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Adam Ritchie, science and public policy lecturer, Blavatnik School of Government, Oxford University, Oxford, UK, @adamjohnritchie
Stop relying on Europe and the US to control epidemics: More African universities, scientists and doctors doing research and who drive their own agendas based on local needs, would help Africans deal with these issues directly.
Don’t neglect evaluation in the rush to deal with emergencies: To move forward we need to learn from each epidemic. The Independent Evaluation Group have produced 10 tips for responding to Ebola and evaluation.
Consider big data’s place in preparing for epidemics: We’ve all heard about Google being quicker to notice flu outbreaks than health authorities, due to people using the search engine to look up symptoms. However, but such concepts have failed to live up to their potential, eg eHealth and mobile health.
Pamela Steele, director and principal consultant, Pamela Steele Associates Ltd, Oxford, UK
Developing countries must create their own national preparedness strategies: African governments need to be working together with their health institutions and disaster risk reduction teams at all times. Countries not affected yet by Ebola should by now have tested their systems, processes, knowledge and understanding of them.
Encourage behaviour change before epidemics: The more we invest in behaviour change communication at a household and community level, the less overwhelmed hospitals will be during an epidemic. Advocacy for behaviour change has worked for HIV and Aids.
Stop supply issues becoming the issue during an epidemic: It is easy for fragile supply chain infrastructure to crumble during a disaster. No one seems to know what is required or where to get it from at the right quality. Make contingency plans for getting supplies.
Lisa Denney, research fellow, Overseas Development Institute, London, UK @odi_development
Local health workers should lead epidemic response teams: People don’t trust outsiders coming in. They fear they are either bringing the disease themselves or coming to take people away to treatment centres from which they won’t come back.
Different government departments must co-ordinate before epidemics: Too often diseases are considered the purview of health and not of the other sectors connected to this – like agriculture, infrastructure, security etc. Taskforces are set up in times of emergency response, but these parts of government need to interact more outside of crisis times, when the space for building resilience is more likely to exist.
Rethink training for community health workers: Currently training is carried out through cascade training models (eg one person trains 10 people, they in turn train 10 people, and so on). It is cost-effective, but often the information ends up at the end of the chain incomplete or inaccurate.
Engage traditional healers: Given that they are a trusted part of the health system from the perspective of service users, healers need to be engaged by governments in promoting appropriate health messages.
Carol Dunn, risk communication specialist, 2resilience, Seattle, US, @caroldn
Encourage communication online or over the phone: Technology can help reduce factors that lead people to leave their house. People can get information and distractions that will help them relax, and can stay connected with loved ones.
Stella Anyangwe, global health expert and consultant, Pretoria, South Africa, @SAnyangwe
Name and shame those not prepared: Calling out countries on their mistakes at international forums has moved some countries to improve preparedness and response. Voicing concerns has also promoted quicker recovery from hard-hitting emergencies.
Allocate funding for training on disaster risk management: Without this training, epidemics and other emergencies are bound to recur.
Ruwan Ratnayake, epidemiologist and technical advisor, International Rescue Committee (IRC), New York, US, @RuwanEPI
Develop higher-quality surveillance systems for detecting epidemics earlier: An alert and response system was effectively used during the cholera outbreak in Haiti to rapidly detect emerging pockets of disease and launch rapid responses to control the disease at the source.
Genevieve Hutchinson, health advisor, BBC Media Action, London, UK, @genevieveh77
More support is needed for communication in an epidemic: What to communicate, how to communicate, who to and when. Health workers, governments, and communities being able to give accurate, up-to-date and consistent information is absolutely key.
Connect local initiatives together to make communities more resilient: Coordinate complementary activities, working together with health workers and service providers in addition to local government and local leaders.
Kweku Ackom, health advisor, International Medical Corps UK, London, UK, @kweku2007
Have more stringent border controls from the start: Where people are coming from Ebola-declared countries they should be screened. Next, those that fit the case definition put in quarantine, observed and tested.
Build strong health systems: They must be built to handle all health challenges, and not just in response to one epidemic. Currently, the international community sees providing this infrastructure as too costly and the job of national governments – but it is the best deterrent against epidemics.
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