Global health security is defined as the proactive and reactive activities required to minimise the danger and impact of acute public health events that endanger people’s health across geographical regions and international boundaries.

Population growth, rapid urbanization, environmental degradation, and the misuse of antimicrobials are disrupting the equilibrium of the microbial world. New diseases, like COVID-19, are emerging at unprecedented rates, disrupting people’s health and causing negative social and economic impacts.

Billions of passengers travel on airplanes each year, increasing the opportunities for the rapid international spread of infectious agents and their vectors.

The use of chemicals in agriculture and industry has increased, as has an awareness of the potential hazards for health and the environment. Air quality may decline with increasing urbanisation and the increasing use of fossil fuels. As the globalisation of food production increases, so does the risk of tainted ingredients and foodborne diseases. With the world’s population becoming more mobile and increasing economic interdependence, these global health threats increase. Traditional defences at national borders cannot protect against the invasion of a disease or vector. Pandemics, health emergencies, and weak health systems.

Climate change effects, including sea-level rise, coastal erosion, extreme weather events and flooding, hold immediate and long-term threats to health. Effects on the marine eco-systems will adversely impact food availability and quality and elevate the risk of toxicity.

One-Health Approach
The One Health approach51, which promotes multi-stakeholder collaboration to achieve better public health outcomes, is yet to be well understood and appreciated by the different sectors. One key aspect of One Health is the collaborative, multi-sectoral, and transdisciplinary approach working at the local, regional, national, and global levels, to achieve optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. It aims at designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work towards the prevention of illnesses and disease outbreaks in people. There is an urgent need to build strong partnerships with non-health sectors to prevent effectively detect, prevent and respond to zoonosis and food safety problems.

A Joint External Evaluation conducted in 2018 systematically evaluated the strengths and weaknesses of the different sectors and derived a plan of action for implementation by all the relevant sectors. The National Action Plan for Health Security will guide the process to strengthen this multi-sectoral collaboration.

Integrated Disease Surveillance and Response (IDSR) and IHR capacity
Seychelles has validated the adapted 3rd Edition IDSR Technical Guidelines since August 2019. Rollout of the guidelines, including training, was planned for 2020, but has been delayed because of the COVID pandemic. These revised guidelines is will support the implementation of a robust disease surveillance system for early detection of outbreaks and swift response.

Non-Communicable Diseases
NCDs cause considerable morbidity and are the leading causes of death. The country is implementing the National Strategy 2020- 2025 that was developed in line with global recommendations. While there has been a decrease in the prevalence of smoking over recent years, there are increases in obesity, and diabetes; in particular, rising obesity among children is alarming.

A more coordinated and integrated national approach and actions is vital for efficient and effective A more coordinated and integrated national approach is vital for efficient and effective intervention surveillance, prevention, detection, screening, treatment and control of NCDs and palliative care. These are key components of the response to NCDs to meet national and global targets to reduce the burden of NCDs.

Communicable Diseases
Seychelles detected its first case of COVID-19 in March 2020 and moved quickly to implement required public health measures and health system response. The country experienced a surge in cases in April-June 2021, with COVID-19, directly and indirectly, leading to excess mortality in 2021. COVID-19 has also negatively affected all the building blocks of the health system and the national economy.

Other communicable diseases of importance for Seychelles are HIV/AIDS, Viral Hepatitis C, Dengue and Leptospirosis. Like the rest of the world, the country conducts surveillance for newly emerging or reemerging diseases that threaten health security.

The country is committed to achieving the global goal to end HIV/AIDS as a public health threat by 2030. In the two years before the COVID-19 pandemic, HIV testing increased; however, more efforts are needed to implement effective biomedical prevention interventions at scale and for better HIV treatment and care outcomes.

Several factors contribute to the increase in dengue infections the country has recorded over the last five years; they include high mosquito density, susceptibility to circulating serotypes, favourable air temperatures, precipitation, and humidity. Although no studies were done recently, these can be linked to change in weather patterns due to climate change.

Vaccine-preventable, foodborne, zoonotic, healthcare-related and communicable diseases pose significant threats to human health and may sometimes threaten international health security. Socioeconomic, environmental and behavioural factors, as well as international travel and migration, foster and increase the spread of communicable diseases.

Health Regulatory Structure
The private health sector is expanding rapidly, and the number of private healthcare facilities has increased over the years, including pharmacies, health clinics, and diagnostic laboratories. There is a need for strong regulatory instruments and monitoring to ensure that all private health facilities adhere to norms, regulations and good practices. Currently, required legal instruments are either lacking or outdated and cannot respond to the continued development and expansion of the private health sector.

Presently the Seychelles Licensing Authority licenses these activities and the concern is that once a license is issued, there is no follow up and ensure compliance. The PHA has been given the task of developing the necessary legislation, tools and processes for regulating the private health sector.

1. Strengthen the One Health approach.
2. Implement the IHR to prevent and swiftly detect outbreaks.
3. Implement IDSR.
4. Develop and strengthen regulatory function of the PHA.
5. Improve public health standards and legislative documents.
6. Strengthen public health law enforcement.
7. Strengthen public health programmes.

To promote and protect health security, through the:

• Strengthening and implementation, in collaboration with national and international partners, the One Health Approach, in line with the IHR and IDSR.
• Development and implementation of legal instruments and national standards in accordance with the provisions of the Public Health Authority Act 2013.
• Strengthening of public health programmes.

^{51 WHO. https://www.who.int/news-room/questions-and-answers/item/one-health}