Strengthening the Detection of and Early Response to Public Health Emergencies: Lessons from the West African Ebola Epidemic

Background In the year since the World Health Organization (WHO) notified of an Ebola outbreak in West Africa, more than 24,000 cases have been reported and over 10,000 individuals have died. Moreover, countless non-Ebola deaths have occurred as a result of health system closings and an international aid effort in the $USD billions has been invested in control efforts. While the international response to the West African Ebola virus disease epidemic eventually exemplified the great potential of the global public health community, the protracted early response also revealed critical gaps, which likely resulted in exacerbation of the epidemic. It is incumbent on international health partners to learn from missteps that occurred in the early stages of the epidemic and strengthen our public health capacity to better respond to future public health emergencies. Findings and Recommendations Strategies to consider to improve capacity to respond global health emergencies include: 1) development of a more precise system to risk stratify geographic settings susceptible to disease outbreaks, 2) reconsideration of the 2005 International Health Regulations Criteria to allow for earlier responses to localized epidemics before they reach epidemic proportions, 3) increasing the flexibility of the World Health Organization director general to characterize epidemics with more granularity, 4) development of guidelines for best practices to promote partnership with local stakeholders and identify locally acceptable response strategies, and, most importantly, 5) making good on international commitments to establish a fund for public health emergency preparedness and response. Conclusions The recent success of the global action to stem the Ebola virus disease epidemic is laudable but should not encourage complacency in our efforts to improve the global public health infrastructure. The current epidemic has revealed both the danger posed by disease outbreaks in states with weak health systems and their widespread impact in an increasingly globalized world. The power of global health law and global health institutions will remain seriously unrealized and deeply compromised if the Ebola epidemic does not spur fundamental reform