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In the Ongoing Ebola Crisis, Emergency Aid Is Not Enough

A version of this piece originally appeared in the News & ObserverMore than 1,400 people have died from Ebola virus in West Africa since March.

One of the over 2,600 infected is Nancy Writebol, a health worker from Charlotte, North Carolina, who was providing aid in Liberia. She was treated at Emory University with an experimental drug and has since been discharged. Here in our back yard, GlaxoSmithKline is working on a potential vaccine.

When such a disaster strikes, our first impulse is often to stop and see how we can immediately help. Can we send supplies? Should we send health workers or other experts? We’re human beings after all, and helping is the right thing to do.

Samaritan’s Purse and other organizations have done just that during this crisis, sending experts to care for the suffering.

This type of emergency aid is noble and necessary. But it is not enough. It is not sustainable.

No longer do we simply helicopter in with supplies, expertise, and technology to save the day.

There is another vital component to international aid that is far less known—and many don’t realize that we’re on the leading edge of it here in the Triangle. It’s called health systems strengthening. And it’s a very different kind of aid.

No longer do we simply helicopter in with supplies, expertise, and technology to save the day. Today we must look not only at individual diseases but also at the bigger picture. Whenever we provide aid, we must ask ourselves: How can we make a positive impact not only today but for years to come?Health systems in particular are crucial. They include infrastructure, policies, disease surveillance, education, facilities, and, of course, producing and maintaining a homegrown health workforce to provide care to the population.

This matter of “homegrown” is vital—health workers who belong to the communities they serve are much more likely to have the trust and acceptance of their clients.

We’ve seen many accounts of a disease spreading due to fear of foreign health workers. We saw it after the earthquake in Haiti, and we’re seeing it now with the Ebola crisis.

The existing health systems in West Africa and in many countries are not strong or resilient enough to handle such crises. Most of these countries struggle to provide even basic health services to their people.

Part of the reason is our global shortage of health workers.

Weaknesses in West Africa’s health systems do not affect just West Africa—they affect us all. Ebola, HIV, and other infectious diseases do not respect borders. Globally, our countries’ health systems are interconnected, creating one larger global health system.

Today, that system is woefully precarious.

All countries must be more coordinated around disease surveillance, international regulations, and development of the workforce we need to ensure long-term health and well-being for all 7 billion of us.

USAID could stipulate that a small portion of all its projects be invested in health systems strengthening.

The U.S. has done a tremendous amount to improve global health over the past several decades. The U.S. Agency for International Development funds several major global projects to strengthen health systems, including CapacityPlus; the Leadership, Management & Governance Project; and the Applying Science to Strengthen and Improve Systems Project. The U.S. is also a leader in establishing systems to ensure supply of medicines and commodities.

But we could do more.

USAID could stipulate that a small portion of all its projects be invested in health systems strengthening. And the U.S. government and other donor countries—including Brazil, Russia, India, China and South Africa—could accelerate progress even further by establishing a fund specifically to strengthen the global health workforce.

Global health organizations in the Triangle—such as IntraHealth International, RTI International, and FHI 360, to name just a few—can help, too.

At IntraHealth, we’ve created mobile learning courses with specialized guidance on care and prevention for health workers in Ebola-affected areas. We’re also reviewing health workforce information systems we’ve supported in eight West African countries to see how their data can be used toward targeted education, communication, and coordination among frontline health workers.

So what else will we do to prevent health crises and their global ripple effects for years to come? Yes, we need to stop and help, to provide emergency aid that saves lives today.

But if we did only that, it would not be enough.

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