The Next Ebola: Can We Do Better?

The human catastrophe of the Ebola epidemic that began in 2013 shocked the world’s conscience and created an unprecedented crisis. An independent panel of global experts has called for critical reforms to prevent future pandemics. The group of 19 experts, convened by the Harvard Global Health Institute (HGHI) and the London School of Hygiene & Tropical Medicine, has issued its analysis of the global response to the 2014-15 Ebola outbreak in West Africa, published in The Lancet.

The report outlines 10 recommendations to prevent future such catastrophes, with emphasis on: preventing major disease outbreaks; responding to outbreaks; the production and sharing of research data, knowledge, and technologies; and ways to improve the governance of the global health system, with a focus on the World Health Organization (WHO). Taken together, the Panel’s ten recommendations provide a vision for a more robust, resilient global system able to manage infectious disease outbreaks.

Panel members represent academic institutions, think tanks and civil society, with expertise in Ebola, disease outbreaks, public and global health, international law, development and humanitarian assistance, and national and global governance.

Panel Chair Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine and co-discoverer of the Ebola virus said: "We need to strengthen core capacities in all countries to detect, report and respond rapidly to small outbreaks, in order to prevent them from becoming large-scale emergencies. Major reform of national and global systems to respond to epidemics are not only feasible, but also essential so that we do not witness such depths of suffering, death and social and economic havoc in future epidemics. The AIDS pandemic put global health on the world's agenda. The Ebola crisis in West Africa should now be an equal game changer for how the world prevents and responds to epidemics."

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In addition to over 11,000 deaths from Ebola, the epidemic "brought national health systems to a halt, rolled back hard-won social and economic gains in a region recovering from civil wars, sparked worldwide panic, and cost several billion dollars in short-term control efforts and economic losses."

"The most egregious failure was by WHO in the delay in sounding the alarm," said Ashish K. Jha, Director of the Harvard Global Health Institute, K.T. Li Professor of International Health at the Harvard T.H. Chan School of Public Health (Harvard Chan) and a professor of medicine at Harvard Medical School. "People at WHO were aware that there was an Ebola outbreak that was getting out of control by spring...and yet, it took until August to declare a public health emergency. The cost of the delay was enormous," said Jha.

The report's 10 recommendations provide a roadmap to strengthen the global system for outbreak prevention and response:

1.  Develop a global strategy to invest in, monitor and sustain national core capacities
2. Strengthen incentives for early reporting of outbreaks and science-based justifications for trade and travel restrictions
3.  Create a unified WHO Centre with clear responsibility, adequate capacity, and strong lines of accountability for outbreak response
4. Broaden responsibility for emergency declarations to a transparent, politically-protected Standing Emergency Committee
5. Institutionalise accountability through an independent commission for disease outbreak prevention and response
6. Develop a framework of rules to enable, govern and ensure access to the benefits of research
7. Establish a global fund to finance, accelerate and prioritise R&D
8. Sustain high-level political attention through a Global Health Committee of the Security Council
9. A new deal for a more focused, appropriately-financed WHO
10. Good governance of WHO through decisive, timebound reform and assertive leadership

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According to Liberian Panel member Mosoka Fallah, Ph.D., MPH, of Action Contre La Faim International (ACF). "The human misery and deaths from the Ebola epidemic in West Africa demand a team of independent thinkers to serve as a mirror of reflection on how and why the global response to the greatest Ebola calamity in human history was late, feeble and uncoordinated. The threats of infectious disease anywhere is the threat of infectious disease everywhere," Fallah said. "The world has become one big village."

"We gathered world-class experts and asked, how can we bolster the dangerously fragile global system for outbreak response?" said the Panel's Study Director, Suerie Moon, MPA, PhD of the Harvard T.H. Chan School of Public Health and Harvard Kennedy School. "Now, the billion-dollar question is whether political leaders will demand the difficult but necessary reforms needed before the next pandemic. In other words, will Ebola change the game?"

"There is a high risk that we will fail to learn our lessons," said the Harvard Global Health Institute's Ashish Jha. "We've had big outbreaks before and even careful reviews after, but often the world gets distracted. We owe it to the more than 11,000 people who died in West Africa to see that that doesn't happen this time."

The report was launched in London on 23 November.

Source: London School of Hygiene & Tropical Medicine
Image credit: Pixabay