Ebola crisis provides framework for responding to outbreaks like Zika virus

As world leaders grapple with containing the Zika virus, the Ebola epidemic in West Africa provides valuable lessons for how to respond to infectious disease epidemics, according to a policy report published by researchers at Princeton University and the Wellcome Trust.

Rebuilding local health care infrastructures, improving capacity to respond more quickly to outbreaks as well as considering multiple perspectives across disciplines during decision-making processes are among the key recommendations the authors propose.

The report, which was published in Science, states the World Health Organization (WHO) must again become the respected global health body with a clear mandate to provide global health leadership. This can only be made possible with binding commitments from the international community alongside an ability and willingness of WHO to lead, the researchers conclude.

Based on an international conference held in Dublin, Ireland - "Modern Plagues: Lessons Learned from the Ebola Crisis" - the report was written by Janet Currie and Bryan Grenfell, both based at Princeton University's Woodrow Wilson School of Public and International Affairs, and Jeremy Farrar, director of the Wellcome Trust. Farrar was a keynote speaker at the event, and Currie and Grenfell served as panelists.

"We hope that the Ebola crisis will provide the impetus to change the ways in which we prepare for and respond to epidemics, especially as new threats like Zika virus continue to emerge," the researchers wrote.

The researchers' recommendations are as follows:

• Strengthen local health care. During the Ebola epidemic, workers on the ground bore the brunt of the outbreak. More than 800 health care workers were infected, and 500 workers died. Therefore, strengthening and rebuilding these local health care infrastructures is the key to containing future outbreaks. This can be done by building trust within the health care system as well as political structures.
• Improve international response. The first cases of Ebola were confirmed in March 2014, and yet, the WHO did not declare it a public health emergency until August 2014. The WHO must be able to respond more quickly and with greater impacts going forward. By setting up a dedicated Center for Health Emergency Preparedness and Response, this could be achieved. Likewise, research should be coordinated during the time between epidemics as well as during outbreaks.
• Considering multiple perspectives. The Ebola crisis shows that social structures, living environments and human behavior all influence the course of an epidemic. Therefore, moving beyond disciplinary silos is essential. One example that illustrates this importance involves the development of safe, effective and deployable vaccines. A recent Ebola vaccine in Guinea has been successful, but it could have been deployed earlier. Developing an international cooperative to support the development and licensing of vaccines is an urgent priority.
• Acting synergistically. History shows that the best results occur when international bodies work in collaboration with local governments and health systems with a shared agenda in mind. Providing basic health services at a community level is the key to establishing trust, improving surveillance and creating capacity to mount a rapid response.

The article, "Beyond Ebola," was published online Feb. 18 as a perspective piece in Science. The review draws on themes developed at an international conference, "Modern Plagues: Lessons Learned from the Ebola Crisis," hosted by the Princeton-Fung Global Forum, held Nov. 2-3, 2015, in Dublin, Ireland.