Ebola, beyond the headlines

I’ve spent the past week meeting with politicians, policymakers, and reporters in New York, Washington D.C., and Boston. One topic has pretty much dominated the conversation: Ebola virus.

It’s not surprising. Most of the headlines lately have focused on the undeniably awful news—the number of people who have died, the escalating rate of infection, the first case on U.S. soil. It is a tragedy for the families of those who have died. It is frightening for communities where people are sick. And it is yet another blow for countries that were already hit hard by poverty and other diseases. 

Although you can never move too fast at a time like this, it’s easy to forget just how much has been done. Médecins Sans Frontières initiated a global call to action and has mobilized all its available resources to help combat the spread of the disease. Weeks ago, after the head of the Centers for Disease Control, Dr. Thomas Frieden, came back from Liberia with dire reports of the situation on the ground, President Obama sent the military to set up hospitals there. Congress agreed to pay for emergency supplies. The National Institutes of Health and other leading research institutions started working on drugs to treat the sick and vaccines to prevent the spread of the virus. France and the United Kingdom committed large sums of money and resources. Philanthropists, doctors, nurses, and other health workers from around the world have signed up to help the communities suffering the most. The global response has been remarkable.

Even as we do everything we can to stop this crisis, we should also be studying its long-term implications. It’s a reminder of the urgent need to strengthen health systems in the world’s poorest countries. (As former foundation’s CEO, Sue Desmond-Hellmann, wrote last week: “America has an incredibly responsive public health system that will ensure the virus is quickly contained, and that anyone suffering from it receives high-quality care in medical isolation.”) Health systems—which encompass everything from rural clinics to community health workers to hospitals—are the best protection against epidemics.

For example, as soon as the first case was identified in Nigeria, doctors and other people who were there to fight polio immediately helped set up a center to fight Ebola. This was critical in preventing the spread of the disease. Senegal, which has a more developed primary health care system than the most devastated countries, was also able to handle the first cases effectively and prevent a significant outbreak.

Improving health systems has other benefits beyond dealing with outbreaks. Providing basic health care raises the quality of life for everyone. It unlocks economic potential—healthy people are more productive. And countries with strong health systems can do a better job fighting both epidemics and ongoing diseases like malaria (which kills 600,000 people every year and leaves many more too sick to work for long periods).

What does this mean in practice? Liberia, Sierra Leone, and Guinea need support to strengthen their primary care systems now. Governments, donors, and other partners—from the private sector to NGOs and faith-based organizations—can join forces to build short-term capacity, while also building the foundation for health systems of the future. It will take an aggressive plan, with accountability measures in place, to start delivering core services such as routine immunization, maternal health, and family planning again.

So I hope we fight Ebola on two fronts: a short-term response to stop this crisis, and a long-term effort to build the health systems that will help prevent the next one.