The Power of Preparedness

September 2, 2016 by Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

The Power of Preparedness. National Preparedness Month 2016.

If there were one thing I’d wish for, it would be the ability to predict when and where the next infectious disease outbreak would occur and stop it before it starts. I can’t do that. And neither can anyone else.

At this moment, in addition to combating Zika in the United States and polio in Nigeria and Pakistan, we’re putting out the last embers of Ebola in West Africa, stomping out cholera in Tanzania and Kenya, and fighting yellow fever in Angola. We’re keeping vigilant for the re-emergence of H5N1 influenza and Middle East respiratory syndrome, and monitoring chikungunya, dengue, monkeypox, Lassa fever, measles…the list goes on.

It’s a lot to do. And these are just the diseases we know about. The brutal fact is that there are diseases we haven’t discovered yet. They’re out there, waiting to expose the cracks in our systems – to find the places where we aren’t watching, the areas where we aren’t prepared. And we can’t know the potential danger.

Finding – and filling – the gaps

The fact is, if you leave an opening – any opening – disease will find it. This is why it’s critical to have strong public health systems in place before emergencies happen. We can do more to recognize what causes outbreaks, respond to them faster, and bring them under control more effectively.

Around the world and at home, we need to know the level and types of disease that are normally present, so we can detect when there’s a change that requires our attention. We need safe laboratories that can rapidly diagnose the cause of illness close to the source. We need emergency operations centers that can bring experts together quickly to make decisions. Until we have these things, there will be gaps.

And where there are gaps, there is the potential for disaster. The unexpected eruption of Ebola in West Africa showed us this clearly. Before that there were others: HIV raged undetected for a decade; SARS spread to 37 countries across three continents in four months; Anthrax drew the world’s attention to the threat of intentional releases of lethal pathogens.

The human and economic costs are dear. SARS killed nearly 800 people and cost an estimated $40 billion. Ebola has killed over 11,000 people and cost billions. The potential costs of Zika to the lives of our children are unfathomable.

The value of being prepared

Each day, we continue to learn by doing. Every disaster teaches us how to do better the next time. We are seeing results, both here at home and in countries around the world.

We know that preparedness can stop unexpected health threats, even when the disease is fast moving and deadly. Take Nigeria as an example: with a highly trained team of disease detectives and an emergency operations center at the ready, Nigeria was able to thwart Ebola’s spread in Lagos and elsewhere in Nigeria, stopping the outbreak at 20 cases and averting a potential public health catastrophe.

Cameroon’s emergency operations center was recently able to head off an outbreak of H5N1 influenza by activating within 24 hours of notification. Through investments in training and preparedness, they have dramatically improved their response times – just one year ago, it took that same center eight weeks to respond to an outbreak of cholera.

At home, our flu program serves as a gold standard for how to be flexible and responsive in an emergency. When H1N1 influenza hit, we were able to act faster and more effectively through systems we already had in place for vaccine shipping, coverage, and monitoring. The outbreak response also demonstrated how we can work effectively across sectors – across CDC, between levels of government, and with global partners like the World Health Organization and ministries of health.

Despite these successes, nearly 70 percent of countries remain unprepared to handle a public health emergency. That’s a scary number – and a lot of vulnerable people.

Building well for the future

We cannot accept the status quo; we must put our investments into work that will make the world a safer place for us all. In doing this, we must first believe – as I do – that it is possible to create positive change and get results.

In a time when what pops up in one corner of the world can find its way across the globe in a matter of hours, we all have a responsibility to each other to be prepared.

We cannot take this responsibility seriously enough.