When thinking of global health emergencies, including pandemics and terrorism, and after all the preparedness measures, here’s our big question:

Are we safer now?

That’s the sort of rhetorical ask that is meant to lead into the same sad answer: “NO! Everything is getting worse.” But not so fast: The answer we expected is not what we got when we spoke with Brad Goble, a Canadian consultant working around the world, including with NATO and with the Global Health Security Initiative community. He surprised us by responding to our question about the state of the world’s security by saying this:

“I’ve been extremely optimistic. We have made enormous progress in the last 50 years, and particularly the last few years. We have made the world safer.”

Naturally, we wanted to hear more. “The global effort really started after 9/11,” he began. “Then, in 2007, we had the Global Health Security Agenda. But it was in 2020, when we had the first pandemic of our era, that we discovered just how underprepared we had been and that’s when lots of lessons were learned.”

Brad suggested that one of the most significant responses to the pandemic was the creation of by the EU of HERA, the Health Emergency Preparedness and Response Authority. Of that organization, he told us, “The European countries really did respond, demonstrating that they are taking health security seriously.” An article from the journal Health Policy put “seriously” in perspective: “The European Union (EU) Health Emergency Preparedness and Response Authority (HERA) is a new Directorate-General within the European Commission. With a budget of at least €1 billion per annum, about the same as the World Health Organization (WHO) holds in its core budget, HERA is set to become a major global health player.” The goals of HERA included what’s called “horizon scanning”, the monitoring of potential health threats, but also the support for increased drug and vaccine manufacturing capacity, and the stockpiling of medical countermeasures.

Indeed, Brad points out, “There is a shift in the international scene. For many years, the U.S. held the keys to advances in health security; but now global units are recognizing that they need to become more engaged. The world is paying more attention.”

One current example of international cooperation is mpox (the virus originally known as monkeypox, thanks to its discovery among medical research monkeys in Denmark in 1958). “When the WHO brought monkeypox onto the international stage,” Brad explained, “the international community pushed significant support into Africa. This was a positive development, but it also served to keep possible pandemics at bay. Organizations around the world now understand the incentive to get engaged.”

Brad did interject one note of concern, and that involved the WHO’s Global Pandemic Treaty. The WHO includes 194 member states and the treaty is designed to increase collaboration around pandemics. Collaboration seems like the sort of goal everyone can get behind, but two years on, the full agreement has yet to be signed, with the chief obstacle being legally binding rules on vaccine-sharing. He said, “Given the change in the political climate, there is uncertainty about the role of the United States in international agreements and specifically the Pandemic Treaty.”

This relates to Brad’s assessment that more nations and organizations have been stepping up support: “Concerns about the U.S. involvement has been a net positive because of that increased support elsewhere.” He went on to add, “Being Canadian and having worked with the United States, it has been fascinating and a privilege to be involved in work with those from the U.S. I am gob smacked by the capabilities and leadership among the people of the U.S. international health safety system. The two most important traits for change are collaboration and trust, and those are the very things we have counted on from our American colleagues. Their collaboration and trust have driven enormous progress. Without the U.S., should they really pull back from international efforts, we could have a speed-wobble and even go backwards, but hand to heart, I think we will continue to work together to make the world safer.”

Speaking of world safety, we know that Brad’s work has included dealing with the effects of the Russia-Ukraine War. More positive news: “Given the new administration in the U.S., the EU is now working on post-conflict needs. NATO is now working to cauterize against future conflict.”

And, finally, we asked Brad to reflect on where he sees his international work headed: “I come from a military background and now also work in public health. Think about the amount of money spent on each of those. And when it comes to global security, there are synergies. That the conversation we’re having now, how to bring both defense and public health together in ways that stop wasting money.”

(START SIDEBAR)

We got to interview Brad last year, and you can read more about his counter-terrorism work in “Something Wicked This Way Comes” at

Something Wicked This Way Comes And Where You Fit Into The Defense

Here is the brief bio from that article.

BRAD GOBLE and

The day the world got smaller

Goble is Canadian, a graduate of the Canadian version of West Point, the Royal Military College, and served fifteen years in the military. He described how he came to be involved in the fight against the CBRN threats (Chemical, Biological, Radiological, Nuclear):

“I backed in. The General I had worked for was retiring and I was ready for a new career. So I’d gone back and gotten an MBA from Queens University, and I became one of the people working to create the Canadian version of the CDC. This was right before 9/11. After that happened, the world got smaller, and we became more focused on new and emerging threats. Not long after 9/11, Tommy Thompson, then Secretary of HHS, came to Canada to meet with our Minister of Health, and out of those meetings came the Global Health Security Initiative – bringing together the ministers of health from the G-7 countries, Mexico, the WHO and the European Commission.  I was one of the people assigned to figure out how the international community prioritized investments against threats.”

(Photo: Brad Goble outside the United Nations HQ in Geneva)

“After 9/11, we were paying more attention to what the bad actors were doing,” Goble explained, “working to assess the new threats and to coordinate the work of defense departments and health organizations.” Included in that work was the development of plans to deal with terrorist attacks, which Brad summed up this way: “We couldn’t assume rational behavior – we have to assume crazy.”

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STATS OF THE MONTH

Does the Geography of Population Change Really Matter?

By Bill Davenhall, Geospatial Advocate

Sometimes just the way organizations group and present data makes you stop and think — like TED talks analytics perhaps?

Here is a typical example of a recent update of population data collected and published by a commercial demographic research company (Scan\US, LLC).  It contains 2024 estimates from the US Census Bureau and estimated population counts by 12 age groups they selected from among a host of various combinations.  It probably reflects what most demographic researchers would want to see.  Healthcare of course, has interest in many of these groupings, largely influenced by decades of use by groups like the DHHS and the CDC.

While it may look a bit daunting to many, it’s a straightforward table of population counts by age groups. Does anything “pop” out to you? – Do your eyes quickly search for the  significant increases and decreases represented in this chart and does this quick look suggest some ideas or concerns about what your observing? Are there other discoveries looming here? Does it encourage you to become curious about what some of these estimated changes (maybe trends)  portend for the various “geographic patches” of the population you care most about?

So here is what jumped out at me:

•  Serious growth among populations living in Non-Family Households. Do you understand the impacts of this?
• Conversely, there are far fewer people living in what has been more traditional Family Households. Interesting ideas here?
• Five (5)  million more people in 2029 will be over 75 years of age. Surprised this is a growth market?
• 346,553 fewer children under 5 years of age showing up by 2029? Any alarm bells ringing yet?
• 1 million fewer children 5-14 years of age by 2029? Create angst in your organizational plans?
• 8.3 million new people expected by 2029?  Will you lose any sleep over this trend?
• 55–64 year-olds in 2029 will be rare. Who knew?

Planning for and delivering your messaging and solutions to the various groups in all the geographies you care about, is no easy task. It requires a lot of analytics and understanding of the populations that you will serve. Geographical analysis of your data could be the best antidote for the pain of unexpected surprise.

As always, I appreciate a 2^nd opinion,

                                Population Changes by Age Group, 2024-2029