Transcript

[TEXT: Young African Leaders Initiative: Online Training Series]

Hi, my name is Dr. Edmund Rutta, senior technical advisor on tuberculosis in the USAID Bureau for Global Health, and this is Global Health Security and You.

[TEXT: Edmund Rutta, Senior Technical Advisor on Tuberculosis, USAID Bureau for Global Health]

[TEXT: Effective Communication for Healthy Outcomes, Global Health Security and You]

In this lesson, we will focus on global health security and the critical role that health information plays in surveillance, prevention and mitigation of infectious disease outbreaks. We will look at the key elements necessary for the collection, analysis and dissemination of health information. And, finally, we will examine the importance of giving citizens access to digital tools to support the collection and use of reliable health data.

As a TB expert, I know firsthand how easily an infectious disease can spread from a localized threat to one that puts at risk entire populations in multiple cities and even across regions, countries and continents. Diseases don’t respect borders. Credible information, a resilient health system and contingency planning can stop an epidemic and prevent it from turning into a pandemic.

The West Africa Ebola outbreak in 2014 could have been contained, but poor health infrastructure, weak surveillance systems, lack of reliable health data and often contradicting health messages turned it into an epidemic of global proportions. The international community was caught unprepared, and the consequences were grave: over 30,000 Ebola cases, including approximately 11,000 dead from the disease, another 10,000 estimated deaths due to other health conditions going untreated, and millions of dollars lost in duplication of efforts due to poor coordination and communication across the global system. Further impacts on the food security, employment, health care and education were felt for months after the end of the outbreak. Many survivors still struggle.

Rumors, which tend to increase during any crisis, were not promptly addressed via credible sources of information, a factor that contributed to speculation, misinformation and increased infections.

In many ways, the Ebola outbreak was a wake-up call that exposed major weaknesses in the global system for addressing epidemic threats. But this tragic event also brought forth a commitment to a new collective paradigm centered around global health security. We will look at the communication challenges and lessons learned on the digital front from the Ebola outbreak later in this lesson. But first, I will outline the Global Health Security Agenda.

The Global Health Security Agenda, or GHSA, was launched in partnership with countries from around the world. The GHSA seeks to improve the capacities of countries by strengthening health systems to protect people around the world against infectious diseases. It also aims to attain a world safe and secure from global health threats posed by infectious diseases through multilateral and multisectoral collaboration and the sharing of best practices and metrics between partners — both those in government, as well as private and nongovernmental stakeholders.

As one of several implementing agencies for the United States’ GHSA programs, the U.S. Agency for International Development is actively working with our interagency partners around the world to channel resources to issues like animal health and addressing existing and emerging zoonotic pathogens. Are you aware, for instance, that 60–80 percent of new infectious disease outbreaks originate in animals? With our partners, we are working towards the prevention of animal-to -human infections, as well as anti-microbial resistance, by promoting the rational use of antibiotics. By doing this, we will be better prepared to work with governments and communities to prevent and mitigate future health threats.

Furthermore, USAID supports preparedness and response to infectious disease outbreaks at the community level, including training health care workers in how other sectors can influence disease transmission. The unifying theme of our work is to bring together the sectors of animal health, human health and environmental health to address the burden of disease on communities.

Strengthening health systems and enhancing critical infrastructure also serves to provide better access to health care for citizens and improve the quality and reliability of available health information.

With the frequency and intensity of infectious disease outbreaks and events increasing, there will be a continued need for global health security resources.

All countries need safe, secure and strong laboratories; a well-trained workforce; multisectoral collaboration; reliable and sensitive real-time disease surveillance systems; and a command structure to coordinate an effective and focused response that includes health practitioners and other professionals, along with the general public. Strengthening the surveillance, laboratory and workforce will be critical as countries build the capacity to respond on their own to new disease threats.

So, you have a role to play in making sure your country is supporting to prevent the next disease outbreak and promote global health security, including prioritizing capacity building for these kinds of resources before an outbreak strikes.

As health communicators, you have a vital role to play to ensure that accurate and timely information is delivered to the public to inform, raise awareness, respond effectively during an outbreak and teach the best practices for the community to take action. For instance, to help prevent the spread of zoonotic diseases, educate yourself about food safety regulation in your country and why it is important to vaccinate animals against certain diseases.

The collection, analysis and dissemination of accurate health information is also critical for making effective policy and programmatic decisions that will ensure that resources get to where they are needed most. Unfortunately, communities must often deal with an array of disconnected and parallel data systems; weak governance on enforcing information system standards; and insufficient capacity of data use in health care.

For example, a recent assessment of Tanzania’s information system found 153 disconnected and separately financed and implemented health information systems operating in various programs and geographies across the health sector. This is particularly troublesome during a health crisis, when the health infrastructure is under siege and basic health services are disrupted due to a surge in demand.

In 2016, USAID published a report entitled Fighting Ebola with Information: Learning from the Use of Data, Information and Digital Technologies. A number of factors contributed to the “fog of information” that characterized the collection and use of data in early days of the epidemic to capture how Ebola spread. These included weak infrastructure, such as gaps in reliable electricity and digital connectivity; an absence of baseline data on populations; comprehensive and accessible geographical maps, and the lack of machine-readable data.

Given the lack of data in communication infrastructures, rumors about how the Ebola virus was transmitted and inaccurate health information on what constituted safe or unsafe behavior caused panic and fueled the epidemic. Training local journalists on how to responsibly report a health crisis became a priority as efforts to contain the epidemic increased and people realized that existing public messaging was not sufficient. Adequately trained local journalists have a role to play in fostering dialogue, addressing rumors and providing accurate health information.

Building strong digital health systems and integrating social and behavior change approaches are vital steps to advance global health security and be better prepared to contain the next epidemic.

As outlined in the Fighting Ebola with Information report, key recommendations 1) investing in the physical infrastructure that extends digital connectivity — that means building more digital towers to connect people who live in remote areas; 2) conducting baseline, countrywide information and communication technology assessments to gauge the reach, quality and access to mobile and broadband connectivity; 3) building staff capacity and data literacy as well as institutional capacity to leverage digital systems and real-time data in support of operations, programs and decision making; and 4) negotiating preparedness protocols with key actors to increase telecommunication network access in emergency situations. By doing all of this and more, we will be better prepared to respond effectively to a health crisis in the future.

One of the positive examples that came out of the Ebola crisis is the mHero platform, a two-way, mobile phone–based communication platform that supports dialogue between ministries of health and health workers. This tool contributed greatly to improving the collection of accurate health data and the dissemination of reliable health messaging in the affected countries.

Going forward, we must strengthen the technical, institutional and human systems required to rapidly gather, transmit, analyze, use and share health data that is essential to promoting global health security. This is critical both to keep pace with diseases that spread with the ferocity and velocity of Ebola and to be more resilient in the face of future global health threats.

After you have completed all the lessons in this course at YALI.state.gov, you can test your knowledge and earn a YALI Network Certificate.

[TEXT: Test your knowledge … YALI.state.gov … YALINetwork]

[TEXT: Produced by the U.S. Department of State]

[TEXT: Photo credits: USAID, HRSA at U.S.
Department of Health and Human Services,
Centers for Disease Control and Prevention]