One year ago, Ebola was all this country could talk and worry about, but today it seems to be a distant memory. Yet the risk of a future outbreak – whether it be Ebola, another infectious disease, or a bioterror event – remains very real.
There have been more than 17,000 Ebola cases and 6,482 deaths reported to date, representing the largest outbreak in world history. And while cases have significantly declined, they have not yet reached zero. The fact that more than one year later this outbreak is still not contained serves as a reminder that the United States must remain vigilant in order to prevent a future outbreak from happening here at home.
The ongoing cases of Ebola in Sierra Leone and Guinea are also important reminders of the role of preparedness when it comes to stopping an outbreak before it starts. Preparedness against manmade or naturally-occurring threats can often be challenging, mainly because the public’s attention calls for action only when there is dire and present danger. But it is clear had the world been more aggressive in its preparation in fighting Ebola we might have been able to better contain the outbreak.
The challenge is that disease outbreaks give little to no warning that they are coming. And when they arrive, they can come with devastating effects on our way of life. American and international leaders know this, and must take the necessary steps to be prepared, even if current public opinion does not demand it.
This year’s flu season provides another example of how preparedness is the only way to prevent tragedy. While we can make predictions about the specific flu strains that will circulate, and how hard they will hit around the globe, ultimately flu season in the U.S. will have its own specific impact that may not follow our predictions. This is why we have put in place public education campaigns, vaccination programs, and robust monitoring and surveillance designed to save lives. With better and more consistent preventive measures we could reduce death and illness even more. Although we’ve seen with flu that prevention is difficult, the better prepared we are, the better we can respond when an outbreak does hit.
In the case of Ebola, we were slow to detect and engage, and importantly we had no tested and effective countermeasures or vaccines to administer. It could be argued the outbreak would have unfolded very differently had we responded more quickly and had a reliable vaccine or therapeutic to provide to health care workers, which could have had a dramatic impact on how quickly and effectively the outbreak was controlled. Tested, effective and safe treatments for infected patients would have lessened the death toll and slowed the spread of the disease. These measures would have reduced fear in the United States.
However, instead of being ready before the Ebola outbreak, we could only rush to fund development of vaccines and therapeutics after the crisis hit. But this was too late. Trying to prepare with an outbreak already underway is the worst case scenario.
Fortunately, Congress and the Administration recognized that the development of licensed vaccines and therapeutics to prevent and treat Ebola was essential in the fight against the Ebola epidemic and appropriated emergency funding.
Now, a year after the World Health Organization declared the Ebola outbreak an international health crisis, effective Ebola vaccines and therapeutics are on the horizon. For example, one vaccine candidate recently showed strong efficacy in a Phase III trial; the trial continues as more conclusive evidence is needed to see if the vaccine is effective at protecting populations. Two other promising vaccine candidates are currently in late stage development and several therapeutics are being tested.
Because developing medical countermeasures like vaccines and treatments is risky and uncertain, sustained funding and support for research and development programs is essential. Unfortunately, there has not been sustained support for funding and preparation since the wake-up call of the anthrax letters. In fact, the BioShield Special Reserve Fund is authorized at $2.8 billion over five years for the development and purchase of these medical countermeasures, but Congress is on track to fund less than half of that amount, resulting in a $1.53 billion funding shortfall.
We must stop this see-saw behavior. We need to prepare for the worst case by investing in vaccines and treatments not just for biological threats but also for chemical, radiological and nuclear threats. And at the same time we must do everything we can to make sure that we’re never called upon to use them. This is the odd contradiction we must embrace if we are to truly be ready. Other steps Congress should take include creating new incentives for biotech companies to conduct research on these threats and removing outdated regulatory hurdles that prevent promising vaccines and treatments from ever becoming a reality. As President Obama declared, “We have to change our mindsets and start thinking about biological threats as the security threats they are.”
Preparedness is the key to thwarting biological threats. An outbreak of smallpox or pandemic influenza, for example, could dwarf the current Ebola crisis because both are more easily transmitted than Ebola. Consistent, well-funded public-private partnerships are the best hope for successfully developing these necessary products to protect Americans. Investing now will help to prepare for the next natural or man-made outbreak that the world will inevitably face, and hopefully halt it before it becomes a crisis.
It will be the best investment we hope we never have to call upon.
Paul Chaplin, Ph.D., is co-chairman of the Alliance for Biosecurity and president & CEO of Bavarian Nordic, a biotechnology company with research operations in California and Europe.
Elizabeth G. Posillico, Ph.D., is co-chairman of the Alliance for Biosecurity and president and CEO of Elusys Therapeutics, a biotechnology company based in Pine Brook, New Jersey.