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We must learn lessons from this Ebola outbreak

30 Jul, 2014

Ebola virus virion

The current outbreak of Ebola in West Africa is the worst since the virus was first identified in 1976. Wellcome Trust Director Dr Jeremy Farrar, explains why we mustn’t underestimate the huge challenges presented by this deadly infectious disease…

It is easy to think of Ebola as an outlier, a rare and exotic disease that is particularly hard to learn about due to the sporadic nature of its outbreaks. Yet there is much we could and should learn from this outbreak, and quickly.

From the spread of countries affected, to the number of those who have lost their lives, this situation cannot be ignored. It is compounded by the movement of people, the pressures on infrastructure, and the capacity of the healthcare systems in the regions trying to cope with the crisis they face.

Information is hard to come by and rumours abound, and there are a surprising number of basic elements that we still do not understand. For example, we know little about the characteristics of this virus infection and the clinical response in humans. Despite the large number of deaths reported, the mortality rate during this outbreak has so far been lower than might be expected for the strain of the virus we believe is responsible.

Does this mean there is more to this virus than we know? Or perhaps there are differences in the human physiological response that we don’t yet appreciate or in the clinical care of the patients.

As the disease tightens its grip it surely threatens the resolve of those on the ground, who are doing all they can despite incredibly difficult circumstances.

These issues affect all of us.  Even if Ebola does not reach our shores, other emerging infectious diseases or drug resistant pathogens will, and this must be addressed in an equitable and globally responsible way.

Indeed SARS, avian and swine flu outbreaks have already had an impact much closer to home, and while we are much better at the surveillance of such outbreaks we are still not tackling them – or learning from them – fast enough.

In a world made so much smaller by the ease and speed of travel, what is happening in Lagos or Shanghai today may be relevant in London tomorrow, and vice versa. This means we have to get much better at dealing with outbreaks if we are to be truly prepared for the global damage they may bring.

We need to work with at-risk communities and national governments to discuss potential new treatments and how they might work within ethical, logistical and assessment frameworks, and we need them to be ready to go within days.

We also have to work out how to ethically, and practically, undertake the essential clinical research in an emergency that is critical to save lives and reduce disease transmission.

This needs extensive preparation in the period between epidemics, full engagement with all countries – particularly those most at risk of epidemics – and full consideration of the ethical and health frameworks involved.

It is a huge undertaking, complex and challenging in many ways. But our ability to control this and future outbreaks may depend on it.

Dr Jeremy Farrar is the director for the Wellcome Trust. Before joining the Trust he spent almost two decades in Vietnam, where his research focussed on emerging infectious diseases.

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