Using the Law to Prepare for Global Health Emergencies

CDC country office sign in Liberia

Countries need to be prepared to handle emergencies. Having the right laws in place is an important part of the preparation.

When laws are not clearly defined, responders can have a hard time figuring out what to do during a public health emergency and who has the authority to take action. When a deadly disease outbreak hits, this can have devastating consequences.

Liberia knows firsthand what can happen when laws don’t match the needs in the field. Their experience with the recent Ebola epidemic exposed gaps in legal authority during the response. This is one reason why Liberia’s government recently reached out to the GHSA Public Health Law Project. The project team is helping them document issues that could be improved by updating Liberia’s public health law, which was last fully revised in 1976.

Advancing the Global Health Security Agenda

Bucket of bleach for washing of hands before entering public buildings and entering counties
Ebola preventive measures in Liberia: Buckets of chlorine solution to wash hands before entering public buildings and entering counties.

The GHSA Public Health Law Project takes a close look at how the law can help (or hinder) countries as they prepare to handle public health emergencies through the Global Health Security Agenda (GHSA). Right now, over 50 countries around the world are working through the GHSA to improve their ability to prevent, detect, and rapidly respond to infectious disease threats. The GHSA Public Health Law Project currently covers nearly half of the GHSA countries. The team helps analyze the laws of a country and provides training to country officials to help them understand the importance of law as a public health tool.

The team begins its work by gathering information about existing laws and talking to experts about how public health law works in their country. In Liberia, the team found that people felt unclear about their roles during the Ebola response. As one country health official told the team, “There is confusion about roles in an emergency and enforcement. What is the role of the police? The ministry of health? The military? [This] needs to be better defined.”

Public Health Law in Liberia

Before the CDC team arrived in Liberia, the Ministry of Health’s Legal Counsel were already taking the lead to help modernize the law. This is a massive undertaking that the Government of Liberia hopes to accomplish as soon as possible.

The Liberian Ministry of Health’s (MOH) Legal Counsel and CDC’s Country Office Director invited the CDC project team to help them reach this goal through research and analysis of where there may be gaps in the law. The project team worked with a team from the University of North Carolina’s School of Government, who were invited for public health law support by Liberia’s Chief Medical Officer.

CDC Public Health Law team
From Left to Right: Jeff Austin (University of North Carolina), Emily Rosenfeld (CDC), Akshara Menon (CDC), Tomik Vobah and Aimee Wall (University of North Carolina)

Liberia will be able to use the information gathered by the team as they update their public health law. Once the laws are updated, the next step is making sure people are aware of them. A county health official laid out the problem he saw in Liberia: “Fundamentally, what is wrong is that the public health law is not widely known.” This official had been a practicing doctor for 11 years, but he had only read Liberia’s public health law for the first time two weeks prior to talking with the team.

Planning for the Future

The GHSA Public Health Law Project is being done collaboratively between CDC’s Center for Global Health and the Public Health Law Program. The project is compiling the laws from these countries into a single, searchable database to give a more complete picture of the legal landscape relating to the GHSA. The legal data obtained from this project will be a valuable resource when countries want to update their public health laws.

This initial legal mapping phase is only the beginning. What is really vital is how countries will use this information to help guide their work. The law can be an effective tool in meeting global health security goals and protecting people’s health — not only when a crisis hits, but every day.

Repost: Where Does Ebola Come From? Communicating Science as a Matter of Life and Death – Part 1 of 2 By Ida Jooste | PLOS SciComm

Repost: Where Does Ebola Come From? Communicating Science as a Matter of Life and Death – Part 1 of 2 By Ida Jooste | PLOS SciCommAddThis Sharing Buttons above Editor’s note: In light of yesterday’s confirmation by the Liberian Health Ministry of the death from Ebola of a thirty year-old woman, the first such death since January (2016) when the country was again

Ebola Response: Year in Review

A person washing their hands at a water station in West Africa

Throughout the month of December, Public Health Matters is conducting a series of year-in-review posts of some of the most impactful disease outbreaks of 2015. These posts will give you a glimpse of the work CDC is doing to prevent, identify, and respond to public health threats.

Getting to Zero

Getting to Zero was a theme and goal that dominated much of CDC’s attention in 2015. In January 2015, The World Health Organization reported that the Ebola epidemic had reached a turning point with the most impacted countries, Liberia, Guinea and Sierra Leone, seeing declines in the number of new cases of Ebola.  This turning point came after a year of battling the worst Ebola outbreak in history—resulting in over 20,000 cases by December 2014.

While the spread of the disease and U.S. media attention was at its peak in 2014, some of CDC’s most impactful and important work took place in 2015. This year’s response to the Ebola epidemic was marked with many challenges and accomplishments, new discoveries, and continuous hard work by hundreds of CDC staff. The dedication of CDC and its partners throughout the year has also led to the successful end of widespread Ebola transmission in Liberia and Sierra Leone.

Ebola Vaccine Trials

In April 2015, CDC, in partnership with The College of Medicine and Allied Health Sciences, University of Sierra Leone, and the Sierra Leone Ministry of Health and Sanitation, began a clinical trial to test the potential of a new vaccine to protect against the Ebola virus. This vaccine trial, known as Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE), is designed to help protect against Zaire ebolavirus, the virus that is causing the current outbreak in West Africa.

Person getting a vaccine“A safe and effective vaccine would be a very important tool to stop Ebola in the future, and the front-line workers who are volunteering to participate are making a decision that could benefit health care professionals and communities wherever Ebola is a risk,” said CDC Director Tom Frieden, M.D., M.P.H.  “We hope this vaccine will be proven effective but in the meantime we must continue doing everything necessary to stop this epidemic —find every case, isolate and treat, safely and respectfully bury the dead, and find every single contact.”

This vaccine trial, along with a series of other vaccine trials taking place in West Africa, represents an important step in the response to the Ebola epidemic. In addition to the tireless efforts being made to completely eliminate Ebola cases, efforts to discover a vaccine could prevent an outbreak of this size in the future.

Leaving Lasting Infrastructures for Health

Programs like STRIVE seek to contribute not only to the future of Ebola prevention research, but also to the future of health care capabilities in the areas impacted by the Ebola epidemic. The STRIVE study is strengthening the existing research capacity of institutions in Sierra Leone by providing training and research experience to hundreds of staff to use now and for future studies.

CDC is leaving behind newly created emergency operation centers (EOC) in countries affected by widespread Ebola outbreaks.   The ministries of health will fully lead these new EOCs, which will provide a place to train healthcare workers to be better prepared to conduct outbreak surveillance and response.

Additionally, 2015 brought the official announcement of plans to create the African Centres for Disease Control and Prevention (African CDC). First proposed in 2013, the African CDC will seek ongoing collaboration with other public health entities across the continent and the world to elevate health outcomes for all citizens. Partners will assist by implementing activities, supporting the establishment of regional collaborating centers, advising the African CDC leadership and staff, and providing technical assistance.

Celebrate the Successes, Look to the Future

2015 brought significant progress in the Ebola response. Yet, while the successes and improvements made to public health infrastructure in West Africa are important to celebrate, the work continues to get to zero and end the largest Ebola outbreak in history.

As we draw closer to our goal of zero cases of Ebola, we are reminded of how critical it is to identify, prevent, and respond to outbreaks to prevent future epidemics of this magnitude.

The Sexual Transmission of Ebola: Scicomm as a matter of life and death – Pt 2 of 2

SurvivorTalk1_eBy Ida Jooste, Internews “The resurgence of Ebola in Liberia in late June 2015, seven weeks after the country had been declared Ebola free, put a spotlight on how the disease is transmitted, and brought the

Where Does Ebola Come From? Communicating Science as a Matter of Life and Death – Part 1 of 2

eb  must go bbBy Ida Jooste, Internews When I was in Liberia in June this year, just one month after the country had been declared “Ebola-free,” I noticed how often I heard the phrase “that was before Ebola”

APHL is a proud partner in the Global Health Security Agenda

Today President Obama announced the United States and 30 other nations have committed to join together to achieve the targets of the Global Health Security Agenda (GHSA).  APHL is proud to be a key partner in the effort to make the world safe from infectious disease threats.

APHL is working closely with US federal agencies as well as domestic agencies within African and Asian partner nations to achieve the following GHSA targets:

  • Countering antimicrobial resistance
  • Preventing the emergence and spread of zoonotic disease
  • Advancing a whole-of-government national biosafety and biosecurity system in every country
  • Establishing a national laboratory system
  • Strengthening real-time biosurveillance
  • Advancing timely and accurate disease reporting
  • Establishing a trained global health security workforce
  • Establishing emergency operations centers

APHL in Africa
Guinea, Kenya, Liberia, Sierra Leone, Tanzania, Uganda

To address the limited laboratory capacity and capability in many African nations, we are currently partnering with the African Society of Laboratory Medicine (ASLM) to provide technical and management assistance for design, development and implementation of the African Public Health Laboratory Network (APHLN).  Working with ASLM, APHL will convene stakeholders to develop the operational rules for the network, support laboratory accreditation and set goals for national public health laboratories. We will leverage existing laboratory models, notably the US Laboratory Response Network (LRN), to design an effective laboratory network for the continent.

As our GHSA work moves forward, APHL is also planning to initiate laboratory assessments, inventory and review of laboratory policies, training and mentoring of laboratory staff, support for development of biosafety facilities, and review of specimen referral systems, quality management system programs and capacity for detecting anti-microbial resistance.

APHL in Asia
India, Indonesia, Vietnam

In Asia, APHL is working directly with ministries of health and other national health officials to develop laboratory systems capable of safely and accurately detecting and characterizing pathogens causing epidemic disease. Lucy Maryogo-Robinson, APHL’s global health director, is traveling to partner countries in southeast and central Asia to plan activities under GHSA. In November she traveled with an APHL team to Vietnam to discuss projects to expand APHL’s longstanding relationship with that country.  Ongoing development of informatics systems and strengthening of capacity to respond to infectious diseases will be priorities.

Eman’s Emails from Liberia: Through September

Emmanuel Gokpolu, who lives in Liberia, calls me Mom, although he has a wonderful real mother. In Africa, family isn’t only about DNA. Eman contacted me in 2007, after using my human genetics textbook in college. My husband Larry and I had been … Continue reading »

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