Ebola's future development footprint

A post-Ebola world will not be Ebola-free. Though hopeful for a vaccine, experts believe global pandemics like the current one ravaging West Africa are set to become regular fixtures in tomorrow’s development landscape. A growing population, the crowding of urban spaces, poor sanitation and easier global transport are all to blame, according to Dr. Tara O’Toole, former undersecretary of science and technology at the U.S. Department of Homeland Security. “We have more people living closely with their animals, and two-thirds of the emergent diseases that we’ve discovered in the last several decades have been zoonotic, affecting both humans and animals, like AIDS and Ebola,” O’Toole said Oct. 20 during a discussion at the Heritage Institute in Washington, D.C. As the virus continues to outpace international efforts to contain it in West Africa and global powers redirect resources to the region, governments and development organizations on the ground are trying to address the unique challenges of Ebola. Often, they’re faced with a gap in their own abilities. “We have to understand these phenomena and guard against letting them rule our better judgment,” cautioned O’Toole. “We’re going to be more vulnerable to epidemics, we’ve got to get better at managing.” If global epidemics indeed take center stage among development priorities, shifts in funding, how the commercial pharmaceutical industry works and even how humanitarian organizations are structured will surely follow. R&D funding Funding for research and development in the United States and elsewhere has long been based on the “pay-as-you-go” model, with hot-topic issues like Ebola attracting large amounts of cash and then petering out over time. Many organizations also push R&D to the fringe of their projects or periodically hire outside contractors, rather than placing it at the center of programming activity. “Like how a large amount of funds was set aside for bioterrorism research, but then a third was moved over for [the H1N1 strain of] swine flu,” O’Toole said. “It was the right thing to do at the time, but then it never came back.” Today’s R&D funding strategies don’t yield results because they aren’t built for the long term, she explained. A greater risk of epidemics will likely engender a new model, with R&D producing an ever-evolving flow of data. “This lumpy-bumpy budget pattern is very cost-ineffective, because you never figure out if what you were investing in the front end was working or not,” O’Toole noted. Big Pharma and commercial health reform Related to shifts in R&D funding, public health’s connection to American commercial interests must come to bear if the U.S. hopes to remain competitive. “Remember, [Big Pharma] can make a lot more money producing the pills you take every day for the rest of your life,” O’Toole said. “And what I would argue for is a concerted national effort. Some of this is a big data exercise, some a manufacturing exercise, but I would organize it differently than basic R&D.” Incentivizing vaccine and antiviral production seems a likely course of action, she explained. “It’s time for America to have a strategic approach to the biological and life sciences. We’ve done it with the physical sciences because of national defense, but national defense is going to start to depend upon biology in a big way.” Bob Kadlec, former senior director for biological defense policy in the White House Homeland Security Council, predicted a certain congressional committee will likely become the fledgling body for shaping reforms. “A project of the House Energy and Commerce Committee called the 21st Century Cures Initiative, though not currently focused on Ebola, may soon afford the opportunity and the vehicle to get away from the hit or miss approach to developing countermeasures,” he said. When asked what the effort might look like, Kadlec said: “We need to think creatively. We’ve been relying on faith-based organizations and NGOs. We have to think — how do we create an international medical corps?” Multitasking Monitoring and evaluating possible threats to public health could become the lingua franca for organizations working in the developing world. Practitioners on the ground are already playing a role in crude monitoring practices, whether they know it or not. “A university in Boston did a modeling of all the social media that was going on, and there were actually clear indicators of an Ebola outbreak as early as February, and WHO didn’t know until March,” observed Charlotte Florance, a research associate at the Heritage Foundation. “A lot of those were development workers who weren’t working in public health, but were in the space and hearing and seeing things. This is an opportunity to start utilizing those people.” Mitigating the economic repercussions — both Guinea and Liberia saw their GDPs halved in a matter of months — as well as the societal windfall requires a varied development toolbox. What works in an economically depressed farming community might work in the aftermath of an epidemic — but how do you address the fear? Bring in post-conflict expertise. “Having a more rationalized approach broadly would benefit across disciplines, and not only improve health but lower the cost of health,” said Kadlec. He said, to quote Rahm Emanuel, “Don’t let a crisis go to waste.” “In this case, rather than trying to address the Ebola problem, see if you can assess a set of issues through the Ebola problem, to identify the things that will make a difference not only for the next epidemic, but also for the next common thing that also has a way of causing disruption.” Read more development aid news online, and subscribe to The Development Newswire to receive top international development headlines from the world’s leading donors, news sources and opinion leaders — emailed to you FREE every business day.