BOSTON – Lives are not all that have been lost in the ongoing Ebola crisis. In recent discussions about how to combat the virus, the methodical rigor of science and medicine has given way to hyperbolic politics and public hysteria. To be sure, informed, data-driven public policy to manage the current outbreak must remain a top priority. But it is equally important to take stock of the epidemic’s lessons and to ensure that we are prepared for the emergence of other diseases.
Two major lessons should be learned from the current Ebola outbreak. First, the fight against a single disease must not come at the expense of strengthening an entire health-care system. Countries with fragile health systems may be able to tackle a given ailment with the help of NGOs and foreign governments, but they are likely to be dangerously unprepared when confronted with unexpected outbreaks of new diseases.
In Liberia, for example, the prevalence of malaria in children under the age of five declined from 66% in 2005 to below 32% in 2011. Nonetheless, when the Ebola virus entered Liberia from neighboring Guinea earlier this year, the country’s health-care infrastructure was quickly overwhelmed. More than 2,000 Liberians have died of the disease, and the virus remains rampant. Similarly, unless they strengthen the health-care system as a whole, other countries that have performed well in some areas – say, the fight against Ebola – could still face large death tolls and long-term economic turmoil.
The second lesson that the Ebola epidemic holds concerns major gaps in our ability to develop new methods and technologies to fight the virus and other diseases like it. Our policies and approaches have too often been reactive, not proactive. As a result, affordable and easy-to-use protective equipment for frontline health-care workers and point-of-care tests that are quick, reliable, robust, and cost-effective have been hard to find. The public and non-profit sectors should support innovations that are not only focused on solving immediate problems, but that also address potential future challenges.
The United States Agency for International Development, the White House Office of Science and Technology, the Centers for Disease Control and Prevention, and the Department of Defense have declared Ebola a “Grand Challenge for Development” and have launched an effort to sponsor practical, cost-effective innovations to treat and prevent it. This is an important step in the right direction, but such efforts need to start well before an outbreak if they are to have a significant impact. New technologies require time to be tested before they can be deployed in the field, and scaling up to large-scale production is a major challenge for any new invention.
The Ebola crisis has shown that we need to think about developing our ability to innovate at the most basic level. Just as health-care systems in the developing world need to be strengthened, we also need to build up our capacity to develop new solutions for similar challenges when they arise.
Engineering schools often fail to provide students with knowledge or understanding of the challenges faced by those outside of the developed world. Medical students and public-health professionals sometimes study or do internships in places where the disease burden is high; but a miniscule number of similar opportunities are available to engineers and technologists. As a result, talented scientists and engineers are often grossly unaware of problems that need to be solved, and even those that might be motivated to do so are unlikely to apply their training to address new and emerging threats.
Developing technology takes time and commitment. In addition to promoting awareness of global challenges in science and engineering schools, and providing opportunities for students to start addressing them in the field, we need to establish mechanisms that will foster and sustain the ideas that this process brings forward. By creating research grants that do not expire as soon as an outbreak is under control, we would substantially increase our portfolio of solutions to manage the next epidemic better.
When faced with the next Ebola-like challenge, our ability to meet it will depend on the strength of local institutions and our ability to develop the right tools with which to fight it. There is no telling how many lives may depend on the steps we take now.