Globalization has influenced the rate and severity of reemerging and emerging infectious disease on their effects on the modern world. International trade and travel have accelerated the spread of technological advancement, but also the spread of disease. While developed countries grow further through this process, developing states still struggle with public health facilities and capabilities. The internationalization of public health has failed and the needs and quality of public health systems are deteriorating or nonexistent. In addition, the ever-increasing economic, social, and environmental problems in the developing world have cultivated the emergence and reemergence of infectious diseases. The large scale of international mobility through trade and travel put the developed world constantly under threat from the spread of disease in more urban areas that pose a severe risk of transmission between large populations. Dangerous infectious
116 Salaam-Blyther, T. The 2009 Influenza A (H1N1) “Swine Flu” Outbreak: U.S. Responses to Global Human Cases //
Congressional Research Service, 2009. URL: https://biotech.law.lsu.edu/blaw/H1N1-2009/R40588.pdf (accessed 24.02.2018).
117 Salaam-Blyther, T. The 2009 Influenza A (H1N1) “Swine Flu” Outbreak: U.S. Responses to Global Human Cases //
Congressional Research Service, 2009. URL: https://biotech.law.lsu.edu/blaw/H1N1-2009/R40588.pdf (accessed 24.02.2018).
55 diseases, as a result of globalization, are brought under attention through different sectors, such as security and international relations, that further emphasize the importance of creating effective preventive methods and response plans to combat these health threats.
As seen in the 2001 anthrax bioterrorism attacks, improving public health preparedness of the United States was a main concern for health officials across the country. Preexisting planning efforts and exercises and previous experience helped promote an early and coordinated response, but bureaucratic complications and cross-state and cross-jurisdiction agreements slowed down the response. Effective communication, the benefits of planning and exercise, and the importance of a strong public health infrastructure became the main areas to improve for future public health emergencies. The failure to communicate a clear and timely message to the public was one of the main areas that fell short during the anthrax attacks. First responders needed to be engaged in training and exercises to simulate a public health crisis to prepare in advance for complications and casualties under an effective chain of command. The U.S. public health infrastructure was a fragmented system, with under-prepared and lack of facilities in the affected areas that resulted in inefficiencies when it tried to enact a coordinated response later on during the crisis. The CDC was challenged to coordinate the federal public health and to meet extensive resource demand from state and local officials, but were not fully prepared on the federal level. The organization recognized the importance of tracking the vulnerable, sharing sensitive information, treating aggressively, and improving communication among agencies, the media, and the public.
The SARS outbreak required the collaboration between many international agencies, with the WHO at the forefront of the response. The Global Outbreak Alert and Response Network (GOARN) provided an operational platform to mobilize experts from different fields to address the global public health emergency. Through GOARN, the WHO coordinated the development of standards and tools for containment of the epidemic. The joint effort monitored the magnitude and spread of the disease to provide advice on prevention and control. However, China’s
commitment to the WHO raised doubts due to their inaccurate statistical results and vague public health transparency. The U.S. State Department counted at least six cases among American citizens in China, where the number of cases reported was misrepresented. When SARS first arrived in the U.S., the improved and aggressive public health measures helped the country to
56 mostly escape the full effects of the epidemic. Since the 2001 anthrax attacks, it was vital to inform the public to follow guidelines to help stop the spread of disease. The two previous outbreaks gathered an increase in the development of detailed plans for responding to an
infectious disease outbreak and led to the creation of the International Health Regulations (IHR) in 2005 to define the rights and obligations of countries to report events and establish procedures to uphold that must be followed to uphold their work on global public health security.
The considerable efforts after the development of the International Health Regulations helped to detect and isolate the H1N1 influenza virus reasonable early, although it was too late for any attempt at containment. Vaccines were the core preventive intervention method for the virus, but the availability was limited and was distributed late to the poorer national affected by the pandemic. Some countries could also not obtain technical help in their languages as the WHO ceased routine new conferences and its bureaucracy created an uncontrollable number of documents causing confusion. The CDC, acting as one of the four collaborating centers around the world with the WHO, directly or indirectly supported pandemic influenza preparedness efforts in more than 50 countries, but its communication strategy garnered criticism and the public’s confidence in the organization wavered. It was seen that effective responses to the increasing threat of infectious disease require a multi- faceted and disciplined approach to bring together those from a variety of sectors, as well as the improvement for detection of disease within developing countries to create, procure, and distribute appropriate preventive measures and treatments.
57 III. CASE STUDY: EBOLA VIRUS