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DoesEbolaRevealWHOShortfalls?JoeDeCapua

October28,2014

AstheEbolaoutbreakragesinthreeWestAfricancountries–andraisfearsabroad–somearequestioningwhetherthe

salforanewglobalagencytodealstrictlywithinfectious

diasisgainingsomesupport.

Rubinwritesthatthat“localphenomenacanhaveglobalconquences.”AndhepointstotheEbolaepidemicas

aprimeexample.

RubinisdirectoroftheInstituteforStrategicThreatAnalysisandResponattheUniversityofPennsylvaniain

STAR’sassociatedirectorNicholasSaidelhavewritteninNewScientistMagazinethat“global

infectiousdiacontrol,asitnowstands,isadisjointedeffortriddledwithgapsandinconsistencies.”Rubinsaidthiscan

beenintherespontoEbola.

“Theworld’atragedyatmany,iouslypeopleare

dying,commerceisimpacted,economicdevelopmentisimpacted,but,overwhelmingly,peoplearedyingandwecouldhave

avebeensomegroupsthathavebeenabsolutelyfantasticlikeDoctors

WithoutBglobalcommunityhasdropped

theball.”

Rubinsaidmanyhavebeenworriedaboutsuchascenarioforalongtime.

“Alotofthis,maybenotallofit,butalotofthiscouldhavebeenavoidedwithamorerobustglobalgovernancesystemfor

’vebeentalkingandwritingaboutthisforalongtimenow–foratleastveral

eoplehavebeenwritingaboutthis,”hesaid.

TB,malaria,varioustypesofhepatitis,MERS,theflu,avianflu,measles,polioandEbola–thearesomeoftheinfectious

ntherearethemanynoncommunicablediason

theri,suchasdiabetes,obesity,cardiovasculardiaandcancer.

“Believeme,”,“I’esoover

ly,morepeopledieofinfectiousdiasthanjustaboutanythingel.

AlotofthearepreventablediasandtheWorldHealthOrganizationhasahugemandate.”

Hesaidthere’saloominghealthcrisisthat’snotgettingnearlyasmuchattentionasEbola.

“IfIhadtolistthenumberoneproblemthatweeacrossthebordersandcertainlyinthiscountry,it’santibioticresistant

anepidemicalreadyandanimpendingdoomanddisaster–andIdon’twanttooverstatethis–butwe

haveorganismsinthiscountryinootic

resistantbacteriaisanenormousproblem,”hesaid.

He’scallingforaGlobalGovernanceStructureforInfectiousDia–aplacewhereanynationcangoandraithealarm

itwouldprovideamorefocudapproach.

“Whatkindsofresourceareavailableforus?Arethereexperimentaldrugsthatwecouldstartdeveloping?Aretherewaysto

distributethedrugs?Aretherewaystodosurveillancethat’smeaningful?Aretherewaystoharmonizeandalignvarious

regulatoryaspectsofgettingdrugsandvaccinestotheplacesthatareneeded?That’swhatwemeanbyafocudapproach

snoothergrouplikethat.”

HesaidthepropodGlobalGovernanceStructureforInfectiousDiashouldbeapublic/privatestand-aloneagencythat

receivesriousinputfromtheUnitedNationsandothers.

TheNewScientistarticlelistsfourinterconnectedgoals:“First,coordinatethecollection,sharingandanalysisofinfectious

diainformationinrealtime;cond,encouragetheprivatectortodevelopanddistributeaffordabledrugs,vaccines

anddiagnostics;third,establishanetworkofinternationalcentersforfundamentalrearchintomicrobialthreats;andfourth,

promotestandardsforbestlaboratory,regulatoryandethicalpractice.”

Rubinsaidtheaimistonothavesuchanagencyboggeddowninbureaucracy.

“tohavedecision-makingwithadequateinputandtransparent--andwiththe

llthediasthatwetalk

andlecturetothestudentsabout,wewouldalwayssay,oh,’’sinNew

’torethinkfromthebeginningour,sortof,entrenchedideas.”

Hesaiditcouldbeginasagrassrootffort,butaddsitmaybejusttherighttimeforittohappen.

“WhenI’vegiventhistalkaroundtheworldIhaveenormoussupportbymembersinmyownmedicalcommunity,alotofthe

NGOs–cademicsreallyunderstandthisandwe’reud

toczwordsaroundnowareinnovation

,ifanybodywantsinnovationandmulti-disciplinary,thisisit.”

TheUniversityofPennsylvaniamedicalprofessorsaiditmustbealf-sustainingagencywithinnovativewaysoffunding.

ddedthatitwon’tworkifithastorelyondonors.

ThestaffoftheInstituteforStrategicThreatAnalysisandResponincludesdoctors,lawyers,businessleaders,engineers

andpoliticalscientists.