To quickly summarize the state of affairs, the 2014 Ebola outbreak not only the first in western Africa but one of the largest in history. The virus is transmitted through direct contact with a sick person's blood or bodily fluids, contaminated objects or infected animals. This leaves healthcare works and other caregivers, such as family members, at the highest risk of infection because they are the most likely to come into contact with bodily fluids (1). While the number of known cases has yet to match that of another recent viral outbreak, SARS, the known number of Ebola deaths has already more than tripled those caused by SARS (2).
It's plain to see that the containment of the outbreak is not going as well as the world would hope. In a recent Newsweek article, an official from the National Institute of Health described the outbreak as "completely out of control" (3). As the projections of the outbreak spread, Ebola will continue to be a global health security concern. Global health security focuses on outbreaks haven't occurred yet as a way to prevent the spread of a deadly pathogen from threatening wealthy counties. The pathogens of concern, such as SARS, originate in developing regions of the world and have the potential to travel to the rest of the world. To stay a step ahead of potential outbreaks, large health organizations, disease control institutes and laboratories use cutting edge technology to track occurrences of disease around the world (4).
While resources are being spent to monitor and control the further movement of Ebola, there is a desperate need for medical treatment and care for people already infected with the disease. Some of those who are sick now are members of the global humanitarian biomedicine networks. Professionals who's primary global health concerns are the alleviation and mitigation of suffering in afflicted populations often work in apolitical settings. They work for and coordinate with non-governmental organizations, activists, and other health-related parties to bring health interventions to individuals and communities in need (4).
With hundreds of millions of dollars pouring in from international organizations, governments and private charity, the question of who will, and should, be the primary benefactor of those financial resources. Ethically, that decision is tricky and can one's view can depend greatly on what they regard to be the primary focus of global health which, when greatly generalized, boils down to protection of the wealthy or assistance to the poor. The issue of ethical funding distribution is not so simple, of course.
The protection of global health security, by way of improving disease surveillance and global health crisis response, stands to serve some of the world's poorest citizens. A significant issue facing respondents to this year's Ebola outbreak has been coordination of local and state governments to disseminate information and maintain a civil and cooperative society. Expending resources to streamline outbreak response and international coordination policies could, in the long run, save lives through the prevention of outbreak growth. Issues with inter-organizational communication plight humanitarian efforts as well. In their efforts to provide basic care and alleviate acute suffering, health professionals face problems of transaction costs related to management and coordination when new actors are introduced, and many are (5).
When deciding where international aid money should be spent, the question does not have to be framed as, "save the rich, or save the poor". There are merits to both views of and approaches to global health. I believe some prominent global health practitioners like Paul Farmer would argue for a strong centralized public authority over small, disconnected, health service providers, based on the grounds of improved efficiency and power to accomplish complex, long-term health goals. In this instance, I would have to side more with those who favor global health security. Perhaps the best way to stop future viral outbreaks is to increase international response efficiency and provide support for country-level health authorities.
With hundreds of millions of dollars pouring in from international organizations, governments and private charity, the question of who will, and should, be the primary benefactor of those financial resources. Ethically, that decision is tricky and can one's view can depend greatly on what they regard to be the primary focus of global health which, when greatly generalized, boils down to protection of the wealthy or assistance to the poor. The issue of ethical funding distribution is not so simple, of course.
The protection of global health security, by way of improving disease surveillance and global health crisis response, stands to serve some of the world's poorest citizens. A significant issue facing respondents to this year's Ebola outbreak has been coordination of local and state governments to disseminate information and maintain a civil and cooperative society. Expending resources to streamline outbreak response and international coordination policies could, in the long run, save lives through the prevention of outbreak growth. Issues with inter-organizational communication plight humanitarian efforts as well. In their efforts to provide basic care and alleviate acute suffering, health professionals face problems of transaction costs related to management and coordination when new actors are introduced, and many are (5).
When deciding where international aid money should be spent, the question does not have to be framed as, "save the rich, or save the poor". There are merits to both views of and approaches to global health. I believe some prominent global health practitioners like Paul Farmer would argue for a strong centralized public authority over small, disconnected, health service providers, based on the grounds of improved efficiency and power to accomplish complex, long-term health goals. In this instance, I would have to side more with those who favor global health security. Perhaps the best way to stop future viral outbreaks is to increase international response efficiency and provide support for country-level health authorities.
1."Ebola Hemorrhagic Fever." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 29 Aug. 2014. Web. 4 Sept. 2014.
2. "What You Need to Know About the Ebola Outbreak." The New York Times. The New York Times, 30 July 2014. Web. 5 Sept. 2014.
3. Kloc, Joe. "NIH: Ebola Outbreak Is 'Completely Out of Control'" Newsweek 4 Sept. 2014. Print.
4. Lakoff, Andrew. "Two Regimes of Global Health." Humanity: An International Journal of Human Rights, Humanitariansim, and Development 1.1 (2010): 59-79. Web. 5 Sept. 2014. <http://muse.jhu.edu/journals/humanity/v001/1.1.lakoff.pdf>.
5. Schieber, George. "Financing Global Health: Mission Unaccomlished." Health Affiars 26.4 (2007): 921-34. Print.
5. Schieber, George. "Financing Global Health: Mission Unaccomlished." Health Affiars 26.4 (2007): 921-34. Print.
I definitely agree with your point on how global health security would be the best way to stop future viral outbreaks. I do believe that one of the biggest issues right now is getting the medicine and other necessary supplies to the people who actually need it, as we discussed in class yesterday. In this case, the question is whether that money should go towards prevention efforts or towards treatment efforts (which is definitely a tough situation for those global health officials that have to "choose" between the two). Our best bet to eradicate Ebola in the future would be by prevention, but right now in the midst of this huge outbreak, it is hard to ignore all of the people who are still suffering from the illness.
ReplyDeleteI agree with you. But I think that is because global health security involves wealthier nations investing in surveillance and ostensibly prevention. I also agree with your evaluation of Paul Farmer's position (and with Paul's position, if true)-- there is a need for highly centralized authority over disease surveillance and prevention. These would serve to connect smaller networks of health interests.
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