The deadly Ebola virus is back and knocking on the world’s door. How we answer may determine how we survive it!
The deadly Ebola virus can no longer be considered an “over there” problem. It is an international problem. WHO Director-General Dr. Tedros Adhanom Ghebreyesus today declared the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) a Public Health Emergency of International Concern (PHEIC).
“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,” said Dr. Tedros. “Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders -- coming from not just WHO but also government, partners and communities -- to shoulder more of the burden.”
You would think that by now, we would have an easy and automatic way of responding to such an epidemic and would be wrong!
A little over four years ago, in the April issue of Homeland Security Today, an article was published called, “Responding to the Ebola Epidemic – The Actions Necessary to Prevent its Global Spread” (Cowan & Cowan, 2015). Sadly, the very same things said in that article could be said today. It is disappointing because after 4.3 billion dollars was invested in the Ebola outbreak of 2014, no residual medical health infrastructure was left behind. Why is that? When the response assets used to build medical capacity for an event are essentially designed to be thrown away after a single use there cannot be an expectation that those assets will be available for use the next time there is a medical surge event. While this is both frustrating and predictable, an article in the Yale Journal reported on the waste and came out with one possible solution “Don’t Spend Money Responding to Ebola, Save Money Building Healthcare Systems in Africa” (Burnett, 2019)
While the Yale report encourages not wasting money on tents and tarps, their proposition regarding healthcare infrastructure investment is the correct long-term solution for managing future events. As we know traditional approach of bricks and mortar infrastructure development cannot be accomplished quickly enough to address the current Ebola threat.
Fortunately, technological advancements in building materials and construction techniques provide an option that is both rapidly deployable and is economically sustainable over the long term. This technology is currently in use by the US Department of Defense and has also been successfully deployed as part of response efforts for Hurricane Maria in Puerto Rico and for Hurricane Michael on the Florida Gulf Coast. The game changing element of this technology is that not only can it be deployed rapidly for response, but it has the inherent longevity, sustainability, and resilience to remain in place and pivot from response to long term recovery capacity.
This was successfully accomplished after the devastating hurricane that struck Puerto Rico. FEMA spent disaster response dollars to assist the Puerto Rico Department of Health to purchase mobile medical clinics to help support emergency response healthcare needs on the island of Vieques which lost its only healthcare facility as a result of storm damage. These clinics have pivoted from disaster response assets to accredited medical facilities that remain in use nearly two years after the storm. They will remain in place as part of the medical solution for Vieques until a new permanent facility can be built. That will take years. A tent can never pivot, but by integrating best-in-class mobile medical solutions into sustainable mobile platforms, pivoting rapidly deployable structures is a viable solution for providing both short and relatively long-term medical capacity. These cutting-edge technologies are capable of being both fast response assets and when the disaster is over, ongoing public medical health facilities for decades. They are also a far more economical and green solution.
As global attention and resources are once again focused on trying to contain the latest outbreak of the Ebola Virus Disease (EVD), the lack of a reliable public health infrastructure in the countries prone to outbreak are key in enabling the spread and severity of the outbreak. With no diagnostic, quarantine, or treatment facilities available, EVD moves and grows freely until the increasing threat level requires the global community takes drastic action. History demonstrates that this action comes with a significant financial burden. The current Ebola crisis demands immediate action. It is time to change the paradigm. There will be emergency dollars spent to meet this crisis. By investing in today’s technology, instead of tent technology that is thousands of years old, this outbreak can be addressed in a way that not only meets the immediate need to stop the current outbreak, but will put in place long term healthcare infrastructure that will mitigate the risk of future public health disasters. This includes not only Ebola but will help build a public health infrastructure capable of dealing with other endemic public health issues such as malaria and tuberculosis.
Clearly the top priority right now is stopping the current outbreak and keeping it from spreading any further. However, there is a significant opportunity in this response to better spend the funding that has to be spent that both reduces suffering, saves lives and leaves behind a lasting medical public health infrastructure. With even a small sustainable medical health infrastructure, ongoing staffing, logistical supplies and equipment can be maintained for much less than creating infrastructure from scratch with every new outbreak. The focus should be putting an end to this Ebola outbreak while creating a network of health centers in a way that response to the next outbreak does not start with step one - buying tents.