Let’s Fix It: Getting Ready for the Next Ebola

In this series of posts, Influencers explain what they wish they could fix — and how. Read all the stories here and write your own (please include the hashtag #FixIt in the body of your post).

How did we get here? As I write this, thousands of children, women and men are dying horrible deaths from a preventable and treatable disease. The Ebola crisis raging in West Africa has provided a hard dose of reality for those who care about global health. It has shown that, despite our tremendous gains in health in recent decades, we remain woefully unprepared to identify and quickly respond to global public health emergencies. This is one thing that, if I could, I would fix.

The Ebola crisis, as shocking as it is, does not come as a surprise to those who are deeply engaged in global health. The fact of the matter is that we do not currently have a coordinated global system for quickly and effectively responding to public health threats. At the UN General Assembly in New York last month, UN Secretary General Ban Ki-moon rightly called for an unprecedented coalition to come together to combat Ebola. That same coalition — before it disbands and as its final act – should present a recommendation and vision for a powerful emergency response mechanism for health.

I recently spoke with columnist David Brooks as he was preparing a piece for the New York Times about our collective failure to build institutions that can respond to emerging health threats. In Brooks’ article, he compared our approach to meeting global health crises to throwing together an ad hoc team to extinguish a fire every time a new one rages, rather than building a permanent fire department that is ready whenever a fire occurs.

We know that institutional solutions can be hugely effective in combatting disease. In the US, the CDC (originally set up to contain the malaria epidemic ravaging the U.S. South) is a national institution that has been tasked – and funded – since 1946 with protecting public health and safety through the control and prevention of disease. We have a highly functioning system for quickly detecting and addressing problems. The CDC is not infallible, but it is a superb evocation of a systematized health response mechanism.

The closest international example we have to a response mechanism is the World Health Organization. Established in 1946, it is, according to its own website, “responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.” On the emergency response front, WHO is fortified by the International Health Regulations (IHR), a legal instrument that binds 196 countries to help the international community prevent and respond to acute public health risks, requiring countries to report certain disease outbreaks and public health events to WHO.

The WHO budget, however, is roughly one-third that of the Centers for Disease Control (CDC). If we believe that the WHO can or should be our global “fire fighter,” then, to date at least, we have not been serious about it.

Nigeria provides another excellent example of how an institutionalized system can support containing a health crisis, and how important country leadership is to supporting an overall global response system. As you may know, Nigeria also had confirmed Ebola cases in its borders, though the outbreak was limited to far fewer people than in Liberia, Sierra Leone and Guinea. It was successfully contained in part by the government taking swift action and leveraging an existing community health worker-based response system for polio, and converting it into one that could address Ebola.

The three most affected countries in the current Ebola outbreak are heavily rural, among the poorest on earth and supported by very weak health infrastructures. This volatile combination enabled Ebola to spread for months without proper detection or urgent enough response mobilization. Worst-case projections for Ebola contagion are dire. We all hope that the global response – spearheaded by the UN with welcome leadership by the U.S. government, UK, and France, funding from the World Bank, and commitments from several other governments, donors, and NGOs such as Doctors Without Borders (who sounded the initial alarm) – will be able to contain and end this outbreak.

My fix-it wish is that the lasting legacy of the Ebola crisis is a firm commitment and action to build the foundation for a true global emergency response system to health threats. The next health crisis will arrive somewhere on earth, that is for sure. Now is the time to ready ourselves for that eventuality, no matter where or when it occurs.

How you can help: The Ebola Survival Fund has been created to support a coalition of community-based organizations working in Liberia and Sierra Leone to complement the efforts of the larger-scale programs being implemented by international organizations. Learn more here. Save The Children has created an Ebola Children’s Relief Fund to build Ebola health centers, care for orphans, train health workers and provide protective kits and essential medical equipment. Learn more here.

Photo: Petra Silhava and DonkeyHotey / Flickr Remix: LinkedIn