You could die one day from a global epidemic. In our connected world people, goods, information, cultural influences — and disease — travel at remarkable speed. SARS, Lassa fever, Ebola and something called Crimean-Congo Hemorrhagic Fever are on the World Health Organization’s list of eight emerging diseases likely to cause epidemics. And don’t forget the flu. More than 50,000 people could die from the flu in the United States this season.
To be clear, I am not an alarmist. I don’t see a bogeyman behind every bush or scream “the sky is falling” with every bit of bad news. I am an optimist, actually, and a believer in the power of our public health institutions to keep us safe. Those institutions need and deserve our full support. That’s why I am watching current discussions about possible reductions in federal funding to prevent infectious-disease epidemics with, well, a level of alarm. The Wall Street Journal recently reported the Centers for Disease Control and Prevention plans to scale back or discontinue its work to prevent epidemics and other health threats in 39 countries.
I’m shocked this issue is receiving relatively little attention when, just a few years ago, there was massive hysteria and panic around the Ebola outbreak. We seem to have forgotten airport quarantines of Ebola fighters, the tracking of health workers returning from the frontlines and the vilification of a doctor who had no symptoms for riding the New York City subway.
Prevention is the key to keeping us safe and disease surveillance is a key to good prevention. Surveillance systems that provide early warnings to potential epidemics allow us to react quickly and limit the spread of disease and global impact.
We know how costly it is to respond to a full-blown epidemic. I was deeply involved in the response to the Ebola outbreak in West Africa. In fact, we staffed one of the Ebola Treatment Units in Liberia, in partnership with the International Organization for Migration. The time, effort and cost it took to build that ETU and recruit a medical team while the Ebola epidemic was raging were enormous — worth it, but enormous. I witnessed this first hand while in Liberia as we sought final approvals from U.S. and Liberian authorities to open the ETU.
Responding is the costly part of dealing with an epidemic. Surveillance to catch epidemics before they rage is cheap by comparison. As global threats increase, we would be wise to fully fund surveillance and other prevention programs.
A colleague in the global health field Dr. Jonathan Quick, former CEO of Management Sciences for Health, recently published a book on the topic called The End of Epidemics. Based on learnings from the global response to five major epidemics, he prescribes seven actions that should be taken to limit the impact of epidemics. One of them is simply, “spending wisely to prevent disease before an epidemic starts.”
Dr. Quick doesn’t say, “throw money at this problem.” He has been at this work long enough to understand the limits of national and global budgets. His call is to “spend wisely.”
To spend adequately on strong surveillance mechanisms is to spend wisely. Here’s hoping the decision-makers in Washington heed that call.