Ebola Update, Fri, 5/8/15: Lancet Lessons Learned from EBOV epidemic/Horton Comment way off base   Leave a comment

5/8/15

Dear Colleagues:

Today’s Ebola Update focuses on The Lancet 9 May issue received online in my Inbox this morning.  This issue has a Public Policy Forum by Professor Heymann from the London School of Hygiene and Tropical Medicine on the Lessons Learned from the EBOV epidemic; two Viewpoints by other EBOV authorities on Lessons Learned; and a Comment by The Lancet editors:

1.  Professor Heymann’s Public Policy Forum includes many world wide infection and epidemiology experts as participants.  The Forum is a very lengthy article which presents so much information and so many recommendations that I refer you to two graphics within the Forum: Key Messages and Mock Dashboard for Health Services Agenda.  These two graphics summarize the Forum nicely.  Heymann, et. al. conclude that the world needs to do more now to prepare for the future and that African countries need to be self-reliant when it comes to the health of their populations. (RGL: The world has moved on to the next health crises in the Middle East).  See the entire Forum at:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60858-3/abstract?elsca1=etoc&elsca2=email&elsca3=0140-6736_20150509_385_9980_&elsca4=Public%20Health%7CInfectious%20Diseases%7CHealth%20Policy%7CInternal%2FFamily%20Medicine%7CGeneral%20Surgery%7CLancet

2.  Kruk, et. al. from the Harvard School of Public Health in a Viewpoint identify the type of health system that all countries contending with the threat of emerging infectious diseases need to have in place.  The health systems need to be aware of what’s coming down the road; diverse in composition; self-regulating-must depend upon itself-not the international community; integrative; and adaptive.  These characteristics are the same characteristics that military forces strive to have.  See the Kruk, et. al. article at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60755-3/fulltext

3.  Professor Heymann, et. al. have a second Lancet Viewpoint re: how to avoid being behind the curve with vaccine development for emerging pathogens. He recommends:

“Serious consideration should also be given to the creation of an internationally supported facility dedicated to rapidly developing vaccines against known emerging pathogens, such as a multivalent Filovirus vaccine that could protect against multiple Ebola virus strains and the Marburg virus.”

The authors have other recommendations as well.  See: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60645-6/abstract

4.  Horton, et. al., editors of the Lancet, have a Comment which nicely summarizes the Heymann, et. al. and Kruk, et. al. articles in general terms.  But Horton, et. al. are way off base in declaring:

“It is, sadly, also deeply hostile to WHO, which, one senior US State Department official told us recently, has been “overwhelmed” by Ebola. The US Government remains fully committed to global health. But another government adviser tells us that the US administration is “furious” about the way existing international health arrangements failed to contain the Ebola outbreak. The USA will now “go it alone”, he said. It will protect its homeland through bilateral responses, such as the announcement of an African Centres for Disease Control and Prevention through a partnership with the African Union, not WHO. The USA will no longer be interested in UN, let alone WHO, reform, he suggests. Instead, it will do what it needs to do to protect its own interests—domestically and overseas.”

Horton, et. al. have two un-named sources and no corroborating evidence from official HHS documents or speeches that what the un-named sources said is anything more than hearsay.  The editor has shown very poor editorial judgment in including this ‘slam’ against the U.S. and President Obama in his Comment.  The U.S. remains committed to the WHO and UN.  Whatever deficiencies are present at WHO and the UN would quickly be remedied if the member nations made good on their voluntary contributions to WHO and UN.  Remember that WHO is funded >50% now by Bill Gates, Paul Allen, and their friends. I believe the Lancet should do a Erratum of this Comment and apologize to its readers.

See the entire Comment at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60909-6/fulltext

RGL, MD

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Posted May 8, 2015 by levittrg in Uncategorized

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