Today's world is more prone to a pandemic than ever before, and an international plan needs to be established to adequately prepare for such a threat, a group of global health experts said at a panel on pandemics at UC San Francisco Thursday.
For instance, a faster and stronger international response to the worst Ebola outbreak in history could have prevented the disease from spreading to five West African nations and the U.S., which had its first diagnosis in a patient in Dallas this week, panelists said.
“Our global architectures for dealing with international movement of infectious diseases are simply inadequate,” said Dr. Ramanan Laxminarayan, a panelist who is the vice president for research and policy at the Public Health Foundation of India.
Panelists said earlier pandemics such as bubonic plague, smallpox and HIV/AIDS have emphasized the need for a worldwide response plan, and possibly a global fund specifically to fight pandemics.
Pandemics are more likely today because the world's population continues to grow, and people travel more often and faster than ever before, said Sir Dr. Richard Feachem, the panel's moderator and director of the global health group at UCSF's Global Health Sciences.
“The longest intercontinental journey is shorter than the shortest incubation period of any pandemic virus or bacteria,” Feachem noted. “Back in the 1300s … pandemics moved at the speed of a person on foot. Today, we can go halfway around the world in 15 hours.”
But there are ways to stop outbreaks like Ebola from becoming pandemics: faster detection, faster response, coordinated regional action and quelling hot spots, said panelist Dr. Larry Brilliant, president of the Skoll Global Threats Fund.
“The faster we find the outbreak, the smaller that outbreak will be,” Brilliant said.
Another panelist, UCSF clinician Dr. Dan Kelly, returned from Sierra Leone last month where he helped implement a health care strengthening program. Kelly said recent civil wars that weakened the health care systems coupled with late detection of the virus contributed to the outbreak becoming the world's first Ebola epidemic.
As of Monday, there have been 6,574 cases of the Ebola virus in West Africa and 3,091 deaths, according to the Centers for Disease Control and Prevention.
While getting patients into the Ebola treatment units is crucial, an overall strengthening of the health care outreach will need to happen as well, Kelly said.
“We need to make sure that people are believing they can go to Ebola treatment units because we are providing outstanding care,” Kelly said.
Eric Talbert, executive director of Emergency USA that has a hospital in Sierra Leone and its U.S. operation based in San Francisco, said that's precisely why the nonprofit is planning to open its second Ebola treatment center this month.
“We need to do this in the next 90 days,” Talbert said. “We don't have another three to four months to wait until it gets worse.”
Brilliant, who worked on the smallpox eradication program for the World Health Organization in the 1970s, said he's confident that the Ebola threat will be eliminated.
“Five hundred million people died of smallpox in the 20th century,” Brilliant said. “Ebola is a kindergarten transmitter compared to smallpox. Don't give up hope. We will win.”
The panelists emphasized that The City will be part of creating an international plan to respond to pandemics.
“We have not yet built the international collaborative mechanisms to allow the adequate response to pandemics,” Feachem said. “We have not yet developed the 21st-century technologies … that will allow us to detect quickly, to detain where possible and to control pandemics.”
He added: “This is clearly a task to which UCSF and our colleagues in the Bay Area will make a huge contribution.”