The Ebola outbreak in Africa has reinforced the fact that there is no globally linked, interoperable system to prevent infectious disease threats, detect outbreaks in real-time, and to respond effectively before they become epidemics.

"Despite improved technologies and knowledge, concerning gaps remain in many countries in the workforce, tools, training, surveillance capabilities, and coordination that are crucial to protect against the spread of infectious disease, whether naturally occurring, deliberate, or accidental," testified Tom Frieden, M.D., director of the Centers for Disease Control and Prevention, during an August 7 emergency hearing held by the House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations.

To address this shortfall, the United States in February--months before the latest Ebola outbreak--joined with the World Health Organization and 26 countries to launch a Global Health Security Agenda to prevent, detect and effectively respond to infectious disease threats worldwide. One of the primary goals of the initiative is to launch, strengthen and link global networks for real-time biosurveillance by establishing monitoring systems that can predict and identify infectious disease threats, creating interoperable, networked information-sharing platforms and bioinformatic systems, as well as networks that link to regional disease detection hubs and emergency operations centers.

“An outbreak anywhere is a threat everywhere,” Frieden told lawmakers. “One of the reasons we’ve focused on the Global Health Security Agenda program is that we have the international health regulations which require countries to report outbreaks in new diseases so that we can all as a global community work together, because it’s in all of our best interests.”

"The technology, capacity, and resources exist to make measurable progress across member countries, but focused leadership is required to make it happen," he added.

World leaders have a pragmatic reason for protecting the health of their citizens. By doing so, they also protect the global economy. According to Frieden, the economic cost of large public health emergencies can be astronomical. For instance, he said that the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic disrupted travel, trade, and the workplace, costing the Asia-Pacific region alone $40 billion.

As part of a multi-nation effort, the U.S. Agency for International Development is developing and testing a Public Health Emergency tool with WHO and CDC, and is actively supporting countries in Africa to develop national preparedness plans to respond to threats such as Ebola. It has been about six months since the first Ebola case in this latest outbreak was detected, and the rate of new infections appears to be increasing. So far, more than 1,700 cases and over 900 deaths have been reported. 

“We think the data are not as accurate as we would like,” said Frieden. “There may be cases counted as Ebola that are not, and there may well be many cases not counted that are. The lack of treatment facilities and lack of laboratory facilities make it so that the data coming out is kind of a fog-of-war situation, if you will.”

The Obama administration’s fiscal year 2015 budget request includes $45 million ­in new funding for CDC to accelerate progress in detection, prevention, and response to these kinds of infectious diseases and to potentially reduce some of the direct and indirect costs associated with these diseases. 

“When we finish this response [to the latest Ebola outbreak], we’re determined to not only stop the outbreak but leave behind strong systems that will be better at finding the disease--and other threats--and stopping it before it spreads and preventing it in the first place,” said Frieden. “In fact, if those systems had been there in the first place, we wouldn’t be here today and the outbreak would have been over already.”

 

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