Healthcare providers leave a village after completion of a culling operation in response to a bird flu outbreak in Budgebudge, West Bengal, India. © 2008 Sudipto Das, Courtesy of Photoshare.
Few natural hazards threaten more loss of life, economic disruption, and social disorder than serious infectious disease outbreaks. Yet compared to the resources devoted to mitigating other risks, such as climate change, terrorism, or war, the global community invests strikingly little in this disease outbreak preparedness. The consequent underinvestment in preparedness, and overreliance on crisis response is costly. The most recent Ebola outbreak in West Africa is a good example: governments and response agencies poured more than $3.6 billion into containment, 11,000 lives were lost, and the global economy lost $2.2 billion in GDP.
Routine, transparent, and objective monitoring of our national, regional and global preparedness can help ensure sustained financial support and effective prioritization of needs. Sustained monitoring can also directly benefit all nations by reducing the risks that future outbreaks will develop into major epidemics or a pandemic. In response to the growing need for an independent global monitoring program, the Harvard Global Health Institute (“HGHI”), led the development a comprehensive framework for Global Monitoring of Disease Outbreak Preparedness. The report and summary reflect the combined expertise of over fifty public health professionals from institutions from around the world who gathered in Washington, D.C. in April 2017 at the U.S. National Academies of Medicine. The result is a robust, objective, evidence-based monitoring framework structured along four key domains (see figure below), reflecting a multi-sectoral, “whole-of-society” approach to preparedness.
One goal, coming out of the April 2017 workshop, is to build a coalition of members, a Monitoring Coalition, that contributes to data collection and analysis, report-writing and results dissemination, and who jointly own the report. An International Oversite Committee will be formed to provide strategic direction to the initiative and assist in research dissemination and policy translation to political leaders (see Figure below).
Led by HGHI, this initiative aims to establish systematic and rigorous monitoring of the international community to strengthen our preparedness for the next major outbreak. The framework is designed to engage experts and institutions from around the world in data collection, analysis and results dissemination. The work is designed to be collectively owned to reflect our shared risk. It will not duplicate existing work, but rather coalesce and amplify it, so that disease outbreak risks and the state of our global preparedness can be clearly communicated through a single lens to a wide range of audiences. Only where critical data elements are missing, new, original research will be warranted.
While the framework will continue to evolve over time in response to experience and inputs from a variety of stakeholders, the release of this report represents an important step in the right direction.