The New York Times points out that we need a global immune system to prevent future public health crises
Detecting pandemics, malaria, tuberculosis, and other infectious diseases with the Office of the U.S. Agency for International Development
Since I started my job at the U.S. Agency for International Development, I have been surprised by how many emergencies define my work. The bureau I oversee focuses on reducing the global burden of mortality and disease and on protecting the United States from health threats from abroad. Our work is supposed to primarily serve long-range goals — for instance, eradicating polio (after 35 years of effort, we’re down to just a handful of wild-type cases in the world) and ending the public health threat of H.I.V., malaria and tuberculosis by 2030. But from the moment I started, more immediate problems have diverted time, attention and resources.
This is a pattern, and it happens frequently: emergency after emergency diverts focus away from the longer-term public health goals. There has been no indication that this is letting up. The incidence of animal diseases leaping to humans has been due to the increased contact between humans and wildlife. (The Ebola virus, for example, has been linked to bats as a possible source of spread.) The risk of outbreak-causing laboratory accidents is a significant concern as labs proliferate and safety measures lag. On average, between 1979 and 2015, more than 80 laboratory-acquired infections were reported per year, several involving transmission beyond those initially infected, and underreporting is rife. The growing field of synthetic virology has simultaneously generated lifesaving new treatments (mRNA vaccines, for example) and made it easier for bad actors to turn infectious diseases into weapons of mass destruction.
The World Health Organization says that there is a chance of more lives being saved than the combat if disease-restrained efforts are not stepped up in Gaza.
Rick Brennan, the WHO’s Regional Emergency Director for the Eastern Mediterranean Region, says it’s their way of detecting disease that can cause an epidemic very, very, very quickly.
The system to detect disease was a decent one, Brennan states, ” to pick up cases of infectious diseases to transfer the specimens to test them in the laboratories and then implement control measures.”
“We used to culture bacteria in Gaza,” she says, and “prescribe medication based on the results. infections are spreading now we can’t do cultures or anything.
She’s also witnessed a torrent of respiratory illnesses. “I’ve had cases that didn’t respond to any treatment,” she says. “But I can’t tell [the shelter whether] they have COVID, and I can’t diagnose it because I don’t have the equipment.”
“Wherever there’s overcrowding,” explains Marwan Al-Homs, director of the Mohammed Yousef El-Najar Hospital in Rafah, “these epidemics exist — inside shelters, even in tiny apartments where the number of inhabitants is 35 people.”
Juliette Toumas, director of communications for UNRWA, the United Nations Relief and Works Agency, visited the Khan Younis Training Center in south Gaza, a shelter intended for 1,000 people but now hosting more than 30,000. She says that there are 400 people sharing one toilet. The same goes for showers. “There’s not much water to begin with, whether to wash or to stay clean. There isn’t a lot of hygiene supplies.
“It’s a cauldron of possibility of infectious disease,” says Amber Alayyan, deputy program manager for Doctors Without Borders in the Palestinian territories.
Last weekend, the WHO’s team lead for health emergencies in the Palestinian territories traveled to Gaza to bring in rapid diagnostic tests for diseases such as hepatitis and cholera.
“I am bringing the testing kits to timely detect and to respond to different infectious disease outbreaks,” he said in a video posted on X, the site previously known as Twitter.
UNRWA’s Toumas underscores the importance of regular and sustained humanitarian aid, including hygiene supplies, vaccines and chlorine tablets. She says all those things are important in disease prevention.
It will take time and effort to resuscitate one or more of the local laboratories in Gaza that did pathogen screening before the war.
In addition, they hope “to even bring a mobile laboratory from outside,” says Brennan. “And we’re also looking at options for bringing specimens outside the country, particularly to Egypt, for testing. That has been a little bit more challenging than we had anticipated.
Brennan said that if a shigella outbreak were to occur, it could rip through a community very quickly and hurt the most vulnerable. To be honest, I’m grateful that we’ve got to this point. We haven’t had a fatal outbreak yet, we’ve got increased rates.
That good fortune can last, depending on the number of cases of a serious disease and their ability to be contained.
World Health Organization’s Regional Emergency Director for the Eastern Mediterranean region Rick Brennan said, “We hope to even bring a mobile laboratory from outside.” The WHO has said that if disease-restrained efforts are not stepped up in Gaza, there is a chance of more lives being saved than the combat if disease-restrained efforts are not stepped up.