We do not yet have a reliable or robust global system for preventing, detecting, and responding to disease outbreaksSuerie Moon
Led by Professor Suerie Moon at the Graduate Institute of International and Development Studies in Geneva, the researchers looked at progress and gaps in actions and concluded: ‘Ebola and, more recently, Zika and yellow fever, have demonstrated that we do not yet have a reliable or robust global system for preventing, detecting, and responding to disease outbreaks.’
The warning came after the team reviewed reports on the recent Ebola virus outbreak in West Africa and say better preparedness and a faster, more coordinated response could have prevented most of the 11,000 deaths directly attributed to Ebola and also the broader economic, social, and health crises that ensued.
In August 2014, the World Health Organisation (WHO) declared the Ebola outbreak in West Africa a Public Health Emergency of International Concern (PHEIC).
In the aftermath, several reports were published reviewing what went wrong and how infectious disease outbreaks should be better managed.
However, a lack of clarity in terms of the main priorities and proposed reforms, led the researchers to look closer, synthesising seven major post-Ebola reports to assess recommendations and progress.
Their findings recognised that the reports differed in scope and diagnosis of the key problems and recommendations for action converged in three critical areas: strengthening compliance with the International Health Regulations (IHR); improving outbreak-related research and knowledge sharing; reforming the World Health Organisation (WHO) and the broader humanitarian response system.
According to the team, so far progress has been mixed in addressing the issues raised. Key problems include the fact that investments in country capacity building have been inadequate and difficult to track; arrangements for fair and timely sharing of patient samples remain weak, and reform efforts at the WHO have focused on operational issues but have neglected to address deeper institutional shortcomings.
The analysis authors say they found ‘remarkable consensus on what went wrong with the Ebola response’ and what is needed to address the deficiencies but so far ‘not nearly enough has been done’.
Warning: prepare or face significant threats
Moon has warned that being underprepared for infectious disease is one of the most significant threats facing the global community: ‘The risk of emerging infectious diseases is increasing due to environmental degradation, increased human-animal interaction, urbanisation, intensified trade and travel, and inadequate investment in health systems.
‘It poses risks to all countries - the richest, poorest and all countries in between. The losses in human lives, health, and economic activity would be devastating. Estimates based on the risk of a major pandemic over the next century have found annualised losses in the range of between $60-$570 billion.’
In terms of next steps to avert crisis, Moon acknowledges that there has been significant progress since the 2014 Ebola outbreak. ‘But the glass is still half-empty, maybe even less than half,’ she warned. ‘Many different organisations need to take action to improve preparedness - local and national governments, intergovernmental organisations, companies, NGOs, academic institutions, and others.
‘I’d say three ingredients are especially crucial now: political leadership to keep the issue on the global agenda, financing from richer and poorer countries alike, and a system to monitor what is and isn’t being done in order to achieve mutual accountability.’
The researchers urge the global community ‘to mobilise greater resources and put in place monitoring and accountability mechanisms to ensure we are better prepared for the next pandemic’. Failure to do so, they conclude, could mean the world will not be prepared for the next outbreak.
Dr Suerie Moon is Director of Research at the Global Health Centre, Graduate Institute of International and Development Studies in Geneva and adjunct Lecturer on Global Health at the Harvard T.H. Chan School of Public Health. She was also Study Director of the Harvard-LSHTM Independent Panel on the Global Response to Ebola and co-founded and led the Forum on Global Governance for Health, a focal point at Harvard University for research, debate and strategic convening on issues at the intersection of global governance and health. Her research and teaching focus on global governance and the political economy of global health, focusing on areas such as outbreak preparedness and response.