WHO Zika plan release highlights need for overhaul of first step in emergency response

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Following WHO recognition of Zika and observed increases of microcephaly as a PHEIC, $56 million strategy stresses need for surveillance, analysis, monitoring

WHOZikaIn the last week of January, a World Health Organization spokesman was asked why the agency charged with recognizing and coordinating responses to global public health emergencies had yet to convene a panel to explore the threat posed by multiplying outbreaks of the Zika virus and the clusters of microcephaly and neurological disorders that followed in their wake. His answer, according to a STAT report, was that the agency had not taken that first step necessary to assess a threat because “more evidence and data” were needed. It was circular logic highlighted this week by the agency’s release of a plan recommending strengthened surveillance and monitoring to collect actionable data on the spread of the virus and its potential links to other health threats — a plan developed only after a panel was convened and swiftly advised that the situation be declared a Public Health Emergency of International Concern.

The WHO Zika Strategic Response Framework and Joint Operations Plan presents a history of the known spread of the virus and with it, the complications of responding to a disease with only recently noted and unconfirmed potential links to graver health impacts that is spreading rapidly in environments of high poverty and limited resources. The plan calls for measures to gather information not only on the virus and its impacts, but on capacities to track and respond to the spread. It notes the need to address in-country gaps in laboratory capacities and to coordinate and support activities to communicate risks and take preventive measures. And, with the rapid spread of a virus transmitted by a vector found around the world, to previously unexposed populations, and a newly discovered need for diagnostic, preventive and vector control tools, the plan stresses a need for quickly accelerated research and development efforts. It is the first attempt, the document notes, to put into action a research and development road map developed by WHO in the wake of its delayed and ill-prepared response to Ebola. Some $56 million for the plan will come from a new emergency fund also established in the wake of the Ebola crisis.

The research and development planning, the emergency fund were among the steps recommended by a Harvard Institute of Global Health/London School of Hygiene and Tropical Medicine convened panel examining failures in the international responses to Ebola. Among the steps yet to be addressed, however is one necessary to set the rest into action, and that is to create accountability for recognizing public health crises through an independent commission for disease outbreak prevention and response, that does not depend on the WHO director general.

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