Are we “grossly underprepared” for future outbreaks of infectious disease?

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In a new study, published recently in the BMJ, a team of international experts have analyzed shortcomings in the global response to the 2014 Ebola crisis and have warned that the world is “grossly underprepared” for future outbreaks of infectious disease.

In August 2014 the WHO declared Ebola a “Public Health Emergency of International Concern” prompting a global scramble to respond. In the wake of the crisis many reports were published analyzing what went wrong, and what could be improved. However, the priorities highlighted in these reports, and whether action has been taken on these, have never been clearly assessed.

This study suggests that a more coordinated response to Ebola might have prevented up to 11,000 deaths, in addition to resultant social and economic crises. In light of this, the researchers reviewed seven major reports on the West African Ebola outbreak with the aim of identifying areas of disease response that require improvement. The team then evaluated the progress made towards these suggested reforms and investigated how the remaining gaps could be addressed.

The team discovered that, while the reports all varied in scope and emphasis, their diagnosis of key problems and their suggestions for improvements were all similar. The recommendations converged in three critical areas: strengthening compliance with International Health Regulations (IHR), improving the sharing of outbreak-related research and knowledge and finally reforming the World Health Organization (WHO) and broader humanitarian response system.

The researchers suggested that significant efforts are starting to be undertaken in order to address these issues, however, some critical issues have not yet been addressed and progress is mixed. For example, the infrastructure for fair and timely sharing of patient samples remains weak; in addition, it has been difficult to track investments in country capacity building.

The authors write: “We found remarkable consensus on what went wrong with the Ebola response and what we need to do to address the deficiencies. Yet not nearly enough has been done.”

They concluded: “We will not be ready for the next outbreak without deeper and more comprehensive change.”

Source: Moon S, Leigh J, Woskie L et al. Post-Ebola reforms: ample analysis, inadequate action, BMJ. doi:10.1136/bmj.j280 (2017) (Epub ahead of print) http://www.bmj.com/company/wp-content/uploads/2017/01/infectious-diseases-the-bmj.pdf

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