Delays in Global Disease Outbreak Responses: Lessons from H1N1, Ebola, and Zika

Am J Public Health. 2018 Mar;108(3):329-333. doi: 10.2105/AJPH.2017.304245. Epub 2018 Jan 18.

Abstract

In global disease outbreaks, there are significant time delays between the source of an outbreak and collective action. Some delay is necessary, but recent delays have been extended by insufficient surveillance capacity and time-consuming efforts to mobilize action. Three public health emergencies of international concern (PHEICs)-H1N1, Ebola, and Zika-allow us to identify and compare sources of delays and consider seven hypotheses about what influences the length of delays. These hypotheses can then motivate further research that empirically tests them. The three PHEICs suggest that deferred global mobilization is a greater source of delay than is poor surveillance capacity. These case study outbreaks support hypotheses that we see quicker responses for novel diseases when outbreaks do not coincide with holidays and when US citizens are infected. They do not support hypotheses that we see quicker responses for more severe outbreaks or those that threaten larger numbers of people. Better understanding the reason for delays can help target policy interventions and identify the kind of global institutional changes needed to reduce the spread and severity of future PHEICs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communicable Diseases, Emerging / epidemiology*
  • Communicable Diseases, Emerging / prevention & control
  • Disease Outbreaks / prevention & control*
  • Global Health*
  • Hemorrhagic Fever, Ebola / epidemiology*
  • Hemorrhagic Fever, Ebola / prevention & control
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Public Health Surveillance
  • Time-to-Treatment*
  • Zika Virus Infection*