Can the nations of the world work together to stop the next deadly pandemic – before it happens? Is it possible to make the world safe and secure from infectious disease threats, whether natural or man-made?
Yes, it’s not only possible – it’s underway. A coalition of 48 member countries have now committed to the Global Health Security Agenda (GHSA), originally launched in February 2014. The GHSA provides a framework to ensure that all nations are able to prevent, detect, and rapidly respond to infectious disease threats – protecting these countries and protecting Americans from deadly, global outbreaks.
Monday, the U.S. announced the full 30-country commitment for GHSA. As part of this effort, CDC has already begun expanding the number of disease detectives on the ground, establishing safe and secure lab networks to find deadly microbes, strengthening response to public health emergencies and upgrading systems to track health threats.
Preparedness can stop disease threats – even when the disease is fast-moving and deadly. The evidence: last year’s Ebola outbreak in Nigeria.
The health and safety of Americans is inextricably linked of the health and safety of the world. We must make sure every nation is able to prevent, detect and respond to infectious disease threats.
By July 2014, Ebola had spread from a single case in Guinea to an epidemic engulfing three West African nations. In Monrovia, the densely populated capital of Liberia, the fragile health system collapsed. People were literally dying in the streets with bodies uncollected and unburied, increasing the risk of spreading disease with each passing moment. That month, a very sick man who denied he had Ebola flew by commercial airline to Lagos, Nigeria – the largest city in Africa, at least 20 times larger than Monrovia and at least as densely populated.
As a crossroads for regional and global travel and trade, Lagos had all the ingredients to convert a terrible epidemic into a global catastrophe: crowding, limited health infrastructure, poor infection control practices in health care facilities, and a highly mobile population. But the nightmare worst-case scenario didn’t happen. Nigeria was prepared.
Two CDC-supported programs played a pivotal role in success in Nigeria: the Nigerian polio eradication program, which sent a seasoned manager to oversee the Ebola response, and the Field Epidemiology Training Program (FETP), which trains local health workers to detect and stop disease outbreaks. These individuals quickly become the frontline defense for their own country, protecting the rest of the world, including America.
These CDC-trained Nigerian FETP graduates and polio workers took immediate action. They identified nearly 900 people potentially infected by close contact with an Ebola patient, made 19,000 home visits to monitor for symptoms and fever, trained thousands of staff, and isolated and tested 43 people who showed symptoms. Another 150,000 travelers were screened at airports to ensure that no one who was sick would board an airplane.
The result: Nigeria’s Ebola outbreak was over after just 19 cases. Lagos did not become another, far larger Monrovia. If Ebola hadn’t been stopped in Lagos, it could well have spread throughout Nigeria and Africa for months and years, killing hundreds of thousands of people and setting back public health programs that have saved so many lives over the past decade.
It’s a powerful lesson. Nations with basic public health capacity to conduct disease surveillance, laboratory testing, preparedness and response can, with international support when needed, stop dire health threats. America’s safety depends in large part on how the rest of the world responds.
It is for this reason the United States is so fully committed to the GHSA. The health and safety of Americans is inextricably linked of the health and safety of the world. We must make sure every nation is able to prevent, detect and respond to infectious disease threats. With bipartisan support from Congress, the U.S. is investing nearly a billion additional dollars to help dozens of countries with billions of people in them become safer – for their sake and for ours. It’s a lot safer, more effective, and less expensive to stop threats where they emerge rather than on U.S. soil.
When it comes to the public health capacity to find and stop diseases, the stronger other countries are, the safer we are here at home.
Tom Frieden, M.D. is the former director of the U.S. Centers for Disease Control and Prevention.