As part of its review of U.S. engagement in the global response to the current Ebola epidemic, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) sought insights from a panel of experts with decades of experience on the front lines of fighting infectious diseases.
Peter Hotez, M.D., Ph.D., Dean of the National School of Tropical Medicine at Baylor College of Medicine and President of the Sabin Vaccine Institute, said he hopes the Ebola epidemic will prompt health officials in the U.S. and around the world to get ready for what he believes could be even more disruptive and deadly encounters with infectious disease in the near future.
“It would be nice if for once the world could be proactive,” he said.
For example, Hotez said he has been advising the State Department and the White House that “the next shoe about to drop is in the Middle East and North Africa.”
“In ISIS-occupied Syria and Iraq we are already seeing refugees pouring across the border into Jordan, Lebanon, and Turkey. We are seeing rabies, huge amounts of Leishmaniasis. We are going to see Middle East Respiratory Syndrome. We have got to build capacity for the next big thing that is going to happen.”
Helene Gayle, President and CEO of CARE USA, observed that it has been the enduring frustration of public health veterans that preventative measures often are not widely embraced and thus struggle for attention and funding.
“Having spent most of my life trying to get people excited by non-events, which is what prevention is, we have to be realistic,” she said. “It is much more difficult to get people to care about something that they are preventing versus something they can change.”
Gayle said the lesson from her work at CARE is that if the U.S. wants to be more effective in its efforts to deal with threats like Ebola, it needs to establish trust and relationships in the affected countries.
“In our work in Sierra Leone and Liberia around Ebola, it has been with communities we have been working with for years,” she said. “We work in micro-finance, in agriculture productivity, so they already trusted CARE and our partners. We were not just there for Ebola. We were not just there for this disease that America now cares about.”
William Foege, M.D., M.P.H., is a Senior Fellow for Health Policy at the Carter Center, a Senior Fellow in the Global Health Program at the Bill and Melinda Gates Foundation, and an Emeritus Presidential Distinguished Professor of International Health at Emory University. Foege was deeply involved in the battle against smallpox in the 1970s, and served as Director of the Centers for Disease Control and Prevention (CDC) from 1977-1983. He said among the lessons from his many years of experience, he learned that it’s very hard to get people to focus on problems affecting the poor. But he believes Ebola may be a prime opportunity to generate a new level of support for fighting the diseases of poverty and conflict and it should not be wasted.
“We should make the most out of Ebola,” he said. “Despite the fact that there are bigger problems, I always tell students that one of our jobs is to tie the fears of the rich to the needs of the poor. And Ebola has become a fear of the rich and we should use that to the maximum.”
Next up: The Bioethics Commission turns its attention to how the Ebola crisis has played out in Western African immigrant communities in the United States and among health care workers returning from working in affected countries.