Oliver Wyman Partner Suresh Kumar, former US Assistant Secretary of Commerce, spoke last week at the Institute of Medicine of the National Academies in Washington, DC, as part of the two-day workshop “Enabling Rapid Response and Sustained Capability with Medical Countermeasures to Mitigate Risk of Emerging Infectious Diseases.” The workshop was attended by policy makers, innovators in the vaccine field, and other global health leaders. Below, Kumar shares an excerpt from his address on adopting lessons from Ebola to develop a robust Global Health Security Strategy:
Can we afford to continue “business as usual” after every successive outbreak of an infectious disease or should we determinedly move to correct the deep systemic flaws in our preparedness and our response? Developing an objective “outside in” global health security strategy for the future requires establishing enabling frameworks: from raising money to conveying resources and services to affected populations; establishing policies and protocols that enable the developing of innovative products, programs, and pathways; and ultimately understanding and sharing risks, liabilities, and responsibilities to pre-empt, combat, and contain infections.
Some good has emerged: Unlike multiple sources offering confounding communications in the early months of the outbreak, WHO and CDC agree on and cross reference the facts. But as panelists at a session I chaired at Davos this year stated: communications, coordination, and logistics – unless overtly addressed – will continue to pose a challenge. If we learn from this Ebola experience and act upon it, we will at least move to make vulnerable populations more secure in the future….
There is no shortage of ideas on the use of funds – but limited agreement on how programs will be executed and pervasive lack of clarity on the cost of programs and the source of funds. This results in “on again, and off again” programs. Keeping the world safe in the future requires viewing infectious disease as a chronic threat for the foreseeable future, and establishing both a proactive approach to “curb and contain,” and a reactive one that builds sustainable capabilities and processes to facilitate rapid and timely response….
Besides financing, several other pathways warrant consideration:
- Scientific Pathways that help allow us to better combat disease
- Regulatory & Clinical Pathways that help bring diagnostics, drugs, and systems to market
- Legal Pathways – intellectual property to liabilities – that lead to discovery and partnerships
- Technology Pathways from prefab modular clinics to telemedicine that help enhance patient access to care
- Community Engagement Pathways that help enroll and educate local communities
- Capacity- and Capability-building Pathways that help rapid mobilization of community workers and an international cadre of healthcare workers
- Institutional Framework that promotes specialization and removes duplication
- Public Private Partnership Framework to serve as catalysts in delivering on-the-ground care and in developing better prevention-and-cure products and programs
A practical, not a pedantic approach is necessary with a dual focus on science and technology and on operations and execution, including building local, regional, and global capabilities and capacity. The question frequently comes up if we have let institutions become too big and permitted ”scope creep” in what they do.
The response to Ebola has not been “our finest hour” but has sounded the wake-up call for renewed and reinvigorated commitment to global health security. The time for tweaking plans, programs, or processes has passed: it is time for a comprehensive new look based on what global health strategy entails, how it will be financed, and the appropriate institutional frameworks and governance mechanisms to keep us all safe. Developing robust global health security strategy requires objectivity and commitment of donor, non-aligned, and recipient nations and likely sponsorship at the G7 and G20 level. It will need an objective, “outside in” process that engages all stakeholders but is not subservient to any institution.