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Harvard Professor Talks Learning from Ebola and Zika Outbreaks

At the time of the Ebola crisis in 2014, the entire nation of Liberia had as many doctors as there are cardiologists at Brigham and Women’s Hospital. That’s according to Ashish Jha, the director of the Harvard Global Health Institute, who gave the global response to Ebola a grade of D- and continues to call for more preparation in combatting the spread of disease. As the international community has largely turned its attention away from the Ebola and Zika pandemics, Jha insists that the world’s inadequate learning from these crises has left it without the proper mentality to prevent another outbreak.

Jha gave a lecture titled “Preventing the Next Global Pandemic: Lessons from Ebola and Zika” on Thursday. His lecture was the last in the Park Street Corporation Speaker series, which explored the values and ethics related to health and health care practices.

Jha prefaced his lecture by framing the event as a discussion, taking questions and cues from the audience throughout the talk.

Jha began by explaining that his interest in pandemics is rooted in the fact that pandemics are a serious and global threat to humanity likely to occur within the next 10 years. But pandemics have received the fewest preventive measures and resources in comparison to other global threats, such as terrorism. Given this, Jha emphasized that people must rethink how they treat the issue of pandemics in order to most effectively strategize and prepare for another outbreak.

Regarding the Ebola pandemic, Jha discussed what exactly happened and why the system failed. Within Guinea, Sierra Leone, and Liberia, Jha explained that the disaster was caused largely by a health system that essentially stopped functioning. Jha insisted that this was not a health disaster, but a societal disaster.

“The entire nation of Liberia had as many doctors as there are catiologists at Brigham and Women’s Hospital,” Jha said.

Jha elaborated that, in order to more accurately understand what went wrong with the Ebola crisis, people must first realize that Ebola is a highly treatable and manageable virus. The disparity in mortality rates of Ebola between West Africa and other countries is therefore the result of a failed health care system, he said. Jha described the origins of Ebola, discussing the 24 previous smaller-scale outbreaks of Ebola and how the circumstances of patient zero’s location near the border of three countries contributed to the speed with which the virus spread.

“What Massachusetts spends [on health care] in a week is what the world needs to spend on research and development to deal with preventing the next pandemic.”

—Ashish Jha, Director of Harvard Global Health Institute

Most importantly, Jha emphasized the extensive length of time it took before agencies began to take the crisis seriously. It took three months before people knew the virus was spreading, and six months between the declaration of Ebola as a crisis and the start of significant action’s being taken by the international community. Jha described the failures on the global scale by citing the fear and misguided reaction of many authority figures, the lack of trust in government, and little coordination between international efforts.

Overall, Jha said that, while 11,000 have died from the Ebola pandemic, the number likely would have been closer to 300 had there been a proper response.

The issue, Jha explained, was not with a lack of advanced medical research, but with an inadequate investment in natural core capacities. Coupled with deforestation, commercial networks, and a lack of community engagement, weak health care infrastructure rendered West Africa extremely vulnerable to the Ebola epidemic.

Jha prefaced the next part of his lecture—the origins of the Zika virus in Brazil in 2015—with the reassurance that people have done better in handling the Zika outbreak. In the wake of the Ebola outbreak, there has been better coordination between critical organizations. But Jha stressed that improvement is not enough and that there is a need for a financial commitment that matches the problem.

“We can’t keep going on a trajectory where we just invest in the 19 new medications for high blood pressure because we know we can sell it in the U.S. or the U.K. and do nothing for Ebola,” Jha said.
Jha noted that the financial cost of a pandemic is roughly $60 billion a year, even though it would take only $4 billion to prevent a pandemic entirely. Jha remarked that, while we have been increasing our efforts by tens of millions, this is not nearly enough.

“What Massachusetts spends [on health care] in a week is what the world needs to spend on research and development to deal with preventing the next pandemic,” Jha said.

Looking toward the future, Jha explained that there is not an extensive list of things that the world must do. But people must take responsibility for preventing the next outbreak.

“I think that we’re only going to really make progress if individual people and organizations put pressure on their governments,” Jha said.

Jha emphasized that while it is impossible to predict the unpredictable, it is essential to make investments in the fundamental, core functions of health care systems. Furthermore, there needs to be an independent monitor to hold governments accountable for their contribution to the preemptive effort.

Jha noted that interest wanes as soon as a pandemic goes away. He stressed that there needs to be a group of people who are not going to waver in their dedication to preventing what may very well be the next global catastrophe.

“These are small dollars compared to the size of the problem, and I don’t think we should have to choose, but we’re probably going to have to make choices because we’re not going to make the investments that we need,” Jha said.

Featured Image by Kristin Saleski / Heights Editor

December 5, 2016