The Future of Global Health: Case Study Ebola

By Avantika Goswami

“You wake from dreams of doom and–for a moment–you know, beyond all the noise and the gestures, the only real thing, love’s calm unwavering flame in the half-light of an early dawn.”

Quoting former UN Secretary-General Dag Hammarskjöld, renowned philanthropist Betsee Parker introduced the second panel on Day I of the International Conference on Sustainable Development hosted at Columbia University, New York on the 23rd of September, 2015.

Against the backdrop of the 3rd Sustainable Development Goal (SDG) of global health, the panel focused on learnings from the Ebola virus disease (EVD) originating in West Africa. A team of 3 experienced panellists with varying encounters with the global fight against the epidemic spoke of systemic failures, smart technology and the role that the international community can play in mitigating a sequel to the disaster.

On the 70th year of the United Nations, Parker mentioned, there have been numerous breakthroughs – with child mortality being reduced by half worldwide and significant progress being made with studies on AIDS treatment. With these advances in mind, there is hope to combat large-scale epidemics like Ebola as well. Citing her experiences with Columbia University’s Millennium Villages project, Parker stressed on the criticality of understanding the challenges of managing an epidemic of that scale, and of the need to bring healthcare to communities working for less than $2 a day.

The first panellist, Emmanuel Dolo, advisor to the President of Liberia spoke about ground realities in his nation, which was worst hit by the disease (approximate death count of 4808; Source: WHO). A failure to recognize and act upon the outbreak on a timely basis by international communities accelerated the impact. Dolo highlighted the need to understand the local communities and their cultural DNA. He believed that this would aid response teams to understand why patients were initially resisting treatment and how they could be empowered to cope. A lack of sufficient data furthered enlarged the systemic issues prevalent.

Columbia Mailman School of Public Health’s Irwin Redlenner, public health activist and a recognized leader in disaster preparedness cited “global health as the main SDG” – indicating that it could directly lower poverty and enable citizens to reach their full potential. Redlenner stressed on the relationship of disasters to sustainability – that a society incapable of avoiding, mitigating and recovering from a disaster is not sustainable. In Redlenner’s view, Ebola qualifies as a mega-disaster with 30,000 people affected and a total of 11,000 plus fatalities. The lessons learnt are insufficient; it is the application of these lessons and the re-programming of systems to avoid past failures that is critical. He outlined three primary steps as imperative for the way forward:

  • A reset of our understanding of responsibilities when dealing with complex international problems like Ebola. These problems can often be confusing and faces serious issues of jurisdiction, especially when there is a conflict between preserving a country’s sovereignty and disaster response efforts to an issue impacting multiple parties on a large scale
  • “Better, faster science” to offer innovative solutions to communities with diverse needs and vulnerabilities
  • Greater focus on efforts that will avoid large-scale disasters – for e.g., dealing with climate change, civil stability in and protection of countries in the fragile stage of becoming more developed and resilience of infrastructure aimed at promoting development

The third panelist, Elizabeth Zehe, of the Earth Institute’s Millennium Villages project spoke about the facilitative role that technology tools can play in improving the performance of community health workers. She raised the issue of a severe lack of data and described her team’s implementation of a mobile application and an accompanying data analytics platform for contact tracing in Guinea. As the site of the first outbreak of Ebola in December 2013, there was a need to follow contacts on the ground in Guinea to track victims and move them to treatment centers. During the height of the epidemic, response teams needed a robust reporting system, who up until then were reliant on paper-based tracking records. Her team provided workers with smartphones which reported into a real-time dashboard. This was implemented in 5 out of 8 affected prefectures. She was of the view that such smart solutions can be used to strength health systems in general – to provide primary health services and also provide data to management and response teams.

The panel concluded with a Q&A round with questions from the audience and the Twitter community following the conference live at @ICSD2015. The takeaway and overall sentiment of the panel was a forward-looking view that consolidated learnings from an event that has been classified as a global humanitarian disaster and system failure. Ebola Virus Disease has been a wake-up call not only for affected nations, but for the international community as a whole. There is great potential to harness the epidemic control systems created for Ebola and expand them to form a larger integrated health system for fragile communities. For participants and laypersons alike, much of this can be achieved through a better understanding of the intrinsic needs of an affected community, contextualizing them to their societal problems and collaborating with professionals on the ground to resolve issues with the aid of smart technology tools.


Avantika Goswami is a graduate student at Columbia University and a 2015 ICSD Media Fellow.