Treat global health crises the same way as national security crises, panel says

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Congresswoman Rosa DeLauro

Congresswoman Rosa DeLauro

If a panel of U.S. generals went in front of Congress and said they needed $1.9 billion immediately to avert a national security crisis, members of Congress would trip over each other to run to the House and Senate chambers to vote on a funding bill. But when infectious disease experts say they need funding to avert a global health crisis, Congresswoman Rosa DeLauro said this week, lawmakers do nothing.

“Why aren’t we listening to the generals of public health?” she asked at the launch of a Brenthurst Foundation report on the West African Ebola outbreak.

Instead of listening to global infectious disease experts in their call to invest in strengthening health systems globally, “we lurch from one global health crisis to another,” DeLauro said, without the infrastructure in place to avert transmission of infectious diseases across borders and prevent unnecessary deaths.

Full implementation of the Global Health Security Agenda is more important now than ever, Andrew Weber, Assistant Secretary of Defense for Nuclear, Chemical and Biological Defense Programs, said.

“Small investments in prevention and early detection can have huge impacts,” he said.

Currently the U.S. is working with 30 countries to assess their health systems through joint external evaluations, while other G7 countries are working with another 30 nations to assess their readiness to adequately respond to pandemics. The first steps of the GHSA have been so successful that more countries have requested external evaluations than there are teams available to do them, Weber said.

While the Ebola outbreak demonstrated how unprepared the world was to adequately respond to a public health emergency of international concern, the lessons learned had no effect on the current Zika outbreak, panelists said.  Although the Wednesday event was billed as a launch of a report about the West Africa Ebola outbreak, discussion of the current Zika virus outbreak and the greatly delayed U.S. response was a major topic.

The U.S. response in the form of supplemental funding was seven months too late, DeLauro said, and the damage has already been done. Babies born with congenital defects like microcephaly “will be a human reminder of the cost of inaction in Washington,” DeLauro said.

“Every week we’re finding new birth defects,” Dr. Andrew Haddow of the U.S. Army of Medical Research Institute of Infectious Disease, said.

From problems with eyesight to hearing loss, Zika virus can result in a “myriad of birth defects, not just microcephaly,” Haddow said.

Dr. Haddow shared this image of an Aedes Aegypti mosquito his grandfather drew at the age of seven

Dr. Haddow shared this image of an Aedes Aegypti mosquito his grandfather drew at the age of seven

Haddow, whose grandfather was one of the original discoverers of the virus in the Zika forest in Uganda in the 1940s, stressed the need to expand basic research, from understanding more about vector pathogenesis to enhancing biosurveillance and conducting ecological studies. He explained low-level transmission of the virus has occurred since its discovery but in places with little to no surveillance and weak health systems, including no diagnostic capabilities, Zika virus was often misidentified as other illnesses, such as Spondweni virus.

The 2013 outbreak in French Polynesia which resulted in over 30,000 infections and the first signs of Guillain-Barre which should have been a huge red flag, but, Haddow said, went mostly unnoticed because of the Ebola outbreak that occurred at the same time.

In addition to stronger global health security efforts, Glenda Gray of the South African Research Council said, the global health community needs to strengthen the one health approach to global health, which is a concept that recognizes that human health is connected to the health of animals and the environment.

“We have three public health emergencies that are linked to human-animal interaction,” Gray said. “Ebola, Zika, and antimicrobial resistance,” the last of which, she said, is a slow and insidious global health problem that will have a huge impact.

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