When it comes to infectious diseases national boundaries have never been a useful means of control. This is one very important reason why the World Health Organization (WHO) is so important. There is another organization that has done so much to support the WHO called the Center for Disease Control and Prevention (CDC). The CDC is virtually an Agency of the US Department of Health and Human Services but is recognized globally in its role in Pandemic Mitigation and Control.
Before I got some grasp of the dynamics of disease outbreaks and spread I always questioned what business CDC has setting up offices in various countries around the globe. Today, I know there are still some who question this. I did not question them so much though when I had the opportunity to work on their HIV projects in the Caribbean. I would always give a shout out for our CDC partners for the great work they allowed us to do in that part of the world in helping control the HIV pandemic.
In 2014 the Obama Administration recognized the benefits of quick coordinated response by all appropriate government resources in addressing potential global pandemics. This was a reaction to the Ebola outbreaks in Africa. This led to the formation of the Directorate for Global Health Security and Biodefense. This office was located within the Executive Branch and its mission was to enhance US national security and economic prosperity by combatting bio threats and outbreaks of infectious diseases through diplomacy. This office ensured US leadership in the Global Health and Security Agenda.
In 2018 the director of the Pandemic Response position was eliminated by the then Director of the National Security Council John Bolton. Real Admiral Tim Ziemer a global public health expert was let go in an effort described as a move to “streamline” the NSC and “combine a handful of offices with similar mission sets.” Since then many members of the team left the White House and were never replaced.
In a reaction to this situation in 2018 Ron Klain the former Ebola Czar said “I think this is a mistake that puts us all more at risk, combining epidemic prevention and control with weapons of mass destruction issues means that the epidemic work will always take a back seat. It means that no senior level person will be specifically focused on the work that needs to be done to protect us from this serious threat”
Today we have a Coronavirus outbreak which has been declared as a global pandemic by the WHO and the US government. There are many who are asking if the situation and response would have been different if the Office of Pandemic Preparedness at the National Security Council was still intact? This question can be simplified further to make it relevant to us all.
Do we really need to pay for the equipment and manpower for a fire station to ensure that they are available to put out fires quickly when they happen or should we get rid of fire stations and attempt to convene appropriate personnel to handle fire control after the fires occur? To me this question is a simple as that. My fire year old son understands that we need firefighters if not to fight fires but for the simple reason that they are just really cool guys!!
Unfortunately this outbreak is at a point when real control has moved into a totally new domain. The initial attempts at cover-up and denial by the Chinese government and the slow engagement of the Global Health Security team has been very costly.
The current emergency measures rolled out will definitely slow down the progression of this pandemic. The questions that we all need to ask are:
- How long will these measures remain in place?
- What must we look for to help us decide on when to end these emergency measures?
- What are we to expect once these measures are lifted?
At this time all these questions still remain in unknown territory. Many experts believe that short of the possibility of a reduction in virulence of this agent in the course of its new relationship with humans our best solution to all these questions is a vaccine.
At this time there are about 10 candidate vaccines in the works and one is already undergoing human trials for SARS-Co-2.
The race to control this new piece of genetic material circulating and wreaking havoc in our communities is on.
This is a race against time and one that we cannot afford to lose.
Leonard Sowah is a physician in Baltimore, Maryland
Feature photo: Firefighter-Training courtesy of Pickpic
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