Learn from Ebola, Zika outbreaks, and invest in diagnostic labs

This is how it happens now.

A little-known virus begins infecting people in one small corner of the world.  As it spreads, the rate of infection speeds up. It gathers steam, transcending borders and spanning oceans before finally triggering a global response. But the genie is already out of the bottle.

This time, the virus in the news is Zika. As of Aug. 3, Zika had spread to 65 countries.

Now, the past two weeks the virus has had a front-row seat at the Olympics in Rio de Janeiro. Brazil boasts a strong public health and scientific research infrastructure. Within two months of a rise in a mysterious illness in the northeastern part of the country, Brazil’s National Reference Laboratory was able to confirm the presence of Zika, and then tie the virus to a spike in neurological disorders two months after that.

But Zika traveled beyond Brazil almost immediately and now the virus is likely to be an unwelcome souvenir international athletes and spectators carry home to over 200 countries. Many of those countries have far less capacity to diagnose or respond to such an illness. You can imagine how easily a virus such as Zika — that can be spread both by insects and person-to-person — can leapfrog across communities and countries.

Rather than wait until diseases have spread to epidemic proportions, why not empower a global workforce to tackle diseases when and where they emerge?

It must start at the most basic level with the establishment of robust diagnostic labs. One of the principal lessons of the Ebola crisis was the lack of proper diagnostic facilities in the rural areas of West Africa to correctly identify the disease and its rate of spread. The World Health Organization standards of diagnosis for Zika virus call for detection either of viral DNA or antibodies against the virus in patient blood samples.

Using the WHO guidelines, I calculated that the cost to furnish a basic lab to conduct these tests is $124,000. Buying the necessary chemicals and disposables (such as gloves and test tubes) would cost an additional $10,000 per 500 tests.

In contrast, the WHO and partners have called for $122 million to implement their Zika response plan through December 2017. The U.S. government has already directed almost $600 million for critical activities. For the same amount, over 4,000 diagnostic labs could be equipped.

To be sure, that calculation excludes the additional costs to train the necessary personnel and to procure enough supplies to sustain these labs over the long term. And a considerable amount of the U.S. funding will be devoted to developing and testing a Zika vaccine which would have long-term utility. But even thinking more modestly, for a fraction of the cost of the current emergency response, a well-equipped national lab could be built and sustained in every country on earth. This would allow doctors to verify which diseases are circulating in each country and enable scientists to mount a rapid response to nascent outbreaks.

Building that kind of lasting infrastructure is long overdue. Zika is only the most recent in a series of outbreaks proving that diseases do not respect political boundaries and that they are emerging and spreading more quickly than ever. We do not know where the next pandemic will emerge or when. Zika was first identified in rhesus monkeys in the 1940s. SARS jumped from animals to humans as did swine flu and avian flu and Ebola. Already there are worrisome observations, such as the detection of a new strain of Leishmaniasis, a parasitic disease carried by sand flies, infecting people in Ghana.

We must ensure that scientists and public health workers in Ghana and everywhere in the world are properly trained and equipped to monitor such occurrences and detect new ones. They are operating on the front lines of disease and they are our best hope for preventing future pandemics.

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