As health officials work to contain the growing Ebola outbreak that has resulted in over 100 confirmed deaths in the Democratic Republic of Congo, the United States has taken a similar response as it did with the COVID-19 pandemic almost six years ago. Although Ebola and COVID-19 are markedly different diseases, the tendency to respond aggressively only after outbreaks have escalated has typified the U.S. approach to public health in many ways. Here’s how the U.S. approach has been more reactive as opposed to proactive.
The Economics Of Prevention Versus Reaction
One of the most powerful lessons from COVID-19 was the dramatic cost of delayed intervention. The COVID-19 pandemic cost the American economy trillions of dollars through healthcare expenditures, lost in productivity, disrupted supply chains, labor shortages and economic shutdowns. By comparison, investments in outbreak detection, disease surveillance, laboratory networks and overall public health infrastructure would cost only a fraction of these costs; all of which would work to mitigate the spread of an outbreak or a pandemic.
Despite the importance of investing in public and global health infrastructure and pandemic preparedness, the U.S. decided to enact drastic cuts to the USAID in the form of billions of dollars that would have went towards laboratory facilities in Africa, surveillance systems for disease detection as well as the training of many epidemiologists that would have expert authority on controlling the spread of outbreaks. This investment could have proven useful in helping mitigating the spread of Ebola in Africa through earlier disease detection and faster containment implementation.
Despite all the cuts to the USAID, the U.S. has now pledged hundreds of millions of dollars to Africa to fight Ebola, only after the outbreak has escalated into one of the worst on record. Had the U.S. kept investing in USAID, there would not have been a need to send over 200 million dollars in aid to Africa, and it is quite possible more lives could have been saved if the outbreak was detected earlier with surveillance systems.
The Role Of Global Health Infrastructure
The COVID-19 pandemic highlighted the importance of disease surveillance systems and public health partnerships that operate long before a crisis becomes visible to the public. The World Health Organization began issuing technical guidance to countries early January 2020 and declared a public health emergency of international concern on January 30, 2020. The WHO urged countries to prepare testing capacity and contact tracing programs, among other initiatives.
While some countries like South Korea began testing 10,000 individuals daily for COVID-19 in early 2020, the U.S. was slow to roll out tests. Delayed testing undoubtedly hindered the American response to COVID-19 and allowed it to spread faster than our public health infrastructure could handle at the time.
Given how important international collaboration is with global health matters, the United States could have played a leading role in coordinating and collaborating with peer nations with respect to outbreaks like Ebola. Instead, the U.S. decided to officially withdraw from the WHO earlier this year, making critical communications on global health as well as coordination of public health efforts that much more challenging. Withdrawing from WHO means critical global health alerts are delayed, the U.S. has less access to global outbreak intelligence and less funds going to outbreak centers to help contain diseases. A stronger partnership between the U.S. and WHO could have led to stronger surveillance systems, earlier detection and perhaps less cases and deaths during this Ebola outbreak.
The Bigger Lesson
Successful prevention and outbreak preparedness do not manifest after cases and deaths are already recorded, but years before by investing in vaccines, laboratories and cutting edge surveillance systems. Threats abroad can become threats nationally in America because of the ease of modern travel and because infectious diseases do not respect international borders.
Although the current Ebola outbreak does not pose the same type of pandemic threat that COVID-19 presented, it does serve as a reminder of how interconnected public health has become.
