Christopher Dye addresses the 2016 AAAS Annual Meeting | Boston Atlantic Photography
Christopher Dye spent most of his day at the 2016 AAAS Annual Meeting talking about the Zika virus’ march through the Americas. But it was another frightening viral outbreak—the West Africa Ebola epidemic that began in 2014—that was never far from his mind as he spoke about this new threat to international public health.
Dye, director of strategy in the Office of the Director General at the World Health Organization, said in his 12 February plenary address at the 2016 AAAS Annual Meeting that the Ebola crisis demonstrated where global teamwork succeeded and failed during the emergency — in an era where WHO’s share of international public health funding has declined.
“And if you want to think about Zika, because that’s what worries us at the moment,” he asked,” will Zika be a story of global science engagement and global engagement in other forms?”
Thousands of people came from all over the world to join the Ebola response, and Dye remembered walking into a meeting in Monrovia in February 2015 where this global team became apparent to him. “I counted 12 nationalities in the room,” he recalled. “These were people who never worked together, and never met each other before. They came from very diverse backgrounds, and yet they worked together immediately.”
But these determined people were up against more than the virus when they came to West Africa. To begin with, Ebola shed light on some weaknesses in the International Health Regulations, the law signed by WHO and 196 countries to prevent the international spread of disease. For instance, outbreak countries such as Guinea and Liberia did not have the capacity to build the public health systems that would watch for and respond to infectious outbreaks as required by the IHR. As a result, Dye said, the virus spread for at least three months before the epidemic was visible.
Some scientists studying the genetic makeup of the West African Ebola strain were slow to share their data with others, perhaps fearful that they would lose their right to publish their findings in a major scientific journal. “As long as the incentives are aligned that way,” Dye said, “there will always be an obstacle to sharing information.”
In light of the Ebola delays, this week, the Science family of journals joined other scientific publishers in a statement pledging to make all their papers about the Zika virus freely available.
Dye said other tools—some of them quite groundbreaking—could be used against the next international health threats. He pointed to the sudden rise in share prices for pharmaceutical firms working on Ebola vaccines as one type of economic spur to ensure that medicines are there in an emergency, along with WHO’s capacity to “prequalify” drugs as safe and effective so that they can be sold more cheaply and widely.
Although philanthropies like the Bill and Melinda Gates Foundation have had profound effects on international public health, their pockets won’t be nearly deep enough to cover something like the next deadly flu pandemic, Dye said. One hot topic in public health funding, he said, is the idea of working with the private insurance and reinsurance sectors to begin insuring against pandemics in the same way that these companies insure against natural disasters such as hurricanes.
For Ebola, for Zika, and for the epidemics that come next, global engagement will always mean building up trust in local communities as well, sometimes in “imaginative and adaptive” ways, Dye said. He told the story of Sulieman Karbgo, a hospital porter in Sierra Leone who was evicted from his hospital after he fell ill with Ebola. After he died, a nurse reported seeing his ghost, and the nearby village was convinced that they needed to banish his spirit.
“Exorcism is not one of the routine duties of WHO officials,” Dye explained, but the organization’s local staff helped pay for things like the goats, palm oil and the red and black thread necessary to “hook” Karbgo’s spirit. “The most important point was that WHO collaborated in this,” he said, “and given its success, we’re always welcome back in that village.”