Ebola Virus Disease (EVD) outbreaks in Central and West Africa 2013-2020 were the deadliest, most intense and most widely spread. On top of this, the novel Corona Virus Disease 2019 (COVID-19) has given us all a new e...Ebola Virus Disease (EVD) outbreaks in Central and West Africa 2013-2020 were the deadliest, most intense and most widely spread. On top of this, the novel Corona Virus Disease 2019 (COVID-19) has given us all a new experience. It is imperative to draw lessons to prepare for future disease outbreaks. This was a scoping review, a method that allows the assessment of emerging evidence. The objectives of the review were to 1) describe the manifestation of the epidemics;2) elaborate on the social and economic effects;3) characterize the responses;and 4) draw lessons. The findings show that Ebola risk is permanent and even increasing. The next COVID-19 epidemic is around the corner. For Africa, the situation has been made worse by poverty and fragility of institutions. Africa’s incapacity to manufacture its own vaccines, medicines, diagnostics and protective wear has been detrimental in the management of epidemics. The need for personal and home hygiene has been emphatically brought to attention. The trust in the government and other agencies is the cornerstone in the management of emergencies. The use of armed soldiers should be discouraged, for they scare people from seeking help. It is much better to use trusted local leaders instead of strangers during pandemic emergencies. Understanding the local politics without getting involved in them is essential. It is critical to understand community and individual perception of the risk of the disease in question. Often neglected is the psycho-social aspect, which should be planned early. The science of response measures ought to be explained simply and transparently, as part of risk communication. Emergency funds should be raised, and made easy and quick to disburse. Mechanisms of sharing health technologies and knowledge need to be devised under the UN. People centeredness ought to guide the conduct of trans-border movements and all transactions during pandemics.展开更多
There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease(EVD),formerly known as Ebola haemorrhagic fever,and the public health burden that it ensues.Since 1976,there have been 885,343...There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease(EVD),formerly known as Ebola haemorrhagic fever,and the public health burden that it ensues.Since 1976,there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa.There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges.For the purposes of this paper,five have been identified:(i)the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa;(ii)the lack of education and knowledge resulting in an EVD outbreak triggering panic,anxiety,psychosocial trauma,isolation and dignity impounding,stigmatisation,community ostracism and resistance to associated socio-ecological and public health consequences;(iii)limited financial resources,human technical capacity and weak community and national health system operational plans for prevention and control responses,practices and management;(iv)inadequate leadership and coordination;and(v)the lack of development of new strategies,tools and approaches,such as improved diagnostics and novel therapies including vaccines which can assist in preventing,controlling and containing Ebola outbreaks as well as the spread of the disease.Hence,there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases.Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts.Therefore,the following actions are recommended:(i)national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings,as well as critical human resources development,must be quickly adopted by allied ministries and organisations in African countries in epidemic and pandemic responses;(ii)harnessing all stakeholders commitment and advocacy in sustained funding,collaboration,communication and networking including community participation to enhance a coordinated responses,as well as tracking and prompt case management to combat challenges;(iii)more research and development in new drug discovery and vaccines;and(iv)understanding the involvement of global health to promote the establishment of public health surveillance response systems with functions of early warning,as well as monitoring and evaluation in upholding research-action programmes and innovative interventions.展开更多
Background:West African countries Liberia,Sierra Leone,and Guinea experienced the largest and longest epidemic of Ebola virus disease from 2014 to 2016;after the epidemic was declared to be over,Liberia,Guinea,and Sie...Background:West African countries Liberia,Sierra Leone,and Guinea experienced the largest and longest epidemic of Ebola virus disease from 2014 to 2016;after the epidemic was declared to be over,Liberia,Guinea,and Sierra Leone still experienced Ebola cases/clusters.The United States Centers for Disease Control and Prevention(US CDC)participated in the response efforts to the latter Ebola clusters,by assisting with case investigation,contact identification,and monitoring.This study aims to estimate the cost to the US CDC of responding to three different Ebola clusters after the end of the Ebola epidemic in 2015:i)Sierra Leone,Tonkolili(Jan 2016,2 Ebola cases,5 affected regions);ii)Guinea,Nzerekore(Mar-May 2016,10 Ebola cases,2 affected regions);iii)Liberia,Somali Drive(Mar 2016,3 Ebola cases,1 affected region).Main text:After interviewing team members that had participated in the response,we estimated total costs(expressed in 2016 US Dollars[USD]),where total costs correspond to travel costs,deployed personnel costs,costs to prepare for deployment,procurement and interagency collaboration costs,among others.We also estimated cost per cluster case(corresponding to the total costs divided by the total number of cluster cases);and cost per case-affected-region(equal to the total costs divided by the product of the number of cases times the number of regions affected).We found that the response cost varied sixteenfold between USD 113166 in Liberia and USD 1764271 in Guinea,where the main cost drivers were travel and personnel costs.The cost per cluster case varied tenfold between 37722 in Liberia(three cases)and USD 347226 in Sierra Leone,and the cost per case-affectedregion varied threefold between USD 37722 in Liberia and USD 88214 in Guinea.Conclusions:Costs vary with the characteristics of each cluster,with those spanning more regions and cases requiring more resources for case investigation and contact identification and monitoring.These data will assist policy makers plan for similar post-epidemic responses.展开更多
Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest expe...Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events.Main text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks.Conclusions: Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.展开更多
文摘Ebola Virus Disease (EVD) outbreaks in Central and West Africa 2013-2020 were the deadliest, most intense and most widely spread. On top of this, the novel Corona Virus Disease 2019 (COVID-19) has given us all a new experience. It is imperative to draw lessons to prepare for future disease outbreaks. This was a scoping review, a method that allows the assessment of emerging evidence. The objectives of the review were to 1) describe the manifestation of the epidemics;2) elaborate on the social and economic effects;3) characterize the responses;and 4) draw lessons. The findings show that Ebola risk is permanent and even increasing. The next COVID-19 epidemic is around the corner. For Africa, the situation has been made worse by poverty and fragility of institutions. Africa’s incapacity to manufacture its own vaccines, medicines, diagnostics and protective wear has been detrimental in the management of epidemics. The need for personal and home hygiene has been emphatically brought to attention. The trust in the government and other agencies is the cornerstone in the management of emergencies. The use of armed soldiers should be discouraged, for they scare people from seeking help. It is much better to use trusted local leaders instead of strangers during pandemic emergencies. Understanding the local politics without getting involved in them is essential. It is critical to understand community and individual perception of the risk of the disease in question. Often neglected is the psycho-social aspect, which should be planned early. The science of response measures ought to be explained simply and transparently, as part of risk communication. Emergency funds should be raised, and made easy and quick to disburse. Mechanisms of sharing health technologies and knowledge need to be devised under the UN. People centeredness ought to guide the conduct of trans-border movements and all transactions during pandemics.
文摘There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease(EVD),formerly known as Ebola haemorrhagic fever,and the public health burden that it ensues.Since 1976,there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa.There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges.For the purposes of this paper,five have been identified:(i)the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa;(ii)the lack of education and knowledge resulting in an EVD outbreak triggering panic,anxiety,psychosocial trauma,isolation and dignity impounding,stigmatisation,community ostracism and resistance to associated socio-ecological and public health consequences;(iii)limited financial resources,human technical capacity and weak community and national health system operational plans for prevention and control responses,practices and management;(iv)inadequate leadership and coordination;and(v)the lack of development of new strategies,tools and approaches,such as improved diagnostics and novel therapies including vaccines which can assist in preventing,controlling and containing Ebola outbreaks as well as the spread of the disease.Hence,there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases.Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts.Therefore,the following actions are recommended:(i)national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings,as well as critical human resources development,must be quickly adopted by allied ministries and organisations in African countries in epidemic and pandemic responses;(ii)harnessing all stakeholders commitment and advocacy in sustained funding,collaboration,communication and networking including community participation to enhance a coordinated responses,as well as tracking and prompt case management to combat challenges;(iii)more research and development in new drug discovery and vaccines;and(iv)understanding the involvement of global health to promote the establishment of public health surveillance response systems with functions of early warning,as well as monitoring and evaluation in upholding research-action programmes and innovative interventions.
基金This study was developed as party of the job duties of the authors,and no special funding was required for this study.
文摘Background:West African countries Liberia,Sierra Leone,and Guinea experienced the largest and longest epidemic of Ebola virus disease from 2014 to 2016;after the epidemic was declared to be over,Liberia,Guinea,and Sierra Leone still experienced Ebola cases/clusters.The United States Centers for Disease Control and Prevention(US CDC)participated in the response efforts to the latter Ebola clusters,by assisting with case investigation,contact identification,and monitoring.This study aims to estimate the cost to the US CDC of responding to three different Ebola clusters after the end of the Ebola epidemic in 2015:i)Sierra Leone,Tonkolili(Jan 2016,2 Ebola cases,5 affected regions);ii)Guinea,Nzerekore(Mar-May 2016,10 Ebola cases,2 affected regions);iii)Liberia,Somali Drive(Mar 2016,3 Ebola cases,1 affected region).Main text:After interviewing team members that had participated in the response,we estimated total costs(expressed in 2016 US Dollars[USD]),where total costs correspond to travel costs,deployed personnel costs,costs to prepare for deployment,procurement and interagency collaboration costs,among others.We also estimated cost per cluster case(corresponding to the total costs divided by the total number of cluster cases);and cost per case-affected-region(equal to the total costs divided by the product of the number of cases times the number of regions affected).We found that the response cost varied sixteenfold between USD 113166 in Liberia and USD 1764271 in Guinea,where the main cost drivers were travel and personnel costs.The cost per cluster case varied tenfold between 37722 in Liberia(three cases)and USD 347226 in Sierra Leone,and the cost per case-affectedregion varied threefold between USD 37722 in Liberia and USD 88214 in Guinea.Conclusions:Costs vary with the characteristics of each cluster,with those spanning more regions and cases requiring more resources for case investigation and contact identification and monitoring.These data will assist policy makers plan for similar post-epidemic responses.
文摘Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events.Main text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks.Conclusions: Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.
