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Selected Category: global health security

CDC Director: Why I don’t support a travel ban to combat Ebola outbreak

Categories: Ebola, global disease detection, global health security, infectious disease

 

This blog was originally posted on Fox News on October 9, 2014.

 

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CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

The first case of Ebola diagnosed in the United States has caused some to call on the United States to ban travel for anyone from the countries in West Africa facing the worst of the Ebola epidemic.

That response is understandable. It’s only human to want to protect ourselves and our families. We want to defend ourselves, so isn’t the fastest, easiest solution to put up a wall around the problem?

But, as has been said, for every complex problem, there’s a solution that’s quick, simple, and wrong.

A travel ban is not the right answer. It’s simply not feasible to build a wall – virtual or real – around a community, city, or country. A travel ban would essentially quarantine the more than 22 million people that make up the combined populations of Liberia, Sierra Leone, and Guinea.

We don't want to isolate parts of the world, or people who aren't sick, because that's going to drive patients with Ebola underground, making it infinitely more difficult to address the outbreak.When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else.

We don’t want to isolate parts of the world, or people who aren’t sick, because that’s going to drive patients with Ebola underground, making it infinitely more difficult to address the outbreak.

It could even cause these countries to stop working with the international community as they refuse to report cases because they fear the consequences of a border closing.

Stopping planes from flying from West Africa would severely limit the ability of Americans to return to the United States or of people with dual citizenship to get home, wherever that may be.

In addition to not stopping the spread of Ebola, isolating countries will make it harder to respond to Ebola, creating an even greater humanitarian and health care emergency.

Importantly, isolating countries won’t keep Ebola contained and away from American shores. Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries, and that we will have more patients who develop Ebola in the U.S.

People will move between countries, even when governments restrict travel and trade. And that kind of travel becomes almost impossible to track.

Isolating communities also increases people’s distrust of government, making them less likely to cooperate to help stop the spread of Ebola.

Isolating communities and regions within countries will also backfire. Restricting travel or trade to and from a community makes the disease spread more rapidly in the isolated area, eventually putting the rest of the country at even greater risk.

To provide relief to West Africa, borders must remain open and commercial flights must continue.

There is no more effective way to protect the United States against additional Ebola cases than to address this outbreak at the source in West Africa. That’s what our international response—including the stepped-up measures the president announced last month—will do.

What works most effectively for quelling disease outbreaks like Ebola is not quarantining huge populations.

What works is focusing on and isolating the sick and those in direct contact with them as they are at highest risk of infection. This strategy worked with SARS and it worked during the H1N1 flu pandemic. Casting too wide a net, such as invoking travel bans, would only provide an illusion of security and would lead to prejudice and stigma around those in West Africa.

Americans can be reassured we are taking measures to protect citizens here.

Today, all outbound passengers from Guinea, Liberia, and Sierra Leone are screened for Ebola symptoms before they board an airplane.

Staff from CDC and the Department of Homeland Security’s Customers & Border Protection will begin new layers of entry screening, first at John F. Kennedy International Airport in New York this Saturday, and in the following week at four additional airports — Dulles International Airport outside of Washington, D.C.; Newark Liberty International Airport; Chicago’s O’Hare International Airport; and Hartsfield-Jackson Atlanta International Airport.

Combined, these U.S. airports receive almost 95 percent of the American-bound travelers from the Ebola-affected countries.

Travelers from those countries will be escorted to an area of the airport set aside for screening. There they will be observed for signs of illness, asked a series of health and exposure questions, and given information on Ebola and information on monitoring themselves for symptoms for 21 days. Their temperature will be checked, and if there’s any concern about their health, they’ll be referred to the local public health authority for further evaluation or monitoring.

Controlling Ebola at its source – in West Africa – is how we will win this battle. When countries are isolated, we cannot get medical supplies and personnel efficiently to where they’re needed – making it impossible to fight the virus in West Africa.

As the WHO’s Gregory Hartl said recently, “Travel restrictions don’t stop a virus. If airlines stop flying to West Africa, we can’t get the people that we need to combat this outbreak, and we can’t get the food and the fuel and other supplies that people there need to survive.”

We know how to stop Ebola: by isolating and treating patients, tracing and monitoring their contacts, and breaking the chains of transmission.

Until Ebola is controlled in West Africa, we cannot get the risk to zero here in the United States.

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Ebola Requires the World’s United Action

Categories: Ebola, global health security

 

This blog is cross-posted on the White House website.

 

White House

The nations of the world, along with key international organizations, gather at the White House today to advance a Global Health Security Agenda that will help keep the world safe from infectious disease threats.

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

This meeting is a critical opportunity to increase international commitment and, more importantly, action to stop the Ebola epidemic in West Africa and the infectious disease threats to come.

Ebola is a critical issue for the world community. There’s a real risk to the stability and security of societies, as governments are increasingly challenged to not only control Ebola but to provide basic health services and other government functions. The stability of these countries and their economies, as well as those of their neighbors and of others, is at increasing risk.

Ebola is the most recent tragic example of why it is imperative to work together to make the world safer from infectious disease outbreaks. Ebola is precisely the kind of health threat the Global Health Security Agenda could have prevented. We and our partner countries have agreed to work together so that effective prevention, detection, and response mechanisms are present in every country around the world.

There are three key actions we must take:

  1. Prevent avoidable catastrophes and epidemics. We can only do this if we track health threats and work strategically to prevent emergence and spread.
  2. Detect threats early. This requires real-time disease tracking and effective systems to identify clusters of illness and to do the laboratory tests, including collecting outbreak specimens and safely and securely transporting them for accurate laboratory testing.
  3. Respond rapidly and effectively. Each country needs trained disease detectives. These individuals can work most effectively in interconnected emergency operations centers connected with response capacity ready to spring into action.

CDC has many years of experience assisting countries throughout the world with public health emergency detection and response capacity. Recent demonstration projects in Uganda and Vietnam created emergency operations centers, national laboratory systems, and real-time information systems, and are a proof of principle that global health security systems can be rapidly implemented and used immediately to find and stop health threats.

Dr. Tom Frieden, Director of the U.S. Centers for Disease Control and Prevention, prepares to don googles before entering the Ebola treatment unit (ETU), ELWA 3. Médecins Sans Frontières/Doctors Without Borders operates the ELWA 3 ETU, which opened on August 17.

Dr. Tom Frieden, Director of the U.S. Centers for Disease Control and Prevention, prepares to don goggles before entering the Ebola treatment unit (ETU), ELWA 3.

Last year, I visited urban and rural areas in Uganda to review the progress of this pilot project and I was deeply impressed; this project is one of the highest impact initiatives CDC has undertaken in my time as director. Progress improving disease detection and response in these countries shows that such models can work on a global scale.

One critical need is to train disease detectives around the world so that they can close gaps in surveillance and detect disease outbreaks as early as possible. CDC’s Epidemic Intelligence Service program is a global model for this type of training.

Since the 1980s, we’ve helped 40 other countries develop their own similar training. Trainees and graduates of these programs find and stop hundreds of outbreaks a year, usually without CDC’s direct involvement, which is exactly the result that we will see the more we invest in smart and effective programs like this one. In fact, graduates of these programs from Cameroon, Democratic Republic of Congo, Kenya, Morocco, South Africa, and Tanzania have been working on the ground to help stop the current Ebola outbreak.

It is increasingly clear that the health of other nations has a direct impact on health in the United States—infectious diseases do not recognize borders, and a disease outbreak is just a plane trip away.

Strengthening global health security will protect Americans, and protect people from around the world.

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What it’s REALLY like fighting Ebola in Liberia

Categories: Ebola, global health security, infectious disease

 

This blog was originally posted on the ONE.org on September 11, 2014.

 

A Médecins Sans Frontières/Doctors Without Borders (MSF) staff member ties the face mask of Dr. Jordan Tappero, CDC, before Dr. Tappero enters the Ebola treatment unit (ETU), ELWA 3. MSF operates the ELWA 3 ETU, which opened on August 17.

A Médecins Sans Frontières/Doctors Without Borders (MSF) staff member ties the face mask of Dr. Jordan Tappero, CDC, before Dr. Tappero enters the Ebola treatment unit (ETU), ELWA 3. MSF operates the ELWA 3 ETU, which opened on August 17.

Jordan W. Tappero, MD, MPH

Jordan W. Tappero, MD, MPH

During my time in Liberia, I have tried not to provide much detail to my family about the day-to-day work we are doing.

I don’t want to cause alarm or propagate fear; conditions in Monrovia can at times be deeply troubling.

I have spent the past month working to help control the Ebola outbreak in Liberia as part of the United States Government’s Disaster Assistance Response Team, or DART.

Our work here has been nonstop and it doesn’t appear that the end of the epidemic will be anytime soon. There are days when there is palpable tension in the air, especially when a new community experiences Ebola virus transmission for the first time, or experiences a second or third wave of disease.

Indonesia Takes a Leadership Position in the Global Health Security Agenda

Categories: global health security

Maluku mom and kid with mosquito bed net (Photo courtesy of Edi Purnomo, UNICEF)

Photo courtesy of Edi Purnomo, UNICEF

Dr. William Hawley, Country Director for CDC-Indonesia

Dr. William Hawley, Country Director for CDC-Indonesia

As the world’s fourth most populated country, Indonesia plays an important strategic role in protecting the global community from infectious disease threats. As one of the early countries to take a leadership role in the Global Health Security (GHS) Agenda, the Government of Indonesia will welcome senior health and agricultural leaders from 36 countries and 12 international organizations for the next commitment meeting August 20-21. The meeting, “Building Global Commitment to Multisectoral Approaches to Manage Emerging Zoonotic Diseases in Support of the Global Health Security Agenda within the Framework of Public Health”, demonstrates the progress and growing momentum of the GHS Agenda.

The High Stakes in Fighting Ebola: Leave One Burning Ember and the Epidemic Could Re-Ignite

Categories: Ebola, global disease detection, global health security, health systems strengthening, infectious disease

 

This blog was originally posted on the Huffington Post on August 7, 2014.

 

A banner encouraging people suffering from Ebola to go immediately to a health center for treatment is seen on a sidewalk in the city of Freetown, Sierra Leone, Thursday, Aug. 7, 2014. While the Ebola virus outbreak has now reached four countries, Liberia and Sierra Leone account for more than 60 percent of the deaths, according to the World Health Organization. The outbreak that emerged in March has claimed at least 932 lives. (AP Photo/Michael Duff)

(AP Photo/Michael Duff)

CDC and our partners are currently fighting the biggest and most complex outbreak of Ebola virus disease ever recorded.

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

There are hundreds of cases in West Africa and now a new cluster of cases in Nigeria is very concerning. The spread of Ebola shows what happens if we don’t have meticulous infection control, contact tracing, and proper isolation of those with symptoms of the disease.

There are two things that are very important to understand about how Ebola spreads.

The evidence suggests that Ebola only spreads from sick people—not from people who have been exposed to the disease but haven’t yet become sick from it. The illness has an average 8-10 day incubation period, although in rare instances the incubation period may be as short as two days or as long as 21 days, which is why we recommend monitoring for 21 days after any potential exposure.

Global Health Security in Africa: Collaborations Between CDC and African Partners

Categories: global health security

2012 investigation of Ebola virus in Uganda

2012 investigation of Ebola virus in Uganda

Thomas Kenyon, MD MPH, Director of CDC Center for Global Health

Thomas Kenyon, MD MPH, Director of CDC Center for Global Health

The ambition and scope of the Global Health Security Agenda are clear. Its reach can be discerned from the very first word: global. The Agenda’s overarching goal is just as expansive—making the world safer and more secure by preventing epidemics and outbreaks, detecting them more rapidly, and responding effectively to lessen the health, economic, and societal consequences from disease threats.

Less obvious, but no less true, is that African ownership will be central and fundamental in shaping the way the Global Health Security Agenda evolves worldwide, the way it is enacted and refined, and to a large extent, how it succeeds.

CDC and African nations have been close and successful partners for many decades in the battle to protect and improve public health. In many ways, the concepts, practices, and tools that are central to the Global Health Security Agenda are drawn from experiences honed with our partners in Africa over many years.

World Cup serving as real-world test for new disease detection technology

Categories: global disease detection, global health security, health systems strengthening, infectious disease

 

World Cup soccer ball

 

With the World Cup underway in all its frenzied glory, you can be forgiven for missing another major effort currently underway in Brazil that represents the first large scale, real-life, real-world test of important new technology.

And no, it’s not the goal-line technology that’s being used for the first time at soccer’s biggest competition.

This technology uses computer tablets, sophisticated software designed by CDC and public health experts from Brazil’s Ministry of Health (MOH) trained in the Field Epidemiological Training Program (FETP) to provide the most complete, detailed and timely information about disease threats and other public health concerns.

Communication Matters in Global Health Deployments

Categories: global health security, infectious disease

During the simulation exercise, ECN trainees deployed to the site of a mock disaster in Avully, Switzerland.

During the simulation exercise, ECN trainees deployed to the site of a mock disaster in Avully, Switzerland.

Communication matters.

Gaya Gamhewage, MD, Coordinator, WHO Communication Capacity Building Team; Founder, WHO Emergency Communication Network

Gaya Gamhewage, MD, Coordinator, WHO Communication Capacity Building Team; Founder, WHO Emergency Communication Network

That’s not a new idea. Many of us have learned this the hard way. This concept is being applied in a new, more comprehensive way for a key purpose—to help the World Health Organization (WHO) communicate more effectively, with more clarity and purpose during humanitarian and public health emergencies.

The idea is to better integrate communications specialists from WHO, CDC, ministries of health and a wide array of other humanitarian and global health organizations into a cohesive, specially trained team that can be dispatched on short notice when public health or humanitarian emergencies occur.

The logic is based on the idea that communications is part and parcel of emergency health response. Communicating in a crisis not only provides the public and policy maker clear and critical information, it also can help the technical side of the response. It connects those affected with those willing to help and can make sure that resources are aligned to the most important needs.

Public Health Informatics in Action in Malawi: Making life easier for healthcare workers and patients while improving quality through an innovative national Electronic Medical Record System

Categories: child health, global health security, HIV/AIDS, women's/maternal health

Instituting an Electronic Medical Record System reduces the need to manage and store growing volumes of patient charts, a major challenge in resource-limited settings.

Instituting an Electronic Medical Record System reduces the need to manage and store growing volumes of patient charts, a major challenge in resource-limited settings.

Denise Giles, M.P.H., Health Scientist, CDC-Malawi

Denise Giles, M.P.H., Health Scientist, CDC-Malawi

Keeping track of even one patient undergoing treatment for HIV/AIDS can be complicated enough.

Doing it for over 472,865 patients when you’re a low income country coping with high demand and a sputtering economy magnifies the complexity.

Which is why Malawi’s story – and its solution – is attracting attention and praise. It’s a story of how Electronic Medical Record System (EMRS) technology is being used and the foresight needed to bring it to reality.

You don’t have to look far to see the positive results.

FETP Work in South Sudan Benefits the Whole World

Categories: global health security, health systems strengthening

I’ve been with the Field Epidemiology Training Program (FETP) for 2.5 years now, where I am currently the resident advisor (RA) in South Sudan. My epidemiology training has provided me with the opportunity to gain a wide variety of experiences; prior to joining FETP, I served as an epidemiologist with Médecins Sans Frontières-Switzerland (MSF-CH), working in the refugee camp in Dadaab, Kenya, and have also worked in Dawei (Tavoy), Burma . I am glad to be able to pass on my knowledge about epidemiology to future leaders in the field. As an RA I assist with basic FETP implementation for county and state surveillance officers as well as immunization managers and supervisors. I also advise on outbreak response for priority diseases as well as assist with cascade training for the health facility staff who provide immunization services.

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