Thanks to Greg Folkers for sending the link to this NEJM article by Dr. Thomas R. Frieden, head of the CDC: The Future of Public Health. Among many other issues, he deals with this one:
The Ebola outbreak offers three essential lessons. First, every country must have the core public health functionality to identify a threat when it emerges, stop it promptly, and prevent it wherever possible. The goal of the Global Health Security Agenda is to strengthen every country’s capacity, including trained epidemiologists, high-quality laboratories, timely and accurate disease-surveillance systems, and rapid response teams.
Second, when national capacity is overwhelmed, the world must be able to move immediately and decisively. Epidemics are global problems. The World Health Organization (WHO) and its Global Outbreak Alert and Response Network need to strengthen global response capacity in epidemiology, laboratory science, clinical care, logistics, anthropology, and other disciplines essential for disease control. The responses in individual countries can be quicker, more efficient, and more cost-effective than a global effort but only if systems in daily use can be rapidly scaled up in emergencies.
Third, the lack of effective infection prevention and control in hospitals and other health care facilities is a key vulnerability. Because Ebola infections, MERS, and the severe acute respiratory syndrome (SARS) usually result in severe illness or death within weeks after exposure, the presence and spread of these infections are readily apparent. But tuberculosis, diseases caused by drug-resistant organisms, Clostridium difficile infection, measles, and many other conditions are routinely spread in health care facilities.
Every country needs a strong system to support, coordinate, and monitor infection control in health facilities. Such facilities need full-time staff dedicated to monitoring and improving infection control, and facility leadership needs to fully support these staff.