In times of disaster, patients expect government to step up to meet their needs

Recent news of the Ebola outbreak in Democratic Republic of the Congo (DRC) and the Nipah virus outbreak in India have reminded the world of threats posed by once unknown pathogens. Weeks ago, when the news first broke, many in the health security community began to brace for another potential Ebola pandemic, recognizing how easily these highly infectious diseases can spread.

While the response to the Ebola outbreak is still underway, we have seen signs that the global community is learning some lessons from previous outbreaks. Yet, there is still much more to do, and we must continue to invest in plans and capabilities that will enable countries to mobilize an effective response in the face of disease threats.

{mosads}A fast response to health emergencies is not only critical for people in the DRC and India, but for patients around the world. A recent YouGov poll conducted for Healthcare Ready asked 15,201 adults in 13 countries across the world (Africa, Asia, Europe and the Western Hemisphere) how long they could go without necessary medicines and medical supplies if a disaster disrupted their ability to access healthcare services.

For 33 percent, the answer was just days. Among respondents in developed economies, including the U.S., nearly half (42 percent) anticipate facing a personal medical crisis after just one week of disruption in care. In countries such as Uganda and Mexico, the figure shot up to 69 and 51 percent, respectively. This means the window for effectively responding to an emergency is quite small before patients begin to face negative health impacts. This is a clear reminder that when disaster strikes, time is of the essence. 

The poll also revealed that patients rely heavily on national and local governments to respond to disease outbreaks and natural disasters. While the level of reliance varied across countries and regions, it topped 50 percent in all polled countries. At the same time, the poll affirmed the majority of patients would rely on their health-care providers for treatment.

For example, if treatment were needed because of the flu, nearly two thirds of respondents said they would first seek help from their health-care provider. It makes sense that patients would depend on their providers and it reaffirms the importance of equipping health-care providers to respond effectively to disasters and disease outbreaks. These statistics, taken together, are important, given that nearly all emergency responses, not just those to disease outbreaks, have a public health component.

The reliance on both government and health-care providers reflects the reality of emergency response, meaning national and local governments and trusted health-care providers are the first responders. But, during international crises, it can take weeks or even months to mount an international response.

Even with financial aid through the United Nations Central Emergency Response Fund (CERF) or the World Bank/International Development Association Crisis Response Window (CRW), which can be released in days, it takes time to mobilize, procure, and deliver supplies. The current Ebola outbreak in the DRC serves as an example of the WHO learning lessons from previous outbreaks, but it also shows that we have a long way to go to ensure that the international community is prepared to respond to a potentially catastrophic disease outbreak.

Now the question remains, are governments and health-care providers ready? Are they prepared to meet the expectations of the people they serve? Probably not. This 2016 report of the High-Level on Global Response to Health Crises found that few countries have built the capacity for disease surveillance and alert recommended by international regulations.

The WHO projects the global shortage of health-care workers will reach 13 million by 2035, meaning response efforts will be strained even further by a lack of trained personnel. Efforts like the Global Health Security Agenda work to equip health systems to prevent, detect, and respond to disease outbreaks, but these efforts need to be sustained and supported by the entire international community. 

As alarming as it sounds, the international community still has significant vulnerabilities, as seen in assessments conducted through the Global Health Security Agenda and other research. Some governments are working to fill gaps in the global system, such as the previous investments from the U.S. Centers for Disease Control and Prevention to support training, evaluation and response. But more investment is needed.  

The challenges of funding are particularly frustrating because the return on investment from emergency preparedness has proven to be significant time and time again.

A 2014 study conducted for UNICEF and the World Food Programme by the Boston Consulting Group found that a $5.6 million investment in preparedness reduced emergency response-related costs by $12 million. Early investment also cut response times by more than a week on average.

Ensuring the world is ready to meet the next health emergency should be top of mind for national health authorities. Before the next disaster strikes, it is important that we focus on bolstering our ability to respond to public health emergencies.

Our latest data tells us that just ten percent of respondents are dissatisfied with their ability to obtain necessary medications in normal times. But that number quadrupled to 40 percent when patients were asked about their confidence in their ability to obtain medicines during a disease outbreak or natural disaster. Given these new findings, I urge the global community to focus even more on addressing patient vulnerabilities before the next global disease outbreak, because if the data tells us anything, it’s only a matter of time.

Nicolette Louissaint, Ph.D., executive director of Healthcare Ready, a D.C. based non-profit that coordinates between the federal government, NGOs and the private sector to meet health needs during and after a disaster and helps advance health-related readiness.