Resilient Health Systems Can Prevent and Contain Pandemics

Capt. John Whiteside of the U.S. Public Health Service dons Personal Protective Equipment as he prepares for a new potential Ebola case at the Monrovia Medical Unit in Liberia. USAID led and coordinated the U.S. Government’s relief efforts in West Africa for the Ebola response. / Neil Brandvold, USAID

Resilience is one of those buzzwords that every so often captures the hearts and minds of development practitioners. The importance of this particular term, though, becomes all too clear as the world faces an increasing number of humanitarian crises, including outbreaks that can turn into pandemics.

Did you know, for instance, that every year, up to 500,000 people die from the flu? And in years when pandemic flu occurs, millions of people can lose their lives. The 1918 pandemic flu is a good case in point, as it infected up to 40 percent of the populations of some countries and killed up to 100 million people.

As a result of global warming, more pathogens with pandemic potential continue to emerge, many of which originate in animals (zoonotic). They include Ebola, H5N1 avian flu, H7N9 avian flu, HIV/AIDS, and two kinds of coronavirus: severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

In this scenario, resilience is about detecting potential pandemic threats, and then mitigating and containing them. This concept came to the forefront during the 2014 Ebola outbreak when already stretched and under-resourced health systems in West Africa were confronted with a surge of patients, a contagious virus, overall lack of preparedness and minimal resources.

A technician swabs the throat of a duck at Bangkok’s Klongtoey Market during an avian influenza survey. / Richard Nyberg, USAID

And to be fair, Ebola caught us by surprise also in North America where health personnel initially felt inadequately trained and hospitals struggled to put in place a rapid plan of action.

The point is that resilience in the health sector is not static but rather an ongoing and evolving state of affairs. Much of the work that USAID does in the global health space is focused on strengthening health systems, so they perform well and are resilient.

Well-performing health systems provide sustained, equitable access to essential services for all without financial hardship. They are better able to bounce back when adversity strikes; are prepared to detect and respond to emerging disease threats; are able to adapt to adverse conditions; address a wide range of health challenges; and offer innovative solutions by leveraging diverse skills and views.

USAID invests in health system strengthening by partnering with countries to better manage financial resources, to ensure the right health workers and medicines are available where and when needed, and to inform and strengthen governance for effective service delivery.

And, yes, we all know that pathogens do not wait patiently in line to get their passport stamped. Contagious diseases will continue to threaten humanity because of the globalized nature of the world we live in and the impact of climate change.

Our work on emerging pandemic threats is meant to prevent, or at the very least, to contain a humanitarian crisis and minimize the impact of disease outbreaks on human health and the economic and social stability of countries. We do this by building the capacity of countries to prevent the emergence of new zoonotic diseases, to detect them early and to control them in a timely and effective manner.

Health innovations can strengthen health systems and save lives during a disease outbreak by quickly leveraging collective expertise and delivering practical and cost-effective solutions. Last year, USAID in partnership with the White House Office of Science and Technology Policy, the U.S. Centers for Disease Control and Prevention, and the Department of Defense launched Fighting Ebola: A Grand Challenge for Development.

The initiative was to help frontline workers provide better care and stop the spread of Ebola in West Africa. Global innovators generated close to 1,500 ideas. Half of the funded innovations are either in use or available for purchase today.

This past April, the Agency launched the Combating Zika and Future Threats Grand Challenge. Through this effort, the Agency will invest up to $30 million in groundbreaking innovations and interventions that enhance our ability to prevent, detect and respond to the Zika virus and other future infectious disease outbreaks—in both the short and long-term.

This latest Grand Challenge specifically calls for solutions that improve and enhance vector control (methods that eliminate the transmission of pathogens from animals to humans), personal and household protection, surveillance, diagnostics and community engagement.

We are also enhancing preparedness and response by creating university networks across the U.S., Africa and Southeast Asia to train graduates in a variety of sectors and disciplines.

As the world becomes increasingly connected, we must ensure that health professionals are able to address the complex, multi-sectoral disease detection, response, prevention, and control challenges in their countries and regions.

In this context, resilience is about helping other countries be more well-rounded and prepared to create a safer, healthier world for all.

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