Evolutions in global epidemic and pandemic preparedness

Abstract

The 21st century poses complex challenges for public health. Our planet is experiencing unprecedented levels of globalization, urbanization and mobility of its 7 billion inhabitants, many of whom live in poverty, conflict or are at risk of natural disasters and suffering from the effects of climate change. Infectious hazards, new and old, threaten the lives and well-being of billions of people across the globe. As the UN's specialized agency for health, WHO investigates around 300 disease outbreaks every year. But detecting and managing epidemic and pandemic-prone diseases is harder than ever. During the last two decades, several high profile disease outbreaks have had a profound effect on public health's response to epidemics and pandemics. Today, in sharp contrast to the last century, there is an expectation that we detect outbreaks faster and manage them better. The response to health emergencies today is vastly different from previous eras where containment was a pre-dominant strategy. Today, for any outbreak, we need to systematically use the combination of modern epidemiology utilizing the power of technology; new and easy-to -use field-based rapid diagnostic tools; clinical care even in the harshest of conditions, vaccines and other medical counter-measures, rapidly developing them if they don’t already exist; real-time training of front-line responders; and effective risk communication and community engagement. This new recognition that we need to marry the social aspects of epidemic and pandemic response with an ever stronger bio-medical response is changing the way disease outbreaks are being managed. Just in the last decade, lessons learnt from MERsCoV in Saudi Arabia and South Korea; Ebola in West Africa; Zika in South America; Yellow Fever in Angola and the Democratic republic of Congo, several ongoing outbreaks of Cholera and Diphtheria in Bangladesh have created the momentum to re-think disease outbreak management to prevent epidemics or pandemics. As the science of epidemic and pandemic diseases marches forward, and social science makes its presence increasingly felt, there is an effort to make the response operations more effective, particularly for large-scale epidemics. The introduction of Emergency Operations Centers (EOCs) in countries, and WHO's own reform establishing the use of an incident management system (IMS) have had an impact on how disease outbreaks are viewed and managed. As the current generation of public health experts and personnel, we will undoubtedly write the next chapter in how the epidemics and pandemics of the rest of the 21st century will be managed.