Consider a threat that is explosive, without bombs; that can pile up IDPs faster than any civil war. A threat by terrorists that cannot be seen by the naked eye, that attack, not one-to-one like foot soldiers, but in billions-to-one.
An image made available by the Center for Emerging and Zoonotic Diseases research laboratory at the National Institute for Communicable Diseases and taken on November 21, 2011, shows laboratory technicians and physicians working on samples during research on the evolving Ebola disease in bats, at the Center for Emerging and Zoonotic Diseases research Laboratory of the National Institute for Communicable Diseases in Pretoria. AFP PHOTO
Such is bioterrorism
Bioterrorism is a deliberate release of viruses, bacteria, fungi or toxins from living organisms to cause illness or death in people, animals, or plants. Harmful agents can be spread through the air, water, or in our food.
Imagine 36 Sawyers (the index Ebola patient) landing in each of our 36 states, at the same time. Frightening?
Imagine it was a deliberate, planned and calculated act. Many countries are now developing strategies, military style, to guard against the threat of infectious diseases to national security; a threat that can aggravate or provoke social fragmentation, destabilize trade and commerce, and undermine national confidence. An infectious disease threat transcends military power and national borders.
The Center for Diseases Control, CDC, in Atlanta is probably the most notable public health institution in the world. This expansive facility stands beside Emory University Hospital where I spent my early professional years in the USA. Many are not aware of the magnitude of the role the CDC and the US Government played (visibly and invisibly) in First Consultants Medical Center’s success with Ebola; a battle now to be immortalized in a movie. But then the USA has long recognized the serious threat a rogue runaway bio-organism can pose to the security of a nation.
Three decades ago cyberterrorism was considered imaginative and pessimistic; not today. In recent years much the same has been said about bioterrorism. Its significance and potential is now recognized by many countries.
What is Nigeria’s Medical Defense Strategy, MDS?
After our success with Ebola, we need to put a Medical Defense Strategy in place……as a national emergency.
Our MDS will necessitate active partnerships between the executive, legislative and judicial arms across Federal, State and local governments.
From our skirmish with Ebola we have learned that interaction between public health policy makers and clinical health professionals must be deliberate and supportive.
We have learned that funding should be spread to staff and training as well, rather than lopsidedly on infrastructure and equipment.
We have learned that quarantine means more than holding people in isolation, but animals and property can be held or also destroyed. The core pillars of a defense strategy are preparation, prevention, and policing.
Surveillance is vital. It is defined by the WHO as: continuing scrutiny of all aspects of the occurrence and spread of disease that are pertinent to effective control.
Surveillance can be external (land, air and sea border control, internal (national notifiable disease surveillance systems; laboratory based detection and reporting networks) or syndromic (Real-time symptom based monitoring by clinicians in the field).
Surveillance does not necessarily have to be accurate but it must be practical, uniform and rapid. It triggers an alarm. However a robust response must be ready to follow.
Funding has to be made available to state and local governments to hire staff, equip and train them. Public health professionals such as epidemiologists, programmers and biostatisticians, will be needed.
Laboratory services will need to be strengthened, especially in the local areas, as well as expansion of the larger labs in the regional centers.
Medical Response Capacity, MRC – measures the ability of our health facilities (primary health clinics, state, general and teaching hospitals both public and private) to handle a sudden increase in patients; a surge capacity. In England (2003) there were 6.3 ICU beds to 100,000 people; Germany (1999) has 8.3; the USA had 24.
During a pandemic, beds may need to be opened in hotels, homes and malls. These must be staffed.
In Nigeria, there is a major and desperate need for Intensive Care Units; a shortage that remains bewildering considering the demands for these services and the availability of trained Nigerian doctors and nurses in this field.
Preparation for an infectious disease outbreak must be considered a national priority for the incoming Federal Minister of Health.
A stitch in time…….
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