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The guest curator of this week’s FT Health is Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, who writes:
Earlier this week I made my second visit to the Democratic Republic of Congo to review the response to that country’s latest Ebola outbreak. I met survivors, health workers, the minister of health and many others. The progress since my first trip a month ago is encouraging. Despite the remote location and the many logistical challenges, the DRC government, the World Health Organization and our many partners have responded rapidly and effectively. As a result, the outbreak has stabilised.
This time we also have a weapon we did not have during the west African epidemic in 2014: a vaccine. More than 2,600 people in the DRC have now been vaccinated against Ebola. It’s not a silver bullet, but it is a vital tool. Shortly after our vaccination campaign began, our field co-ordinator Dr Mike Ryan wrote: “For the first time in my experience I saw hope in the face of Ebola and not terror.”
Even better than responding rapidly to outbreaks, is preventing them. The best way to do that is to invest in stronger health systems that are oriented towards achieving universal health coverage. More than half the world’s population lacks access to essential health services such as vaccination, treatment for HIV and tuberculosis, basic sanitation or cancer screening.
Even when health services are available, using them can cause deep financial difficulty for many people. Almost 100m people are pushed into extreme poverty every year because of out-of-pocket health spending. WHO was founded 70 years ago on the conviction that health is a human right for all, not a privilege for some. Universal health coverage is the best investment in preventing emergencies of all kinds — from the personal crisis of a heart attack to a pandemic.
The book I am currently reading is The Leadership Challenge by James Kouzes and Barry Z. Posner.
Articles I'm reading
Trachoma eliminated in first sub-Saharan African country (The Telegraph)
Antarctic ice melting faster than ever, studies show (The Guardian)
Current academic papers
Response to the Ebola virus disease outbreak in the Democratic Republic of Congo (Lancet). A well-reasoned article that shows how this Ebola response has improved based on past experience and the new technologies (a vaccine) as well as what challenges still face the response to this (and any major) outbreak.
Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations (Lancet) shows the gaps in access to healthcare worldwide. Universal health coverage is one of WHO’s “triple billion” goals — 1 billion more people benefiting from universal health coverage, 1 billion more protected against health emergencies, and 1 billion more people enjoying better health and well-being.
Obituary — Douglas G Altman: statistician, researcher and driving force behind global initiatives to improve the reliability of health research (BMJ). Douglas Altman was a brilliant statistician who never ceased to defend the need to improve research methods; he knew that public trust in science is built on honest reporting of limitations.
International travel between global urban centres vulnerable to yellow fever transmission (Bull. WHO). One of the reasons that WHO insists on a more robust global vaccine supply is the potential spread of yellow fever to populations with no immunity in the megacities of south-east Asia; nicely documented by this analysis of air travel.
Trials and tribulations: cross-learning from the practices of epidemiologists and economists in the evaluation of public health interventions (Health Policy & Planning). Global health relies on research in multiple disciplines; this is an instructive comparison of the approaches used by economists and epidemiologists when employing randomised controlled trials to evaluate the effects of public health interventions.
Bill Gates; Shattuck Lecture. Innovation for Pandemics (NEJM). A timely topic for the Shattuck Lecture by Bill Gates, given the centenary of the 1918 influenza pandemic, accompanied by a 20-second animation showing us what a repeat would look like today.
Current understanding of the human microbiome (Nature Medicine). A superb overview of the next frontier for public health — understanding how our genetic composition and environmental exposures interacts with antibiotic use to condition our microbiome and alter our susceptibility to many non-communicable diseases.
Jean-Jacques Muyembe, director-general of the Congo National Institute for Biomedical Research and veteran co-ordinator of Ebola outbreaks.
What strikes you about the current Ebola outbreak?
It’s a bit different. It has occurred in several places at once. It requires lots of energy and logistical effort to identify cases, but we think we have the experience to tackle the epidemic.
How would you contrast the response to previous outbreaks?
If you compare with the ones in west Africa, the WHO this time reacted rapidly, provided resources and the Congolese are supportive. We have had co-operation with the government and Médecins Sans Frontières. There has also been acceptance of vaccination for the first time without any resistance from the local people as well as the use of antivirals.
Are you getting exhausted after dealing with so many Ebola outbreaks?
This is my ninth outbreak in DRC and the 14th in Africa I have handled. In two years' time I will retire. It’s a bit early to take stock on the latest epidemic but there is greater co-operation and African solidarity now.
How can we make the best use of health data? Should medical data be treated differently from other personal data? What impact will Europe’s new GDPR rules have on medical research and health tech companies? Darren Dodd puts these questions to the FT’s Sarah Neville, Tina Woods of Collider Health as well as data protection and privacy expert Kristof van Quathem. Listen here.
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