Why are we not learning from the past? - Ebola and COVID-19 responses

 In this issue, I intend to reflect on the ongoing pandemic and whether or not public health practitioners have learned lessons from the COVID-19. 

In 2014, there was an outbreak of Ebola Virus Disease (EVD) in West Africa countries of Liberia, Sierra Leone and Guinea resulting in the infection of 28,000 people and 11,310 deaths in the three countries. During that time, there was both solidarity and neglect from public health practitioners and the international community. We saw multiple countries supporting to control the outbreak, including the US National Guards, to help the West African countries. At the same time, because the outbreak was geographically localized, there was a minimal global collective response to the diseases. As a result, only a few companies invested in research and development (R&D) in support of novel diagnostics technologies, treatment, or vaccines. It was also obvious that the affected countries have very weak health systems which further exuberated the collective response to the detection, control, and treatment of Ebola. 

That was the missed opportunity to help those countries strengthen their healthcare systems and most importantly prepare them for future emergencies. It is not a secrete that health systems are not resilient to accommodate emerging infections in most developing countries, but to neglect this fact in responding to the Ebola disease means the same problem will recur in any emerging situation. This is the situation we face now in the COVID-19 pandemic. There is no difference between public health solidarity in the Ebla era and that of COVID-19. The interventions are still focused on "helping" developing countries to "respond" to COVID-19 with minimal efforts to rebuilding broken health systems. With the COVID-19, even developed countries, with so-called strong health systems, are struggling to effectively control the spread of the virus. This situation is worst in most developing countries particularly those who are still fighting infectious diseases including HIV, TB, Malaria as well as Maternal and Child Health.

It is therefore obvious that as much as we missed the opportunity to learn from the Ebola outbreak of 2014 to build health systems, including emergency response, we are still missing the opportunity in COVID-19 interventions. In my publication in AJLM, I called on public health practitioners to consider health systems in their interventions instead of following the responses of developed countries. In cases of emergency, developed countries with strong healthcare have better responses than their developing counterparts, and yet we blindly copy the "success" of developed countries for those with weak systems. If we want to be on the same level of responses (for success sharing), then our health systems must be similar. Hence, public health practitioners globally, regionally, and nationally must seek solidarity to build stronger health systems towards resilient disease prevention, control, and emergency preparedness in order to save the lives of innocent populations from preventable infectious diseases. 

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