The Best Defense is a Strong Offense: Strengthening Our Nation’s Outbreak Preparedness

Dec 22, 2014, 5:08 PM, Posted by

In the shadow of this year’s Ebola outbreak, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Outbreaks: Protecting Americans from Infectious Diseases.

The report finds that while significant advances have been made in preparing for, responding to, and recovering from emergencies, gaps in preparedness remain and have been exacerbated as resources have been cut over time.

On the eve of the report’s release, I spoke with Jeffrey Levi, PhD, executive director of the Trust for America’s Health to get his thoughts on today’s preparedness landscape—think, Ebola—what to do about shrinking budgets and growing infectious disease threats, and where to go from here.

As this year’s Ebola outbreak made clear, our public health system needs to be modernized to match rapidly evolving global disease threats. Every state should be able to provide a baseline of public health preparedness—and the sustained funding to support this is simply not there. We also need to work better together across the health care system, hospitals and public health agencies the common goals of protecting patients, health care workers and the public.

Paul Kuehnert: Ebola is, of course, getting significant attention this year. How does this draw attention to preparedness needs? Has it caused us to overlook other important threats?

Jeffrey Levi: The Ebola outbreak has obviously been a major wake-up call to the United States—highlighting both the strengths of, and some serious gaps in, the country’s ability to manage severe disease outbreaks and contain their spread. But, our hope in writing this report is to remind Americans that as frightening as Ebola seemed, there are routine infectious diseases that pose a greater and daily threat to Americans as well as many other emerging threats that health officials are monitoring.

Antibiotic-resistant Superbugs, health care-associated infections, foodborne illnesses, HIV/AIDS, the seasonal flu, mosquito-borne diseases (Chikungunya, West Nile, Malaria, etc.) Hepatitis B and C, and TB all deserve attention. Beyond Ebola, there are many other emerging diseases of concern that health officials are monitoring—MERS-CoV, pandemic flu, Marburg, dengue fever and Enterovirus D68—all of which illustrate that infectious disease threats can arise without notice.

Infectious diseases are not just a threat to health; they have an impact on how Americans live their daily lives and—depending on the severity and scope of a threat—can influence decisions about sending children to schools, limiting travel, restricting public events and even quarantine activities.

Paul: We all know budgets are tighter every year. How should our nation prioritize spending to prevent and treat infectious disease?

Jeffrey: The best offense to fighting infectious diseases is a strong and steady defense. The post-2001 investments in public health preparedness have led to significant progress in many areas of health emergency preparedness, but they did not lead to a serious modernization of the nation’s approach to infectious disease control. 

The current system must be brought up to date to better match modern global disease threats, technological advances and a clear, consistent set of baseline capabilities. These capabilities should include: investigative capabilities; containment strategies, including vaccines and medicines; continued training and testing for hospitals and health departments for infection control and emergency preparedness; strong surveillance to identify and track threats and communicate across the health care system; and maintaining a strong research capacity to develop new vaccines and medical treatments.

Paul: What other agencies or organizations can help prevent and treat outbreaks?

Jeffrey: Government is only one part in the fight to prevent and control infectious diseases. To take a 24/7 approach, government must work with the health care sector; pharmaceutical, medical supply and technology companies; community groups, schools and employers; and families and individuals. While governments at all levels have the ability to set policies and establish practices based on the best science available to better protect Americans from infectious disease threats, government needs help in creating new vaccines and antivirals, in tracing contacts who may have been exposed to a disease, in communicating risk to Americans that is based on sound science, and any number of other endeavors that keep people safe.


Interested in learning more about our nation's outbreaks prepareness? Download the full report here