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The Legacy and Lessons of Ebola

As we look toward 2015, it’s critical that we learn from this past year’s most talked-about health scare in order to prepare ourselves for future threats.
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(Photo: Festa/Shutterstock)

(Photo: Festa/Shutterstock)

Contrary to what many in the global health community seem to believe, 2014 will not go down as The Year of Ebola. It will, however, be remembered as the year that the world was faced with responding to an emerging pathogen in a rapid and efficient way. Not that this is the first time, of course, with SARS and bird flu being recent history, but it is a particularly memorable one nonetheless.

We know that a devastating disease will have varying degrees of impact on health systems, which cannot be predicted or fully anticipated. But this deadly disease, which quickly jumped country and continent borders, highlighted both how unprepared we are technologically and the fragility of many health systems. To be fair, to decry the fact that we are unprepared for a multi-continent outbreak of Ebola would have been greeted with a chuckle just a year ago—but now the question is: Which highly infectious disease is next?

The last 12 months have also taught us that we need to spend significant time, attention, and resources building durable and broad platform technology that can address a variety of pathogens—not just one.

But today, as we look toward 2015, it’s clear just how real, and just how deadly, threats like Ebola actually can be—it’s also clear that being prepared, and then moving fast, is critical when it comes to saving lives. This will require developing available technologies and a strengthening of health systems, both of which are needed to ensure the capabilities for the rapid response to emerging, deadly pathogens.

This realization, preached by only a few previously but now recognized by many, will be a lasting legacy of 2014. But we must learn from and act upon that legacy now. Just as we hadn’t anticipated the dramatic emergence of Ebola in 2014, no one knows what’s in store for us in 2015, 2016, or years beyond.

The last 12 months have also taught us that we need to spend significant time, attention, and resources building durable and broad platform technology that can address a variety of pathogens—not just one. And these platforms have to be inexpensive and available for use across a spectrum of health interventions, which in turn must be cost-effective and available for deployment through a wide range of local health systems across the globe.

For example, such thought is currently being applied to pandemic influenza. No one knows when the next outbreak will occur, how broadly it will reach, or which strain of the virus it will be. But significant investments and efforts are being applied to reduce the guesswork as to which strain it might be, to design the most appropriate vaccine antigen, to decide upon the adjuvants to formulate the most cost effective and efficacious vaccine, and establish the production capabilities to produce the necessary quantities—all with the aim of empowering health systems to be responsive to a sudden pandemic.

Now that there’s newly allocated funding in the wake of the Ebola outbreak, from both government and philanthropic organizations, we should focus some of those resources on building a series of sturdy platforms that will enable us to respond rapidly and flexibly to a host of diseases.

This is obviously easier said than done—especially when we’re asking researchers to design and develop technologies for a range of diseases that we can’t fully anticipate. It’s also difficult to respond rapidly and effectively when disease transmission today is so fluid, dynamic, and transferable, traveling at jet speed across borders at 38,000 feet. Ebola, for example, was, for the most part, contained in sparsely populated areas across a few African countries—until it found its way into an urban setting, when it climbed aboard an airplane and suddenly turned up in Dallas and New York. Like information, disease today moves much faster than it did in the past.

If rapid response is now a given in keeping the world safe from deadly disease, so is the tone and tenor of our response. It’s imperative that we inform citizens in a calm and fact-based manner; and, as scary as the prospects for public health might be, we need to avoid fear-based communication.

We also need to collaborate. Indeed, the science community, health systems, funding agencies, and the private sector must pool resources, insight, and intelligence—in much the same way that they came together to take on HIV in the late 1980s and ’90s. And the coalition that can best fight disease in 2015 and beyond also includes the airlines, other transportation-sector players, the media industry, and philanthropic organizations of all shapes and sizes.

As we leave the global health challenges of 2014 behind and dig in for whatever newly emerging pathogens may come our way in the next year, it’s important to remember that we learned a great deal and succeeded reasonably well by responding rapidly to Ebola.

And, if we continue building tools that enable us to combat a range of diseases, if we strengthen health systems, if we communicate clearly and non-emotionally, and if we coordinate our efforts widely and effectively, we can level the battleground as we confront the next wave of frightening and fatal diseases around the world.