Investing in health systems may stem Ebola outbreak

A broad humanitarian response that includes investments in health care staff, medical resources, and health systems is more likely to be effective in halting the current Ebola outbreak in West Africa and creating sustainable models for responding to future infectious disease outbreaks than “a surge of stopgap solutions,” according to a Viewpoint article published October 6, 2014 in the Journal of the American Medical Association (JAMA).

The article was written by Ashish Jha, K.T. Li Professor of International Health and Health Policy at Harvard School of Public Health and director, Harvard Global Health Institute; Andrew Boozary, SM ’14 visiting scientist in the Department of Health Policy and Management; and Paul Farmer, MD ’90, PhD ’90, Kolokotrones University Professor of Global Health and Social Medicine at Harvard Medical School and co-founder of Partners in Health.

The Ebola epidemic—which the authors described as one of the most devastating health crises of the 21st century—has exposed “the pathology of chronic neglect amid broad global inequalities.” Before the outbreak, Liberia’s 4.3 million people had only 51 physicians—less than many U.S. teaching hospital clinical units. If the outbreak occurred in cities like Boston or Toronto, the health systems would better control the disease and there would be far fewer deaths, the authors wrote.

The lack of protective equipment, IV fluids, and clear treatment guidelines has dissuaded health workers from risking their lives to care for Ebola patients and has contributed to patients’ mounting distrust in health systems. “When people receive care that is unsafe or ineffective, or they are not treated with respect, it is little surprise they avoid further care,” the authors wrote. “Preventing such ‘betrayals of trust’ through a systematic focus on quality is crucial, for both the current epidemic and the next.”

Read the JAMA article: The Ebola Outbreak, Fragile Health Systems, and Quality as a Cure

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The Forum at HSPH: The Ebola Disaster: How Did We Get Here and What’s Next?

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