Hoping to make the most of the world’s attention in the wake of the Ebola outbreak in West Africa, President Obama and other leaders will try again to strengthen a longer-term strategy to enhance global health security.
The White House, which launched an initiative in February aimed at preventing the global spread of infectious-disease epidemics, will host a meeting Friday of officials from 44 countries to discuss how to develop basic disease detection and monitoring systems to contain the spread of deadly illnesses.
The United States has pledged to help 30 countries bolster their capacity to deal with infectious disease and bioterrorism threats over the course of five years; a total of 100 nations have committed to take action in connection with the administration’s initiative.
While experts have warned for years that all countries — particularly poorer ones, and those prone to political instability — need to do more to improve their ability to detect and curb such outbreaks, many governments have been slow to respond. The World Health Organization had given its members a deadline of June 2012 to adopt international health regulations that would provide some uniformity when it came to infectious diseases: 80 percent of those nations either failed to do so or did not report back on their progress.
“This Ebola epidemic is the most stark notification the world has been given that all of us are vulnerable if all of us are not prepared,” said Gayle Smith, special assistant to the president and senior director for development and democracy. Obama’s announcement last week about the U.S. military role in overseeing the chaotic and widely criticized response to the outbreak “helped wake people up,” she said. “We’re going to keep the pressure on, and the pressure up.”
The initiative’s goals include some concrete targets over the next five years, such as ensuring that every country has at least one reference laboratory capable of identifying at least three of the seven antimicrobial-resistant pathogens the World Health Organization has identified as top priorities; that at least 90 percent of participating countries’ 1-year-olds have been immunized with at least one dose of measles-containing vaccine; and that each country has a public health Emergency Operation Center up and running.
In a speech at the United Nations on Thursday, Obama cited new commitments from the United Nations last week as progress in the fight against Ebola. But after meeting with leaders from African countries at the General Assembly, he cautioned that “we need to be honest with ourselves. It’s not enough.”
“There’s still a significant gap between where we are and where we need to be,” he said.
The United States has pledged to send up to 3,000 military personnel to West Africa in an effort that could cost up to $750 million over the next six months.
On Thursday, the World Bank said it would contribute $170 million in new emergency funding to combat the virus, bringing its total commitments to $400 million.
Joanne Liu, international president of Doctors Without Borders, told the delegates at the U.N. conference that the promised surge in aid has not yet been delivered.
“There is today a political momentum the world has rarely — if ever — seen,” she said. “As world leaders, you will be judged by how you use it.”
Speaking at a conference on global health security at George Washington University on Thursday, Keiji Fukuda, a senior official with the World Health Organization, said that past efforts to improve global health security have faltered. “We go through an emergency, there’s a great deal of attention, there’s a lot of words about how important it is,” he said. “And then it tends to evaporate.”
With the Ebola epidemic, the world is confronted with “probably the most serious global health security challenge we have faced in our lifetime,” he said.
After the SARS (severe acute respiratory syndrome) pandemic of 2003, there was a major push for countries to adopt the international health regulations. Officials vowed to never let such a situation develop again.
“The problem is that we’re seeing it happening again in West Africa, because leaders haven’t been able to implement the standards,” said Beth Cameron, National Security Council director for countering biological threats.
Several countries have already agreed to work together on specific initiatives. Denmark, which has a state-of-the-art biosafety and biosecurity system, is helping Kenya set up an agency that will oversee a program aimed at guarding against these threats. The Centers for Disease Control and Prevention has helped Uganda drastically cut the time it takes to get test results for a range of pathogens, using special printers that operate on mobile networks.
The key is for countries to put in place specific infrastructure for disease detection and prevention, including systems to improve their laboratory network for tracking disease, epidemiological staff to respond and emergency operations centers that can activate within 120 minutes, according to CDC Director Tom Frieden.
None of that exists in Guinea, Sierra Leone and Liberia, Frieden said. If that kind of infrastructure was in place, the Ebola outbreak “wouldn’t have happened,” he said.
Putting those systems in place in countries “costs money,” he said. “It’s not cheap to do something like this.”
In February, officials said the CDC and the Defense Department are committing $40 million to work with 10 countries. The administration has asked for an additional $45 million in its fiscal 2015 budget that would be specifically dedicated to the global health security initiative.
David Nakamura in New York and Joel Achenbach contributed to this report.