G7, We Can Prevent Pandemics

Pandemics are back on the agenda for the 2016 G7 Summit, which convenes this week in Ise-Shima Japan. The Group of Seven is expected to further its commitments to global health security.
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Pandemics are back on the agenda for the 2016 G7 Summit, which convenes this week in Ise-Shima Japan. The Group of Seven is expected to further its commitments to global health security.

Look what has happened in less than one year since the G7 last met (June 2015), just after the Ebola crisis peaked at over 26,300 cases, 10,900 deaths.

Zika hit the Americas and beyond, causing agony for pregnant women, women who may become pregnant, thousands of newborns with Zika-related abnormalities, and their families. Yellow Fever reclaimed ground in Angola and the Democratic Republic of Congo, already infecting well over 2,000 people. Just last week WHO was considering it as an epidemic of international concern. MERS, cholera, influenza, dengue, chikungunya, and malaria persist -mostly in places where health systems are least equipped to contain infectious diseases.

The G7 has taken important steps to invest in pandemic response, including reaching out to over 70 countries, offering to help them implement the International Health Regulations (IHR), a set of regulations legally binding on 196 member nations of the World Health Organization. The aim of the IHR are to help countries protect themselves from disease threats and prevent worldwide infection. But only about 1/3 of the countries in the world currently have the ability to assess, detect and respond to public health emergencies, leaving massive gaps in our defenses against pathogens.

Investing in pandemic response is vital to safeguard people in every nation. At the same time, preventing future infectious disease outbreaks - which will happen - from exploding into regional epidemics and global pandemics requires much greater investment in prevention.

Look again. The perception is that Zika was an innocuous mosquito-borne African virus that suddenly snuck up on Latin America. But Zika began moving eastward from Africa a decade ago. Its arrival in Latin America might have been anticipated. It was not. The conventional wisdom was that Ebola was not in West Africa and in any case is a "dead-end event" because it kills its victims too quickly for them to spread it widely. Yet, scientists had evidence of Ebola in Central Africa 30 years ago. And it has always had the potential to break out. West Africa could have been alerted to the threat. It was not.

What if we could see viral and other microbial threats coming? Epidemics prevention requires development of more robust early warning systems to detect such threats. What if the same workforce that provides routine healthcare was trained and supported as part of a vigilant early detection and response system? In addition to providing primary care and universal health coverage, every public health system must be strong in disease surveillance and epidemic preparedness. For some known pathogens such as yellow fever, outbreaks can be prevented altogether through vaccinations that offer protection to entire populations.

Community mobilization and messages that support the adoption of healthy practices long before outbreaks hit are also necessary components of strong public health systems. As we learned during Ebola, long-standing community practices can lead to rapid transmission of infectious agents. Prevention requires extensive community engagement to improve hygiene, sanitation and vector control. It also requires greater integration across animal and human health to ensure diseases that jump the species barrier are accessed before they are able to pose a major health threat to humans.

The G7 has endorsed the Global Health Security Agenda, a critical global effort to strengthen public health systems around the world. I invite the G7 to also come on board with the No More Epidemics Campaign. Launched in 2015 by Management Sciences for Health and its partners Save the Children, the African Field Epidemiology Network, and the International Medical Corps, the campaign brings together governments, donors, multilateral institutions, civil society and the business community to ensure everyone is protected from epidemics--including by avoiding them in the first place.

Ebola's lethal legacy will remain for years to come. In West Africa alone, Ebola has erased 15 to 20 years of progress in maternal and child health. The epidemic decimated the already scarce workforce, killing doctors, nurses and midwives by the hundreds. With fewer health workers, the World Bank warns of an additional 4000 maternal deaths and 14,000 child deaths each year in Guinea, Liberia, and Sierra Leone.

What will be Zika's legacy? In Brazil alone, as many as 3000 babies may be born with microcephaly before the end of the year. How many more in other parts of the Americas?

How can we prepare not only to respond to epidemics once they start, but to actually stop them from happening?

Are we ready and willing to prevent epidemics, forever?


ABOUT THE AUTHOR: Dr. Jonathan Quick is President, Management Sciences for Health, a Harvard Medical School faculty member, and author of The End of Epidemics: The looming threat to humanity and how to stop it. (St. Martin's Press/Macmillan, U.S. and Scribe, UK and Australia, 2017)