Exploring Lessons Learned from a Century of Outbreaks Readiness for 2030: Proceedings of a Workshop (2019) / Chapter Skim
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5 Building Local and National Capacities for Outbreak Preparedness
5 Building Local and National Capacities for Outbreak Preparedness
Pages 61-74
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From page 61... ...
Moderator Suerie Moon, director of research at the Global Health Centre, The Graduate Institute of International and Development Studies, emphasized that community- and national-level preparedness serve as the first line of defense against any infectious disease outbreak, a concept that was codified in the 2005 revision of the International Health Regulations (IHR) in the aftermath of the severe acute respiratory syndrome (SARS)
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From page 62... ...
in Saudi Arabia in 2012 and changes that have been made in the country's public health systems in the past few years. Mosoka Fallah, deputy director general for technical services of the National Public Health Institute, Liberia, described the lessons learned from the Ebola outbreak of 2014 and progress made in developing core capacities to respond to future outbreaks in Liberia.
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From page 63... ...
To address MERS, he explained that the government has also created a high-level, multidisciplinary One Health team comprising experts from three ministries directly related to zoonotic diseases. While the scientific community in Saudi Arabia has learned from the experiences of MERS-CoV and has moved into a stronger position to prepare for, detect, and respond to infectious disease threats, they have continued to struggle with two country-specific challenges related to infectious disease transmission and outbreaks.
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From page 64... ...
SOURCE: Assiri presentation, November 27, 2018. the Ebola outbreak struck, the country's poor health infrastructure and limited laboratory capacity delayed detection of the disease and precipitated its transmission.
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From page 65... ...
He described some of the lessons learned during the Ebola outbreak, and practices that have since been introduced. To alleviate the burden on the Ministry of Health, Liberia created an independent National Public Health Institute in 2017 to carry out surveillance and develop laboratory capacities.
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From page 66... ...
Leung described some of the capacity-building efforts that have been implemented in Hong Kong since the 2003 SARS outbreak in order to reduce infectious disease transmission, improve public messaging, strengthen early detection, and build laboratory capacity. A set of progressive interventions was implemented in local farm wholesale and retail poultry markets to reduce influenza transmission.
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From page 67... ...
BUILDING LOCAL AND NATIONAL CAPACITIES 67 FIGURE 5-1 Progressive introduction of market-based interventions in Hong Kong to help reduce influenza transmission. SOURCES: Leung presentation, November 27, 2018; reprinted from The Lancet, Vol.
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From page 68... ...
LESSONS FROM WORKING IN THE FRONTLINES WITH LOCAL COMMUNITIES AND INTERNATIONAL ORGANIZATIONS Amanda McClelland, senior vice president of Prevent Epidemics at Resolve to Save Lives, reflected on her global experience working at the interface of communities and health systems. After years focused on engaging community and health care workers, she has come to realize that capacity building and shifting the course of an epidemic ultimately sits with politicians.
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From page 69... ...
DISCUSSION Remarking on the presentations, Suerie Moon, director of research at the Global Health Centre, The Graduate Institute of International and Development Studies, observed that the improvements in capacity building and knowledge gathering described by panel participants are grounds for optimism, but a number of challenges persist. Realistically, it is unlikely 5 The Resolve to Save Lives platform with resources and JEE country data can be found at https://www.preventpandemics.org (accessed February 26, 2019)
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From page 70... ...
Current National Challenges to Manage a Potential Major Disease Outbreak Moon asked Fallah, Assiri, and Leung about the current state of preparedness at the national level, including challenges they continue to face. Specifically, she asked Fallah how national public health institutes in resource-constrained settings might encourage investment in preparedness, despite competing priorities related to the day-to-day provision of health care services.
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From page 71... ...
Although Saudi Arabia's investment in improved infection control within health care facilities has strengthened its preparedness to control future outbreaks, improvements in preparedness have not yet expanded to other infectious diseases or hazards, because efforts have focused primarily on MERS. For example, Saudi Arabia has largely reduced the risk of animal-to-human transmission of MERS by enacting laws to prevent the importation of camels into the Hajj area; as a result, he said influenza transmission is a greater concern during Hajj than MERS-CoV.
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From page 72... ...
Assiri commented that advocacy for preparedness requires keeping decision makers on their toes -- for example, seven ministers were replaced in Saudi Arabia due to the MERS outbreak. This directly led to a sevenfold increase in the public health budget between 2012 and 2018, he stated, and it also changed the way that other diseases are addressed.
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From page 73... ...
In terms of public health, it is difficult for a politician to prioritize investing in an emergency operations center that is activated only once per year over investing in maternal and child health; similarly, she added, it is easier to mobilize a community to demand better maternal and child health care than to demand better infectious disease outbreak preparedness. She underscored that motivating investment in preparedness needs to be country- and community-specific, and suggested taking a strategic view -- country by country and community by community -- to assess the risks, risk perceptions, and choices that communities and governments make to prioritize preparedness above other health risks or other economic or safety risks.
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