Long-term Outbreak Management Approaches

Integration of Epidemic Preparedness into National and International Development and Health Policies 

Epidemics arise massively because the national health services and infrastructures fail. Due to a lack of information, people don’t know how to protect themselves. Well-run education systems and health services, as well as functioning infrastructures, are the best protection against epidemics. 

However, the path towards this ambitious goal is long and costly. A faster and more effective intervention would be the integration of epidemic prevention into all areas of development aid. In regions particularly affected by outbreaks many small and simple measures can be implemented that contribute to the protection against dangerous pathogens. 

Early Warning System for Emerging Pathogens 

Newly-emerging pathogens almost always jump from animals to humans. Ebola virus came from fruit bats or some other, yet unknown reservoir; HIV-1 from chimpanzees, swine flu from pig, etc. Strengthening the capacity of Early Warning and Reporting System (EWARS) can be one of the major long term approaches to tackle outbreak potential diseases. 

Strengthening Epidemiology and Disease Control Division 

The prevention, early detection and control of outbreaks are managed by Epidemiology and Disease Control Division (EDCD) in Nepal. EDCD should strengthen the quality and capacity of laboratories and intervention teams. 

Preparedness of Adequate Medical Response Unit 

The fast setup of medical response unit and treatment centers, in sufficient numbers, is crucial for the early containment of an outbreak. The necessary technical equipment is not a challenge. Mobile units in tents or containers have proved to be superior to fixed buildings. The provision of consumable materials (e.g., protection suits, disinfectants) should be secured through supply contracts or stockpiling, respectively. 

A far greater challenge than equipment is the personnel. The outbreak investigation team should be adequately available and prepared through continuous education (disaster medicine, languages, etc.) and, when necessary, through special field training. The Medical Response Unit should as a rule act in conjunction with aid organizations in the affected region, which in particular provide the necessary field staff. 

Development of Outbreak manuals, protocols 

The outbreak plan should clearly document or identify locally appropriate protocols for outbreak management. Outbreak protocols should encompass the entire outbreak management process. Outbreak protocols should suggest thresholds for each stage of the outbreak investigation and response. 

Research & Development (R&D) Blueprint for action to prevent epidemics 

It is a global strategy and preparedness plan that allows the rapid activation of R&D activities during epidemics. Its aim is to fast-track the availability of effective tests, vaccines and medicines that can be used to save lives and avert large scale crisis. 

Long-term substantial investments should be made to strengthen health systems so they are able to provide safe, effective and qualitative health services before, during and after epidemics. 

Others: 

• Training to front-line responders to prepare them for emergency. 
• Health screening of travelers especially foreigners, refugees at cross borders, airport. 
• Maximum coverage of vaccination, especially in the unreached areas 
• Regular surveillance of areas with past outbreak records, high risk areas