1. Global Health Engagement BGen Hugh Colin MacKay OMM, CD, MD Surgeon General Canada AMSUS 2015 - San Antonio, Tx December 03, 2015

2. Statement of Speaker Disclosure I, members of my immediate family and partners, have NO financial arrangement or affiliation with a commercial interest as defined by the Accreditation Council for Continuing Medical Education. In addition, I do not intend to reference unlabeled/unapproved uses of drugs or products in my presentation. BGen Hugh Colin MacKay

3. Session Objectives 1. Review the importance of health to security. 2. Review Canada's Global Health Engagement.

4. Agenda Complexities of health and security The delicate ecosystem of a developing health system Military engagement Whole of Government

5. Health and Security…are they linked? 1994 United Nations Human Development Report introduced the concept of human security. Concept of security as protecting a territory from external aggression to a much greater stress on the security of the people themselves.

6. Health and Security…are they linked? Main components of human security by the UN: –Economic: creation of employment and measures against poverty. –Food: measures against hunger and famine. –Health: measures against disease, unsafe food, malnutrition and lack of access to basic health care. –Environmental: measures against environmental degradation, resource depletion, natural disasters and pollution. –Personal: measures against physical violence, crime, terrorism, domestic violence and child labour. –Community: measures against inter-ethnic, religious and other identity tensions. –Political: measures against political repression and human rights abuses.

7. Securitization of Illness “many of us used to think of AIDS as a health issue. We were wrong... Nothing we have seen is a greater challenge to the peace and stability of African societies than the epidemic of AIDS... We face a major development crisis, and more than that, a security crisis.” James Wolfenson, president of the World Bank (2000)

8. Newly Emerging Infectious Diseases Severe Acute Respiratory Syndrome (SARS)had all the features that made it an international security threat. –It spread easily from person to person; –It did not require a vector; –It incubated quietly for about a week; –It mimics many other common illnesses; –It took a heavy toll on medical staff and –It had a high mortality rate

9. Influenza One of the most feared security threat today is pandemic influenza. The bigger concern - Emergence of a new form of influenza that is more virulent.

10. Health and Nations Stability Ebola killed just over 11,300 people SARS killed 774 and 5 people died as a result of the anthrax attacks in the US But…

11. Health and Nations Stability Each year over 250,000 children under the age of five die from diarrhea; mainly as a result of poor water, poor sanitation and dysfunctional health systems. When developing nations do not have good sanitation, quality food, clean water and a well-functioning health care system, their citizens suffer and this suffering has an impact on the stability and security of that nation. The lower the Human Development Index, the higher the Fragile State Index

12. A Developing Health System Developing nations have little to invest in health Clinicians have options elsewhere Citizens have little money to pay for services or medication Outside “investors” can have both a positive and a negative effect.

13. Global Health Engagement and the Role of the Military

14. Whole of Government Response Global Affairs Canada Public Health Agency of Canada Canadian Armed Forces

15. Canadian Armed Forces Engagement

16. Conclusion

17. Questions?