In 2012, I had the privilege of working with Taiwan’s Department of Health, assessing its public health emergency preparedness programs. It quickly became obvious that preparedness for epidemics was a top priority for good reason: In 2003,Taiwan was hit hard by the global SARS epidemic, suffering nearly 700 infections and 200 deaths—and losing nearly half a percentage point of its Gross Domestic Product. Since SARS, Taiwan has worked hard to develop its preparedness capacities.
L to R: Dr. Jonathan D. Quick, Stefanie Friedhoff, Dr. Peter PiotPhoto credit: Rachel Hassinger/MSH
On March 27, 2015, Dr. Peter Piot of the London School of Tropical Medicine and Hygiene and Dr. Jonathan D. Quick, MSH President and CEO, sat down at the Boston Public Library with Stefanie Friedhoff of The Boston Globe to discuss Ebola, epidemic preparedness and rebuilding public health systems.
Watch the video of the whole program:
Here are some excerpts from their conversation:
Stefanie Friedhoff: What did countries do that worked well in the Ebola fight?
Jonathan Quick: There were 6 things that worked well in three of the rim countries of Nigeria, Mali and Senegal.
Leadership: Ministers of Health were on top of the first cases and declared national emergencies.
Preparedness of public health systems.
Rapid action in getting the index case identified and case detection system for subsequent cases.
Good communications campaigns.
Mobilizing the community.
Heroism of local health workers.
SF: Why was the international response so slow? What should be done?
The World Health Organization (WHO) made waves at the International AIDS Society conference in Kuala Lumpur when it issued revised guidelines for HIV treatment. The new guidelines—WHO’s first major update since 2010—recommend an earlier start to treatment, from a CD4 threshold of 350 cells/mm3 to 500 cells/mm3. While most patients don’t show symptoms of disease at these higher CD4 counts (a measure of immune system strength), the new guidelines responded to evidence that an earlier start improves long-term clinical outcomes and that ARV treatment dramatically reduces patients’ likelihood of transmitting the virus to sexual partners.
“If you want to go fast, go alone,” says an African proverb. “If you want to go far, go together.”
It’s been thirteen years since the international community adopted the Millennium Development Goals, an ambitious, self-imposed “report card” for global development that helped focus attention and resources on issues like HIV and AIDS. Since then, the global HIV response has gone fast. In 2002, just 300,000 people with HIV were receiving antiretroviral therapy in developing countries; today, UNAIDS reports, treatment reaches nearly 10 million.