targeted towards the LGBTQ community, in question, pertaining to all-male

sexual behavior, even between uninfected individuals. Implementing epidemic

management protocols would be meaningless if portions of the victims are unable to

seek recourse.

Three, in the event of an epidemic outbreak, governments may be unwilling to allow

international healthcare workers or NGOs to enter the country so as to prevent “bad

publicity”. This is a recurring issue when it comes to humanitarian aid, even in different

scenarios, including those of natural disaster relief efforts. Regardless, the key question

is what action should be taken should a sovereign country refuse to accept aid (and

hence be unable to properly stem the disease outbreak) given that an isolated

epidemic has the potential to evolve into a global pandemic.

In the case of the Ebola epidemic, high-risk practices such as the adherence to

ancestral funeral and burial rites have been singled out as fuelling large explosions of

new cases. For example, WHO staff in Sierra Leone estimated that 80% of cases in that

country were linked to funeral and burial practices. In Liberia and Sierra Leone, where

burial rites are reinforced by a number of secret societies, some mourners bathe in or

anoint others with rinse water from the washing of corpses. As several experts have

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noted, when technical interventions cross purposes with entrenched cultural practices,

culture always wins. Control efforts must work within the culture, not against it.

Or in the case of HIV/AIDS or Tuberculosis, the slow progress in addressing it may be

due to the social stigma associated with the disease. This invariably creates inertia in

patients which may result in delays in seeking treatment, lower treatment compliance,

and family members keeping cause of death secret. For nascent epidemics, this is

especially dangerous given that the extent that the disease had spread to would be

unknown and potentially of a greater magnitude than expected or prepared for.

Public Information/Communication between Stakeholders

The WHO faced considerable flak during and following the H1N1 Influenza virus in

2009, where critics and many Western nations criticised that it exaggerated the

dangers of the pandemic, spreading fear and confusion rather than immediate

information. Furthermore, following the 2014 Ebola outbreak, the organization was

criticized for its bureaucracy, insufficient financing, regional structure and staffing

profile. An internal WHO report affirmed these criticisms to an extent too.

When an outbreak is declared, there is likely to be widespread public concern and

media attention. It is important to keep the public informed about the outbreak and

the outbreak response. Public information can be transmitted by a number of simple

means, either directly to the community via schools or community meetings, or via the

mass media such as radio, newspapers and television. Simple, clear public information

material can help to allay fears and convey public health messages regarding

appropriate treatment of cases and immunization.

The media are useful partners in keeping the population informed. Regular press

releases and conferences are essential in that they help the media play their role and

help avoid “media hounding” of team members. A single spokesperson should be

appointed and made known to the media. This person must receive clear instructions

from the team and up-to-date information. If the media are to be enlisted in the

delivering of health messages to the population, it is essential that these messages are

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reproduced as exactly as possible as it is not advisable to rely on the media for the

interpretation of detailed health education material and for expert decisions on what to

publish.

Traffic and Trade Disruption during Epidemic Lockdowns

The fastest way to contain the spread of an epidemic is to shut down borders and

prohibit cross border movement. For reasons such as globalisation and the need for

the transport of essentials like food and water, this is highly improbable. Thus, there

would be leakages in and out of countries and epidemics can still be transmitted (if

they are solely limited to human transmission). A system has to established to ensure

that public health and the global economy can both be balanced such that

unwarranted travel and trade restrictions can be prevented. Even then, questions of

what proportion should be set, and which of the two should be prioritised or even

whether countries can afford to close their borders continue to emerge.

Overestimation of Epidemics/Exacerbation of Fears

WHO uses a metric which ranges from Phase 1 to Phase 6 to Post Peak Period and Post

Pandemic Period to ascertain the severity of pandemics. It is an easier way of

communicating to the public the threat level they face. A constant dilemma WHO faces

is whether to err on the safe side of caution and provide conservative reports, that is,

highlighting the imminent threat of an epidemic or pandemic. However, this comes

with the trade off of raising public fear and contributing to “panic buying” which

inadvertently deprives portions of society of both daily essentials and medical

necessities. For instance, there were accusations that WHO exaggerated the dangers

of the H1N1 Influenza virus in 2009 needlessly.

That being said, WHO should never underestimate threats and attempt to paint a

toned-down image of the situation so as to maintain public calm. The magnitude of

negative repercussions in misrepresenting epidemics is unfathomable.

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Limited Supply of Vaccines

It is inevitable to richer portions of society, and correspondingly, richer nations are able

to purchase the necessary medical supplies and cures. Moreover, it is the very same

nations that produce these vaccines given that they have the capital and established

Resource and Development (R&D) industries to do so. This is then further compounded

by the fact that such producers then have monopoly over the market and the very thing

that can save lives - consumers and patients are at the mercy of their avaricious goals.

The outcome is that the poorest of the poor have no way to gain access to medical

care and will be facing eventual demise.

Once again, the 2009 H1N1 Influenza Pandemic saw developed, western nations such

as Germany and Spain placed large orders for the vaccines, effectively depriving other

nations who were less able to afford them. What infuriated many observers was the fact

that they emerged with over supplies and had to resell their stock or cancel orders.

Yet, ameliorating this inequity is not so simple as rationing or increasing affordability.

Market economics are much more complex and even if vaccines were made more

ubiquitous, would it really reach the people and places that need them the most?

Key Stakeholders

Developing countries

Developing countries that lack sufficient sanitation or medical facilities, the relevant

expertise, and effective means of information dissemination are especially vulnerable to

epidemics outbreaks. While prompt international support will help in managing these

limitations, a robust domestic system with up-to-date protocols and hard and soft

infrastructures in place will prove greatly beneficial. In light of constrained resources

and capabilities, the council must precisely diagnose the weaker links in the epidemic

management system of these countries to mete out the necessary support in an

effective and cost-effective manner. Developing countries also have a role to play in

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scientific research concerning epidemics, and should consider how they can better

contribute to the pool of relevant scientific knowledge in spite of less available

resources.

Developed Countries

Developed countries are crucial stakeholders in the global battle against epidemic

outbreaks because of their capabilities in funding to international missions, providing

necessary aid, and spearheading scientific research in the field. Nonetheless, the

resources that developed countries can invest into the matter are not unlimited. Being

also responsible for solving other domestic challenges, governments of developed

countries must exercise careful judgment in their stakes and degree of involvement in

the matter. Cost-effectiveness of international approaches may, in fact, be most closely

scrutinised by developed countries as they are the more prominent financial

contributors and as many governments come increasingly under populist pressures at

home to focus more on domestic affairs.

African Union

The ad hoc mission by the African Union to intervene in the Ebola outbreak in West

Africa, known as the African Union Support to the Ebola Outbreak in West Africa

(ASEOWA), was recognised as a major contributor amongst international efforts against

the spread of the epidemic. Coming from the same continent, the ASEOWA had the

strengths that other international organisations lack. Their health workers spoke the

same language and were seen as “brothers and sisters” by the patients, resulting in a

tremendous trust that facilitated the humanitarian work. Indeed, the African Union is in

a key position to tackle epidemics concerning the continent with its unparalleled

legitimacy and familiarity with the local scene. As African countries continue to be

plagued by recurring epidemics such as cholera, malaria, meningitis, measles and

zoonotic diseases, delegates should think about how can the WHO and the African

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Union better coordinate in their defense against epidemics, or whether collaboration

with the African Union is an effective, desirable strategy in the first place.

Europe

Europe houses many developed countries that are generally better equipped with the

relevant soft and hard infrastructure for epidemic management. With these conditions,

the European countries are often in a better position to mete out financial or technical

assistance to other countries - and had indeed contributed to past UN missions to

ameliorate epidemics. European countries have a collective stake to ensure that each

individual member has a robust system due to their close geographical proximity and

extremely porous borders under the Schengen agreement that abolished border

checks at the common borders of the participating countries. Past epidemics - such as

the Black Death - that ravaged Europe had left but a too painful history. The European

Centre of Disease Prevention and Control under the European Union today is

responsible for strengthening Europe’s defense against epidemics.

United States of America

The United States of America is unsurprisingly the greatest contributor to the regular

budget of the UN, given its superior economic status. The USA is poised to provide

financial and technical assistance to countries plagued by epidemic outbreaks.

Nonetheless, the USA is not immune to the threats of epidemics - about 12,000 people

died from Swine Flu in 2009 as part of the global catastrophe. Large pharmaceutical

companies may wield significant lobbying forces domestically, but humanitarian

concerns and the development of a more effective international response to epidemics

will remain the overarching objective of the USA in WHO.

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People’s Republic of China

China is an emerging world leader not only in the fields of the economy and military,

but also with regards to epidemic management. While certain systemic problems such

as incomplete coverage of sanitation facilities and lack of transparency may remain,

China is taking bolder steps to protect her citizens against epidemics. Ambitious

programmes such as a nationwide roll-out of methadone maintenance therapy to

mitigate the addiction on opiate for drug users, and thus lower their risk of contracting

the HIV epidemic, may eventually turn out to be a successful model that the world can

draw lessons from. China also houses one of the four WHO Collaborating Centres for

Reference and Research for Influenza under the Global Influenza Surveillance and

Response System (GISRS).

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Global Outbreak Alert and Response Network (GOARN)

The Global Outbreak Alert and Response Network (GOARN) is a “multidisciplinary

network of technical and operational resources from over 200 global, regional and

national public health institutions, specialist public health networks in epidemiology,

infection control and biomedical sciences, networks of laboratories, many United

Nations organizations and international nongovernmental organizations”. It truly

connects different stakeholders in the world and attempts to bring all together in the

event of an epidemic outbreak. Nonetheless, given the involvement of so many parties

of different natures, delegates should investigate if the collaboration amongst these

stakeholders is really effective and more crucially, if it is on a scale of meaningful depth.

NGOs and other international organisations

Non-governmental organisations such as Médecins Sans Frontières (MSF) and the

International Committee of the Red Cross (ICRC) have traditionally been of great

contribution to international health and scientific research, at times acting more swiftly

and effectively than local governments and the UN. During the recent Ebola outbreak,

MSF (otherwise known as Doctors without Borders) was credited for ringing the first

alarms to the world on the scale of the epidemic. With experiences dealing with

previous Ebola outbreaks at nine other countries, medical personnel from MSF were

able to share their expertise with staff from other organisations – including WHO itself,

and the US Centres for Disease Control and Prevention. NGOs, too, have the insights

and expertise that are relevant to epidemic management and should be taken into

account in any framework concerning the issue. Delegates should consider if an

international framework that depends too NGOs is more holistic and sustainable, or if it

risks demanding too much beyond their capabilities and more fundamentally negates

the functions of states and the WHO in coordinating global efforts.

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Questions to Ponder

Delegates should seek to address the following questions during council debate.

1. What are the current protocols that WHO and other relevant international

bodies, such as the International Committee of the Red Cross, follow in the

event of an epidemic outbreak?

2. What are the current protocols that countries follow in the event of an epidemic

outbreak?

3. What are the unaddressed gaps in these protocols?

4. How can these protocols be strengthened in light of recent developments in

science and technology, amongst developments in other fields?

5. How effectively are these protocols carried out? Who are the stakeholders and

actors involved in the implementation of the protocols? Why is the effectiveness

of the implementation limited?

6. Are there are regional deficiencies or vulnerabilities against particular epidemic

threats, thus calling for collective measures on a regional scale?

7. What are the countries that face systemic difficulties in implementing epidemic

protocols? How can the UN best provide relevant support to these countries?

8. Are the current protocols and infrastructures sufficient in preparing for the next

major epidemic outbreak?

References

"Progress in the Ebola response." World Health Organization. Accessed February 10, 2017. http://www.who.int/csr/disease/ebola/response/en/.

"Ebola response phase 3: Framework for achieving and sustaining a resilient zero." WHO. Accessed February 23, 2017. http://www.who.int/csr/resources/publications/

ebola/ebola-response-phase3/en/.

"Middle East respiratory syndrome coronavirus (MERS-CoV)." World Health

HCCRI 2017 | Page ! of !22 24

Organization. Accessed February 23, 2017. http://www.who.int/mediacentre/factsheets/mers-cov/en/.

"The World Health Organization (WHO) - Structure." Encyclopedia of the Nations. Accessed February 23, 2017. http://www.nationsencyclopedia.com/United-Nations-

Related-Agencies/The-World-Health-Organization-WHO-STRUCTURE.html.

"WHO's Governing Bodies." World Health Organization. Accessed February 23, 2017.

http://www.who.int/governance/en/.

"Epidemic." Merriam-Webster. Accessed February 23, 2017. https://www.merriam-webster.com/dictionary/epidemic.

"The 10 Worst Epidemics In History." WorldAtlas. July 14, 2016. Accessed February 23, 2017. http://www.worldatlas.com/articles/the-10-worst-epidemics-in-history.html.

"Epidemic." Merriam-Webster. Accessed February 23, 2017. https://www.merriam-webster.com/dictionary/epidemic.

Wynne Musabayana. “Africa: The African Union's Intervention in the Ebola Crisis Was a Game Changer”. AllAfrica. February 11, 2016. Accessed February 25, 2017. http://allafrica.com/stories/201602121153.html.

Benido Impouma, Francis Kasolo, Adamou Yada, Zabulon Yoti, Sanyang Yaya, Celia

Woodfill, and Jean Baptiste Roungou. “Recurring epidemics in the WHO African

region: situation analysis, preparedness and response”. African Health Observatory.

Accessed February 25, 2017. https://www.aho.afro.who.int/en/ahm/issue/15/reports/

recurring-epidemics-who-african-region-situation-analysis-preparedness-and.

“About us”. European Centre of Disease Prevention and Control. Accessed February

25, 2017. http://ecdc.europa.eu/en/aboutus/Pages/aboutus.aspx.

“Top Countries Contributing To The United Nations”. World Atlas. August 4, 2016.

Accessed February 25, 2019. http://www.worldatlas.com/articles/top-countries-

contributing-to-the-united-nations.html.

HCCRI 2017 | Page ! of !23 24

Thomas H. Maugh II. “Swine flu danger appears to be ebbing”. Los Angeles Times. March 19, 2010. Accessed February 25, 2017. http://articles.latimes.com/2010/mar/19/science/la-sci-swine-flu20-2010mar20.

Jane Parry. “China’s pragmatic approach to AIDS”. Bulletin of the World Health

Organisation. April 2006. Accessed February 25, 2017. http://www.who.int/bulletin/volumes/84/4/news10406/en/.

Centres for Disease Control and Prevention. “H1N1 flu”. June, 2010. Retrieved 14 April 2017. https://www.cdc.gov/h1n1flu/cdcresponse.htm

Tay, J., et.al. “Influenza A (H1N1-2009) Pandemic in Singapore – Public health control measures implemented and lessons learnt”. Annals, Academy of Medicine Singapore.

June, 2010. Retrieved April 14, 2017. www.annals.edu.sg/pdf/39volno4apr2010/v39n4p313.pdf

Ministry of Health. “Influenza pandemic readiness and response plan”. January, 2009. Retrieved April 14, 2017. https://www.moh.gov.sg/content/dam/moh_web/PressRoom/

Current_Issues/2009/Main%20Document%20Public%20_Jan09.pdf

“WHO Collaborating Centres for influenza and Essential Regulatory Laboratories”.

World Health Organisation. January 10, 2017. Accessed February 25, 2017. http://

www.who.int/influenza/gisrs_laboratory/collaborating_centres/list/en/.

“Partners: Global Outbreak Alert and Response Network (GOARN)”. World Health

Organisation. Accessed February 25, 2017. http://www.who.int/csr/disease/ebola/

partners/en/.

Erika Hayden. “Ebola outbreak thrusts MSF into new roles” Nature. June, 2015. Accessed April 14, 2017. http://www.nature.com/news/ebola-outbreak-thrusts-msf-

into-new-roles-1.1769

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