Get ahead of the next health crisis by rebuilding the public health infrastructure

By Dennis Archambault

We know that public health is largely invisible and hasn’t had much of a voice in public policy – certainly as it pertains to government funding. The coronavirus is a mixed blessing is that it has given the public health system considerably greater visibility and the need of increased funding is apparent. Just as Gov. Whitmer is suggesting we may have a close-to-normal summer by the Independence Day, public health advocates are saying it’s now or never to get spending priorities aligned with developing the public health infrastructure.

A recent Wall Street Journal article documented the failure of the United States and other developed countries in responding to the coronavirus as a cautionary tale that should be studied not just by public health students – which have a real-time, experiential text in their locality – but by policymakers and the general public. Public health is invisible, in the best of circumstances. The Journal article cites a report, “Epidemics That Didn’t Happen,” detailing how fast, disciplined public health response to health crises works – and worked in developing countries like Senegal and Vietnam. Consider these case studies from the report:

• When Ebola started spreading in the northeastern Democratic Republic of Congo in 2018, health officials in Uganda, which is just over the border, kicked a national emergency preparedness and response system into gear. They set up border screenings, opened treatment centers, and vaccinated healthcare workers. The few cases they identified were quickly contained and the virus never spread.
• When health officials diagnosed 10 cases of monkeypox in a coastal Nigerian state, the government dispatched a national rapid response team. It worked with local authorities to search for more cases, improve surveillance and testing, and run education campaigns. The outbreak ended without growing further.
• Mongolia, Senegal, and Vietnam have all kept their numbers of Covid-19 cases low. Mongolia advised its citizens to wear masks in January 2020 and canceled large gatherings before it had a single case. Senegal turned to a health emergency operations center it had set up during the 2014-2016 Ebola epidemic in West Africa and set up a testing system that returned results in 24 hours. Vietnam used its experience from the severe acute respiratory syndrome epidemic a decade and a half earlier, and hospitals quickly identified and isolated patients.

As the morbidity and mortality numbers gradually decrease and the vaccine rates gradually increase, now is the time for public health advocates to be talking to anyone willing to listen, that we need to learn from this experience to prevent a potentially worse epidemic from captivating us. The way to do that is to shore up the public health infrastructure and teach people to behave sensibly.

Dennis Archambault is vice president of Public Affairs for Authority Health.