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Risks posed by pandemic threats such as deadly strains of flu and
drug-resistant superbugs have shot up the agenda of global security
issues at this year's World Economic Forum in Davos as politicians
and scientists grapple with the lessons from an Ebola outbreak that
has killed more than 8,600 people.
One thing is certain: more epidemics are coming and dense urban
living, coupled with modern travel, will accelerate future
infectious disease outbreaks.
"Viruses do not need visas to get across borders," said World Health
Organisation (WHO) Director-General Margaret Chan, who admitted the
international response in future needed to be much better co-ordinated.
Her own organization has been criticised for failing to move faster
to tackle Ebola and has acknowledged that it lacked the staff and
tools to fight the epidemic adequately early on.
Part of that is down to a failure to learn from the past.
After the 2009 H1N1 swine flu pandemic, a WHO review committee
called for an internationally-funded "global public health reserve
workforce" to be set up, as well as a contingency fund for
emergencies and revamped research.
The plea was ignored at the time, but it is finally getting
attention.
"The whole world needs a new early-warning system for these
diseases," said Alpha Conde, the president of Guinea - where Ebola
went undetected for three months in early 2014.
It is not the first time a disease has been able to fester under the
radar in Africa. HIV, the virus that causes AIDS, was missed for
decades before finally bursting onto the world stage after it took
hold in the United States.
In recent years, however, public fears about infections have ebbed,
especially after the flu pandemic of six years ago turned out to be
mild. Unfortunately, there is no guarantee that humankind will be as
lucky next time.
Asked to list the top infectious disease threats for the years
ahead, Tom Frieden, director of the U.S. Centers for Disease
Control, said: "I think we'd all start with flu."
But another big danger is the emergence of drug resistance to
bacteria which causes diseases from tuberculosis to gonorrhoea, as
well as resistance to parasites like malaria.
"Drug resistance has to be put into the same category as the
emerging infectious diseases. In my view, it will be the most
important emerging infectious disease in the 21st century," said
Jeremy Farrar, director of the Wellcome Trust medical charity.
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SCIENTIFIC PLANNING
Being prepared for such future threats requires not only improving
healthcare systems in the developing world, from city hospitals to
village clinics, but also more forward thinking by scientists and
drug companies.
"If we had been ready with protocols for testing new experimental
drugs and vaccines when the Ebola epidemic started, we could have
had a bigger impact," said Peter Piot, one of the scientists who
first identified the virus almost 40 years ago.
Despite an unprecedented scramble, clinical trials testing vaccines
from GlaxoSmithKline and others in Africa are only now getting under
way, just as the number of new cases drops sharply.
One other question that needs answering is whether it is time to
switch the focus from individual diseases - such as AIDS,
tuberculosis and malaria - to improving countries' healthcare
systems as a whole.
There is little doubt that Ebola would not have taken hold on the
scale it did in Liberia, Sierra Leone and Guinea if the health
systems in those countries had been stronger.
"We often talk about a disease-specific approach to the way we build
systems," said the WHO's Chan. "No country in the world can afford
to have a health system for HIV, a health system for TB, one for
maternal and child health, and one for public health ... we need an
integrated approach."
(Editing by Pravin Char)
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