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We’re not close to being prepared for the next pandemic, says this doctor

Is the world ready for the next pandemic? Dr. Raj Panjabi of Last Mile Health joined Judy Woodruff at the Spotlight Health Conference in Aspen, Colorado, to discuss the challenges and importance of preventing, identifying and preparing for the next crisis like Ebola.

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    Next: After the containment of the Ebola outbreak, scientists are looking around the corner for the next serious threat to global threat.

    Judy Woodruff recently sat down with Liberian-Born Dr. Raj Panjabi at Spotlight Health in Aspen, Colorado, to discuss the challenges of preventing the next pandemic.

  • Warning:

    Some of the images in this report may be disturbing.


    Dr. Raj Panjabi, thank you very much for joining us.

    What do you think the world learned from the last Ebola outbreak of just a couple of years ago, and do you think we're ready, the world is ready for the next one?

  • DR. RAJ PANJABI, Last Mile Health:

    You know, I think there are many lessons that have been learned from the crisis and still are, but probably one of the most central, fundamental lessons is this basic notion that illness is universal and access to care isn't, and that that actually places all of us at greater risk.

    We have known this from even the first boy who died in the Ebola crisis, Emile, a 2-year-old in the rain forest in Guinea. He died after having vomiting, fever and diarrhea in December of 2013.

    It took three months for the world to realize that this was an outbreak. He lived in a forest community that — in rural parts of West Africa where the forest is dense, but health workers are sparse. And so the virus spread during that time out of control, led to tens of thousands of people dying.


    One of the things you did was employ what you call community health workers to go out and do what you're talking about. What exactly did they do?


    Well, community health workers are people from villages like Emile's where a middle- to high school-educated person would be trained for a matter of months and equipped to provide medical care door to door to their neighbors.

    Those workers are critical, in addition to nurses and doctors, because nurses and doctors are concentrated in cities. They don't reach rural areas. When I first came back, I grew up in Liberia. I fled during the civil war. I came back as a medical student.

    And what I found is that there were just 51 doctors for four million people. It would be like the city of San Francisco having just 10 physicians for the entire city. So, if you got sick in the city, you might stand a chance.

    But, in rural areas, you didn't. So, community health workers have been critical to providing health care, where doctors don't reach, and linking patients to care.

    What we did, for instance, when an outbreak happened in a rural part of the country, was to train and equip health workers from those communities to go door to door to work with doctors and nurses to find the sick and get them into treatment units.


    We have been hearing about community health workers for a long time. What's different about how they work now, the role that they play?


    I think what's new now is a recognition that this is perhaps one of the most undervalued labor assets in the health work force.

    Long-term, they have been treated as volunteers. So, in other words, they don't get paid to do their work. Most are underequipped and many have been barely trained.

    What's different now is the recognition, as in the case of Liberia, after the Ebola crisis, taking a former volunteer community health work force and upgrading it, hiring those workers, employing them, training them, equipping them with the right gear and medicines to go door to door and provide health care.


    A larger question of epidemic pandemics. It seems we pay a lot of attention to them when we're in the middle of the crisis and it's on everybody's mind, people are dying. It's a very visual thing. But then we quickly forget. We move on. Our attention span is short.

    How confident are you that the world is truly prepared for the next pandemic and the one after that?


    Well, we have done more to become prepared after the Ebola crisis.

    We're not yet close to where we need to be to be prepared for the next epidemic. The data shows this. We know that the cost of inaction is larger than the cost of action; $6 trillion is the estimated potential economic loss of a pandemic. But we're only spending 50 cents per person per year in providing surveillance and preparedness against preventing the next epidemic.


    We know that this is one of the things that funding by the United States can make a big difference, as to your point.




    The legislation that is moving through the Congress right now, or what appears to be moving through the Congress, could make some significant cuts in that area.




    What effect would that have?


    Well, I think, make no mistake, the cuts would be devastating.

    And one of the untold stories of U.S. foreign aid is that it's had such a dramatic impact, largely because of investments in health care systems like Liberia's and poor countries. If there had not been an effort to invest U.S. foreign aid before, during and now after the Ebola crisis, you wouldn't have been able to surge front-line local health workers who went door to door to find the sick and get them into care.

    At that very moment when the CDC told us that there could be as many as 1.4 million cases of Ebola in Liberia and Sierra Leone, in the country I grew up and the one next to it, that very week, in Dallas, Texas, America diagnosed its first case of Ebola.

    So it's not a theory that epidemics that happen to people across the world can impact us at home quite literally. So I think this is the real story about foreign aid is, it's actually not aid. It's investment. It's a win-win. It saves lives abroad and it keeps us safer at home in America.

    And that's something we should all be proud of, actually, as Americans.


    Dr. Raj Panjabi with Last Mile Health, thank you very much.


    Thank you, Judy.

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