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Stienstra Ebola lessons learned publiek 2015

Stef Stienstra
Stef Stienstra

This document discusses lessons learned from the 2014-2016 Ebola outbreak in West Africa. It provides background information on Ebola virus disease, including its symptoms, transmission, and history of outbreaks. It notes that while many countries committed to preparing for pandemics under the WHO International Health Regulations, few were fully prepared when Ebola emerged. The document discusses the roles of various organizations in responding to the outbreak, including militaries, NGOs, the UN, and clusters. It outlines strengths and weaknesses of military involvement in humanitarian aid. Finally, it quotes Bill Gates recommending that countries and alliances like NATO identify military resources available for future epidemics.

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CBRN risk preparedness and response: Lessons learned from Ebola outbreak Stef Stienstra
Selection of emerging diseases
All 194 countries of the world committed to WHO International Health Regulations June 2012 deadline only 16% fully prepared to detect and respond to pandemics
Interpretation of IHR Questionnaire 4
Biosecurity & Biosafety
Ebola shortlist Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. EVD outbreaks have a case fatality rate of up to 90%. EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus. Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals. WHO Fact sheet N属103 Updated April 2014
History of outbreaks 7
Ebola Virus Disease Zo旦notic disease
Transmission routes Most virolent in dying patient Only by contact
Bio-risk is real
11
So, where are we now with IHR Globally? 12 We must come together to prevent, and detect and fight every kind of biological danger whether its a pandemic like H1N1, a terrorist threat, or a treatable disease. President Barack Obama, 2011
US Global Health Engagement program & EU GSHA Partner Nation Announcement by President Obama at G20 Summit in Turkey 6 November 2015: Bangladesh, Burkina Faso, Cambodia, Cameroon, Cote dIvoire, Democratic Republic of Congo, Ethiopa, Georgia, Ghana, Guinea, Haiti, India, Indonesia, Jordan, Kazakhstan, Kenia, Laos, Liberia, Mali, Mozambique, Pakistan, Peru, Rwanda, Senegal, Sierra Leone, Tanzania, Thailand, Uganda, Ukraine and Vietnam. US DoD has already GHE assets (laboratories, bio-survellance emergency operations centers) active in a number of these countries and is poised to support the mission to prevent, detect and to respond to biological threats. DoD Cooperative threat reduction (CTR) / Cooperative Biological Engagement Plan (CBEP) Armed Forces Health Surveillance Center / Global Emerging Infections Surveillance and Response Systems Division (GEIS) PEPFAR; DAHHP; DIMO (15,000 participants in 2015); DTRA; etc > USPHS; Military, Contractors, NGOs, IOs, GOs, Local Health Authorities
Tradition of Humanity in armed forces operations CIMIC ? Civil effects ? Nation building ?
Inter-Agency Standing Committee (IASC) 15 NGO Consortia Interaction (US-based) SCHR (Steering Committee on Humanitarian Response) ICVA (Intl. Council of Voluntary Agencies) OHCHR (Office of the High Commissioner for UN Human Rights) IOM (International Org. for Migration) World Bank Special Rapporteur on the HR of IDPs ICRC IFRC OCHA UNICEF (UN Childrens Fund) WFP (World Food Programme) WHO (World Health Org.) FAO (Food & Agriculture Org.) UNHCR (UN Refugee Agency) UNFPA (UN Population Fund) UNDP (UN Development Programme) UN Habitat 1. Humanity- address human suffering wherever it is found 2. Impartiality- aid without discrimination 3. Neutrality- not taking sides in hostilities or controversies 4. Operational Independence- not influenced by military, political, economic objectives
The Humanitarian Country Team (HCT) 16 UN Country Team UNDP (UN Devt Programme) UNICEF (UN Childrens Fund) WFP (World Food Programme) WHO (World Health Org.) FAO (Food & Agriculture Org.) UNHCR (UN Refugee Agency) UNFPA (UN Population Fund) Other AFPs NGO community International and national NGOs ICRC, IFRC, National society Clusters IOM (Intl Org. for Migration) Other organizations with operational relevance (OOWORs) OCHA
The Cluster Approach is designed to provide: Predictability, Accountability and Partnership in all response sectors Better support for national-led response tools Common standards and tools 1 7
The CIMIC Battlespace Death and Destruction Hugs and Kisses Competition with NGOs?
19 The European Mobile Lab - EMLab Transfer of military know-how
20 Last resort; bridge-truck-cookie CIMIC Civil- Military Interaction MilitaryNGOs CIMIC-activities Liaison, security Ad hoc collaboration in deployment or training Where do NGOs and Military troops meet each other ? CBRNe-incidents = Public Health effects
UN Mission for Ebola Emergency Response (UNMEER) Under the strategic guidance of the SG's Special Envoy, David Nabarro, and the operational direction of the SG's Special Representative, Anthony Banbury, the mission will harness the capabilities and competencies of all the relevant United Nations actors under a unified operational structure to reinforce unity of purpose, effective ground-level leadership and operational direction, in order to ensure a rapid, effective, efficient and coherent response to the crisis. UNMEER will work closely with governments and national structures in the affected countries, regional and international actors, such as the African Union (AU) and the Economic Community of West African States (ECOWAS), and with Member States, the private sector and civil society. The World Health Organization (WHO) will be responsible for overall health strategy and advice within the Mission.
UN Cluster meeting in UNMEER
PSYOPS challenge Some local leaders spread rumors that "the white people" were conducting experiments, infecting Sierra Leonians or cutting off people's limbs. Doctors Without Borders warned that widespread belief that Ebola does not exist threatened to spread the disease regionally. Today the word "Ebola" carries so much stigma that few ailing individuals even seek diagnosis.
Better control
Public awareness
Better control
Military in Humanitarian Aid Strengths Flexibility / Mobility Protection / safe haven Communication Intelligence Logistics Medical Support (Mobile hospitals; standard of care) Ref.: LSHTM & Oxford University, Qualitative study, Refugee Studies, Programme Documentation Centre, 2001 Weaknesses Relatively short deployments Intercultural (in-)competence Cooperation / communication with civilian actors Armed forces No neutrality or impartiality Competition with NGOs Medical treatment standards
The next Epidemic Lessons from Ebola All countries could identify trained military resources that would be available for epidemics; in a severe epidemic, the military forces might have to work together The conversation should include military alliances such as NATO which should make epidemic response a priority Bill Gates, New England Journal of Medicine, March 19, 2015

More Related Content

Stienstra Ebola lessons learned publiek 2015

  • 1. CBRN risk preparedness and response: Lessons learned from Ebola outbreak Stef Stienstra
  • 3. All 194 countries of the world committed to WHO International Health Regulations June 2012 deadline only 16% fully prepared to detect and respond to pandemics
  • 4. Interpretation of IHR Questionnaire 4
  • 6. Ebola shortlist Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. EVD outbreaks have a case fatality rate of up to 90%. EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus. Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals. WHO Fact sheet N属103 Updated April 2014
  • 9. Transmission routes Most virolent in dying patient Only by contact
  • 11. 11
  • 12. So, where are we now with IHR Globally? 12 We must come together to prevent, and detect and fight every kind of biological danger whether its a pandemic like H1N1, a terrorist threat, or a treatable disease. President Barack Obama, 2011
  • 13. US Global Health Engagement program & EU GSHA Partner Nation Announcement by President Obama at G20 Summit in Turkey 6 November 2015: Bangladesh, Burkina Faso, Cambodia, Cameroon, Cote dIvoire, Democratic Republic of Congo, Ethiopa, Georgia, Ghana, Guinea, Haiti, India, Indonesia, Jordan, Kazakhstan, Kenia, Laos, Liberia, Mali, Mozambique, Pakistan, Peru, Rwanda, Senegal, Sierra Leone, Tanzania, Thailand, Uganda, Ukraine and Vietnam. US DoD has already GHE assets (laboratories, bio-survellance emergency operations centers) active in a number of these countries and is poised to support the mission to prevent, detect and to respond to biological threats. DoD Cooperative threat reduction (CTR) / Cooperative Biological Engagement Plan (CBEP) Armed Forces Health Surveillance Center / Global Emerging Infections Surveillance and Response Systems Division (GEIS) PEPFAR; DAHHP; DIMO (15,000 participants in 2015); DTRA; etc > USPHS; Military, Contractors, NGOs, IOs, GOs, Local Health Authorities
  • 14. Tradition of Humanity in armed forces operations CIMIC ? Civil effects ? Nation building ?
  • 15. Inter-Agency Standing Committee (IASC) 15 NGO Consortia Interaction (US-based) SCHR (Steering Committee on Humanitarian Response) ICVA (Intl. Council of Voluntary Agencies) OHCHR (Office of the High Commissioner for UN Human Rights) IOM (International Org. for Migration) World Bank Special Rapporteur on the HR of IDPs ICRC IFRC OCHA UNICEF (UN Childrens Fund) WFP (World Food Programme) WHO (World Health Org.) FAO (Food & Agriculture Org.) UNHCR (UN Refugee Agency) UNFPA (UN Population Fund) UNDP (UN Development Programme) UN Habitat 1. Humanity- address human suffering wherever it is found 2. Impartiality- aid without discrimination 3. Neutrality- not taking sides in hostilities or controversies 4. Operational Independence- not influenced by military, political, economic objectives
  • 16. The Humanitarian Country Team (HCT) 16 UN Country Team UNDP (UN Devt Programme) UNICEF (UN Childrens Fund) WFP (World Food Programme) WHO (World Health Org.) FAO (Food & Agriculture Org.) UNHCR (UN Refugee Agency) UNFPA (UN Population Fund) Other AFPs NGO community International and national NGOs ICRC, IFRC, National society Clusters IOM (Intl Org. for Migration) Other organizations with operational relevance (OOWORs) OCHA
  • 17. The Cluster Approach is designed to provide: Predictability, Accountability and Partnership in all response sectors Better support for national-led response tools Common standards and tools 1 7
  • 18. The CIMIC Battlespace Death and Destruction Hugs and Kisses Competition with NGOs?
  • 19. 19 The European Mobile Lab - EMLab Transfer of military know-how
  • 20. 20 Last resort; bridge-truck-cookie CIMIC Civil- Military Interaction MilitaryNGOs CIMIC-activities Liaison, security Ad hoc collaboration in deployment or training Where do NGOs and Military troops meet each other ? CBRNe-incidents = Public Health effects
  • 21. UN Mission for Ebola Emergency Response (UNMEER) Under the strategic guidance of the SG's Special Envoy, David Nabarro, and the operational direction of the SG's Special Representative, Anthony Banbury, the mission will harness the capabilities and competencies of all the relevant United Nations actors under a unified operational structure to reinforce unity of purpose, effective ground-level leadership and operational direction, in order to ensure a rapid, effective, efficient and coherent response to the crisis. UNMEER will work closely with governments and national structures in the affected countries, regional and international actors, such as the African Union (AU) and the Economic Community of West African States (ECOWAS), and with Member States, the private sector and civil society. The World Health Organization (WHO) will be responsible for overall health strategy and advice within the Mission.
  • 22. UN Cluster meeting in UNMEER
  • 23. PSYOPS challenge Some local leaders spread rumors that "the white people" were conducting experiments, infecting Sierra Leonians or cutting off people's limbs. Doctors Without Borders warned that widespread belief that Ebola does not exist threatened to spread the disease regionally. Today the word "Ebola" carries so much stigma that few ailing individuals even seek diagnosis.
  • 27. Military in Humanitarian Aid Strengths Flexibility / Mobility Protection / safe haven Communication Intelligence Logistics Medical Support (Mobile hospitals; standard of care) Ref.: LSHTM & Oxford University, Qualitative study, Refugee Studies, Programme Documentation Centre, 2001 Weaknesses Relatively short deployments Intercultural (in-)competence Cooperation / communication with civilian actors Armed forces No neutrality or impartiality Competition with NGOs Medical treatment standards
  • 28. The next Epidemic Lessons from Ebola All countries could identify trained military resources that would be available for epidemics; in a severe epidemic, the military forces might have to work together The conversation should include military alliances such as NATO which should make epidemic response a priority Bill Gates, New England Journal of Medicine, March 19, 2015