On January 21, 2015, we gathered some of the best minds in public health to share their insights with other leaders in a panel discussion, “Responding to Ebola,” at the World Economic Forum. Lesson number one: medical protocols are the easiest part of confronting pandemic.
The lessons of the Ebola outbreak are still being processed, but it is already clear that they transcend medicine and public health. Pandemics present policy and operational challenges for leaders in government and non-governmental organizations, enterprise, and civil society. The people who are dying aren‘t just those who contracted Ebola. Entire industries have been shut down in the affected countries. Basic services have disappeared and household incomes have declined sharply.
Creating resilience to catastrophes like this is not an African problem. It is a global problem. The resources to fight disease on a transnational scale are dispersed across continents and constituencies, and are fiendishly difficult to marshal effectively. The lack of mechanisms for multinational risk governance is itself one of the world’s top global risks.
In recent years Oliver Wyman has directed more of its own resources to the challenges of developing shared responsibility and coordinated action across governments, organizations, and borders.
Ebola is drawing oxygen away from businesses and basic services, driving up food prices, stigmatizing growing numbers of people, keeping children out of school, and preventing pregnant women and those suffering from malaria and other diseases from accessing medical care. Household incomes across entire nations have declined by as much as one-third in six months.
Ebola can only be defeated in Liberia, Sierra Leone, and Guinea, not in Europe or the US.
In much of the world there are no front lines for basic health care, let alone for mounting a response to a crisis that endangers an entire region or the world. Ebola is a grisly way to die, but countless others died of Malaria or a lack of prenatal and maternity care as slender health resources were re-directed at Ebola.
Many died where care was in fact available – of fear. They feared the pop-up clinics and the strangers in moon suits. Building local capacity is essential to public health and mitigates the challenges of cross-cultural education that come with “airlift” medicine.
The point of attack lies far upstream from the response to a catastrophe in process. The critical need is local access to medical services. The Ebola endgame in Liberia alone required roughly 1,000 epidemiologists – who weren’t available. “They’re always committed to some other crisis,” says Hans Rosling, a professor of international health who has been working with the Liberian Ministry of Health. Technology can help. Modular medical facilities and telematics can make existing resources and knowledge go farther until national infrastructures are built out – a challenge of decades.
We need a NATO-type body bringing coherence to the global scientific effort.
Epidemics are only partly about health. “The contribution of healthcare to solving crises like this is no more than 30 percent,” Dr. David Nabarro, the UN Secretary-General’s special envoy on Ebola, told our panel. “What is critical are on-the-ground logisticians and top-class coordinators who can work with humility within communities.”
The world’s great industrial organizations devote years to integrating their supply chains. Battling a transnational crisis with no rehearsal and no chain of command requires miracles of sourcing, transport, distribution, and timing.
If we had the right health infrastructure in Sierra Leone, Guinea, and Liberia, we wouldn’t have gotten to this stage. Now the health system will crumble and have to be rebuilt…. So that’s where the world is going to have to go next, is really investing in primary healthcare.
Oliver Wyman specializes in this kind of complex, interrelated challenge.
But transnational solutions require new transnational structures as well as new approaches. Many of the world’s supra-national bodies like the World Health Organization were shaped for a post-World War II environment that no longer exists. We need structures that are more forward looking – and equipped to carry out their mandates. WHO itself is only funded for about 15% of its needs.
Still missing in the global equation is a body to coordinate scientific development, says Dr. Seth Berkley, CEO of GAVI, the Vaccine Alliance. Johnson & Johnson released USD 200 million for Ebola vaccine development overnight, and regulators expedited their answers. But the political and ethical issues surrounding the questions of who receives an unproven drug and when are still being debated.
Photo Credit: UNMEER/Martine Perret
Photo Credit: UNMEER/Martine Perret
We believed this panel could help spark collaborations that better serve affected populations and contribute to a new architecture for global health security.
The discussions continue and the work has begun.
Within Oliver Wyman, we are already at work across practice areas to map approaches that embrace the interrelated challenges of achieving global health security – and addressing other shared challenges that require shared solutions.
Meet The Panel.
We are grateful to our distinguished guests for their insight in helping to shape more collaborative approaches to the next global epidemic.
The Hon. Suresh Kumar is a former Partner in Oliver Wyman’s Health & Life Sciences and Public Sector practice groups. Prior to joining the firm, he served as US Assistant Secretary of Commerce and Director General of the US & Foreign Commercial Service.
From 2003 to 2010, the Hon. Kumar was president and managing partner of Kaizen Innovation, a consulting practice focused on global management, marketing innovation, and global development. His clients included the Bill & Melinda Gates Foundation, the Alliance for a Green Revolution in Africa, and the African Development Bank. He has also held executive leadership positions with Johnson & Johnson and Warner-Lambert. He is a distinguished visiting professor of international business at George Washington University and has served on the faculties of the Rutgers University EMBA program, the Schulich School of Business at York University in Toronto, Canada, and Bombay University in India. He holds degrees from Delhi University and Bombay University and is an alumnus of the Thunderbird International Consortium Program.
LEAD ORGANIZER AND MODERATOR
Dr. Seth Berkley has served as CEO of GAVI, the Vaccine Alliance, since 2011, joining the organization as it was launching its five-year strategy to immunize a quarter billion children in the developing world by 2015.
Prior to joining the GAVI Alliance, Dr. Berkley was the founder, president, and CEO of the International AIDS Vaccine Initiative (IAVI), the first public-private partnership for developing vaccines. Previously, Dr. Berkley served as an officer in the Health Sciences Division at the Rockefeller Foundation. He has also worked for the Center for Infectious Diseases of the US Centers for Disease Control and Prevention, the Massachusetts Department of Public Health, and the Carter Center, for which he served as an epidemiologist at the Ministry of Health in Uganda. He has consulted or worked in more than 50 countries in Asia, Africa, and Latin America. Dr. Berkley sits on a number of international steering committees and corporate and not-for-profit boards, including those of Gilead Sciences, the New York Academy of Sciences, and the Acumen Fund.
Dr. David Nabarro is the UN Secretary-General’s Special Envoy on Ebola, the Secretary-General’s special representative for food security and nutrition, and coordinator of the Scaling Up Nutrition Movement.
Previously Dr. Nabarro served as senior coordinator for avian and pandemic influenza and coordinator of the UN System’s High-Level Task Force on Global Food Security, director of the WHO Department of Health Action in Crises, executive director in the office of former WHO director general Gro Harlem Brundtland, and director of WHO’s Roll Back Malaria Department. Dr. Nabarro has worked on child health and nutrition programs for Save the Children in Iraq, South Asia, and East Africa; taught in the schools of tropical medicine of the University of London and the University of Liverpool; and served as chief health and population adviser to the British government’s Overseas Development Administration and as director for human development in the UK Department for International Development. A physician who studied at Oxford and London Universities, Dr. Nabarro holds a masters’ degree in reproductive endocrinology and public health.
Dr. Hans Rosling is a professor of international health at the Karolinska Institute in Stockholm, Sweden. Since October, 2014, he has been working with the Liberian Ministry of Health to address the country’s Ebola epidemic.
Dr. Rosling has a long-standing interest in infectious diseases, epidemiology, and the impact of poverty. In the 1970s, while working in Mozambique, he discovered the second known outbreak of the paralytic disease konzo and helped confirm the disease’s etiology. He is the author of a textbook on global health and co-founder of the Swedish branch of Doctors Without Borders/Médecins Sans Frontières. Dr. Rosling is a co-founder of Gapminder, a not-for-profit organization that describes itself as “a modern ‘museum’ that helps make the world understandable, using the Internet.” As part of its mission Gapminder created Trendalyzer, a computer program for creating interactive, animated graphics—graphics that are at the heart of Dr. Rosling’s acclaimed TED talks analyzing the impact of poverty.
Dr. Paul Stoffels is the Chief Scientific Officer, Johnson & Johnson, and worldwide chairman, Pharmaceuticals. As Chief Scientific Officer, he works with the company’s R&D leaders to set the enterprise-wide innovation agenda.
Dr. Stoffels serves as a member of the Executive Committee of Johnson & Johnson and has more than 20 years of global health and pharmaceutical experience. He chairs the company’s Worldwide Research & Development Council and provides oversight to Johnson & Johnson Development Corporation, the Johnson & Johnson innovations centers, and for product safety for all of the company’s products. Dr. Stoffels began his career as a physician in Africa focusing on HIV and neglected disease research.
Photo Credit: Oliver Wyman
Suresh Kumar & Oxfam International Director Winnie Byanyima
Photo Credit: Oliver Wyman
Participants (l-r) IFRC Sec Gen Elhadj As Sy, J&J CSO Paul Stoffels, Gapminder Co-founder Hans Rosling, Suresh Kumar, UN Special Envoy David Nabarro & Gavi CEO Seth Berkley
Photo Credit: Oliver Wyman
The panel in action
Today we are building on this specific experience to help develop new approaches of shared responsibility and collaboration across governments; public, private, and multilateral institutions; and civil society.