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Welcome to the WhoWhatWhy Podcast.

Jul 6, 2018

It sounds like it should be the beginning of a joke: A virus walks onto a plane… Only it’s not a joke. It’s how a global pandemic can start. One that could be far more immediate and deadly than our twin fears of climate change or nuclear proliferation.

The recent outbreak of Ebola in the Congo is a grim reminder not only of the 2014 West African outbreak, but of the much wider dangers of the global spread of infectious diseases diseases that know no walls, no travel bans, and respond only to medical and political competence.

The Hill’s national correspondent Reid Wilson, in this week’s WhoWhatWhy podcast, talks to Jeff Schechtman about the very real dangers we face and how the incompetent handling of such a crisis could lead to loss of life on an unimaginable scale.

Wilson, the author of Epidemic: Ebola and the Global Scramble to Prevent the Next Killer Outbreak, takes us through the slowness of the global mobilization in 2014 and what we have since learned. It was a time when as Wilson says in parts of West Africa, it was easier to count survivors than count the dead.

Wilson explains how the World Health Organization (WHO) has learned how to better navigate global politics and local customs. As an example, 70 percent of those that had contact with dead bodies in 2014 contracted the disease; WHO learned that, in dealing with the dead, anthropology was as important as biology. In navigating behavior around the dead, respect had its own rules and customs in the developing world.

Wilson singles out Doctors Without Borders as the most heroic of the organizations that have been called upon in these global outbreaks.

We learn about the role of the Centers for Disease Control and Prevention (CDC) during the previous outbreak. It was an event that precipitated a major transformation of the CDC one that resulted in the CDC sending about 1,400 people to Liberia during this recent outbreak. This was a drastic improvement over past efforts where only a few CDC field operatives were mobilized. Additionally, in 2014 the CDC only had four US facilities prepared to triage highly infectious diseases, such as Ebola. Today there are over 50, at least one in every state.

Even with all the progress and lessons of the the past four years, Wilson reminds us that a strategy for dealing with a rapidly spreading and deadly disease is only as good as the weakest link in the global public health system. That no matter how much the US may want to withdraw from the world, the public health systems in countries like Liberia, Guinea, and Sierra Leone matter to us all.

Wilson reports that what keeps public health professionals up at night is the fear of a disease with the lethality of Ebola, the prevalence and transmissibility of something like Zika and one that develops enhancements for human-to-human transmission capability.

Some bird flu cases in China have already hinted at the possibility of these properties. These are diseases that could easily exceed the Ebola mortality rate of over 40 percent.

All of this is against the backdrop in the US of the Trump administration trying to claw back $250 million out of the Ebola supplemental funding bill, which was passed in 2014 and has been critical to the CDC efforts. Clearly we ignore global partnerships at our peril, especially as they involve the arena of public health. All the while the Chinese seem to be taking on greater and greater responsibility as part of their efforts to sit atop the world stage.

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