An editorial and several opinion pieces discuss ongoing issues in the response to the Ebola outbreak in West Africa.

Nature: Ebola: time to act
Editorial Board

“…It cannot be repeated enough that public health measures and good old-fashioned epidemiological tracking of the infected and their contacts will bring this outbreak to an end. The priority must be to scale these up, alongside establishing more Ebola treatment centers on the ground. … West Africa’s outbreak illustrates the serious weaknesses in the international community’s ability to respond to outbreaks of emerging diseases, despite years of debate. It should also hammer home a truism for future planning — the costs of setting up infrastructure to ensure an early response are small compared with the huge social and economic costs of a large deadly disease outbreak” (9/9).

New England Journal of Medicine: Ebola Then and Now
Joel Breman and Karl Johnson of the Fogarty International Center at the National Institutes of Health

“…In the current Ebola epidemic, we believe that the main priorities should be adequate staff for rigorous identification, surveillance, and care of patients and primary contacts; strict isolation of patients; good clinical care; and rapid, culturally sensitive disposal of infectious cadavers. Timely control will require convincing community leaders and health staff that isolation and rapid burial practices are mandatory; that patients can be cared for safely in improved local conditions; and that only trained, qualified, and properly equipped health staff should have patient contact. These steps from the first Ebola outbreak may help bring the current epidemic under control. We also await key virologic, clinical, epidemiologic, and anthropologic descriptions of the epidemic — which will permit comparison with the other Ebola outbreaks that have occurred since 1976 and help us prepare for future outbreaks” (9/10).

Foreign Policy: The Ultimate Ebola-Fighting Force
Jack Chow, professor at the Heinz College School of Public Policy and Management at Carnegie Mellon University

“…Neither the cluster of industrial countries that gives health aid to poor countries, such as those in the G7, nor international bodies like the World Health Organization (WHO) possess an at-the-ready, deployable battalion with trained health care teams, protective gear, and ample supplies of medicines. That needs to change. … The virulence of diseases like Ebola, along with porous borders and the velocity of global movement, are all factors combining to spark a new wave of dangerous flashdemics. It is essential to rethink how a concerted global health defense can be mounted against today’s most potent threats. A global health emergency corps is clearly insurance worth attaining” (9/10).

Nature: Make diagnostic centers a priority for Ebola crisis
J. Daniel Kelly, infectious disease fellow at the University of California, San Francisco

“…[T]he desperate shortage of Ebola diagnostic centers in Sierra Leone is fueling the Ebola outbreak. … If Sierra Leone’s Ministry of Health and Sanitation could scale up diagnostic facilities, it would reduce fear and help to curb transmission from very sick people who are reluctant to seek treatment. … We need to minimize delays in care and if we cannot speed up the health system’s lethargy, then we need to bring diagnostics closer to the people. That means we need more diagnostic sites. So far, all such sites have been developed as adjunctive services to treatment centers. … One of the challenges is the need to standardize equipment, techniques, and results. The Ministry of Health and Sanitation wants standard diagnostics, and international agencies such as the CDC and the WHO agree. Standardization takes time, but it is necessary…” (9/9).

Washington Post: Ebola funding shouldn’t come at the expense of other global health concerns
Christine Sow, executive director of the Global Health Council

“…[M]oney already allocated for global health would fund the [U.S. Ebola] response, meaning less money for tuberculosis and malaria and depleted funds for health systems serving children and families in developing countries. Redirecting funds would be a shortsighted strategy to respond to a rapidly growing crisis. The U.S. government must provide funding and leadership commensurate with the Ebola emergency while maintaining the country’s place as a global leader in the fight on child and maternal mortality and HIV/AIDS” (9/10).