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The Ebola outbreak that has stricken Sierra Leone, Liberia and Guinea since March 2014 has had a devastating effect on the region. By 2 December 2014, more than 17,500 cases and 6,000 deaths had been reported. Ebola has had wider damaging consequences for local economies, food security, institutional stability and the broader health system. The House of Commons International Development Committee says DfID and the World Health Organisation initially failed to recognise the scale and severity of the Ebola crisis and were too slow to respond. This is in part due the WHO's member states, who have cut its funding and failed to emphasise building sustainable health systems in developing countries, leaving the global health system "dangerously inadequate" for responding to health emergencies. It recommends that DfID press for a review of the international approach to health emergencies, incorporating the function, structure and funding of the World Health Organisation and the role and expectations of major donors.
The deadliest outbreak of Ebola virus disease in history, and the first to hit epidemic levels, struck the West African countries of Guinea, Liberia and Sierra Leone in 2014, killing 11,315 people. Despite being diagnosed in March 2014, there was a slow initial response to the epidemic. This was attributed by many witnesses to our inquiry to delays in WHO sounding the alarm and declaring a Public Health Emergency of International Concern (PHEIC), something which WHO must carry primary responsibility for. As a result, the international community did not fully mobilise until September, in the wake of the World Health Organization's designation of the outbreak as a Public Health Emergency of International Concern in August. We praise those who risked their lives to bring the epidemic under control and pay tribute to all those who lost their lives in the fight against Ebola.
Ebola is a rare and deadly disease. Since late 2013, West Africa has experienced the largest Ebola outbreak ever recorded. We pay tribute to all those who worked tirelessly to tackle this outbreak, some of whom gave evidence to this inquiry, and many of whom continue working to avert similar crises in the future. We also commend the Government on its leading contribution to the fight against Ebola, and the financial, and personnel, commitments that it made, from constructing and staffing Ebola treatment centres in Sierra Leone to deploying troops, helicopters, aircrew and an aviation support ship to provide much needed logistical support. Examples of UK successes in tackling Ebola, however, must not allow complacency to set in. Despite this impressive deployment of resources to combat Ebola in Sierra Leone, the UK response - like the international response - was undermined by systemic delay. The biggest lesson that must be learnt from this outbreak of Ebola is that even minor delays in responding cost lives. Yet delays were evident at every stage of our response, from escalating Public Health England's disease surveillance data to those with the capacity to act, to convening a Scientific Advisory Group for Emergencies which failed to be established until October 2014, three months after 'Cobra', the Government's emergency response committee, first met. In the absence of established mechanisms, ad hoc approaches emerged to fill the gaps. Inevitably, these were not as effective, or as targeted, as they should have been.
As the end of the 2010-2015 Parliament approaches, the Committee has taken the opportunity to look back on their work. This Report outlines some of the Committee's work, progress and effectiveness during this Parliament and sets out areas that may be of interest to their successor committee. It has also provided the opportunity to scrutinise what actions the Government has taken with regard to issues and recommendations raised in our reports.
Government response to HC 693, 2013-14 (ISBN 9780215071750). DFID's annual report for 2012-13 published as HC 12, session 2013-14 (ISBN 9780102983241)
The number of low income countries is falling. At the same time, the importance of global issues - conflict, climate, migration, trade, tax, financial stability, youth unemployment, urbanisation economic development, and infectious disease - is rising. The Committee argues that aid remains vital for addressing poverty in poor countries, for encouraging economic development, for providing global goods such as tackling climate change, combating diseases such as Ebola and providing humanitarian assistance, but new forms of co-operation have to be developed in order to meet these challenges. This will include new financial mechanisms and facilitating links with UK institutions in a wide range of areas, including health, education, culture, law, culture and science. This will require the Department for International Development (DFID) to put more emphasis on working with small organisations and less on programme management.As the focus moves away from aid, policy coherence for development must be at the heart of a new approach. This means working across Government in the UK, and with global partners in the multilateral system, to maximise the impact on development of all the UK's actions. This approach and changes will require DFID staff to develop different skills.
"A complete revision and expansion of ... A-Z of industrial relations practices at the workplace"--Pref.
This practically oriented book provides an up-to-date overview of all significant aspects of the pathogenesis of sepsis and its management, including within the intensive care unit. Readers will find information on the involvement of the coagulation and endocrine systems during sepsis and on the use of biomarkers to diagnose sepsis and allow early intervention. International clinical practice guidelines for the management of sepsis are presented, and individual chapters focus on aspects such as fluid resuscitation, vasopressor therapy, response to multiorgan failure, antimicrobial therapy, and adjunctive immunotherapy. The closing section looks forward to the coming decade, discussing novel trial designs, sepsis in low- and middle-income countries, and emerging management approaches. The book is internatio nal in scope, with contributions from leading experts worldwide. It will be of value to residents and professionals/practitioners in the fields of infectious diseases and internal medicine, as well as to GPs and medical students.
Have the revised International Health Regulations allowed states to rise to the challenge of delivering global health security? In the age of air travel and globalized trade, pathogens that once took months or even years to spread beyond their regions of origin can now circumnavigate the globe in a matter of hours. Amid growing concerns about such epidemics as Ebola, SARS, MERS, and H1N1, disease diplomacy has emerged as a key foreign and security policy concern as countries work to collectively strengthen the global systems of disease surveillance and control. The revision of the International Health Regulations (IHR), eventually adopted by the World Health Organization’s member states in 2005, was the foremost manifestation of this novel diplomacy. The new regulations heralded a profound shift in international norms surrounding global health security, significantly expanding what is expected of states in the face of public health emergencies and requiring them to improve their capacity to detect and contain outbreaks. Drawing on Martha Finnemore and Kathryn Sikkink’s “norm life cycle” framework and based on extensive documentary analysis and key informant interviews, Disease Diplomacy traces the emergence of these new norms of global health security, the extent to which they have been internalized by states, and the political and technical constraints governments confront in attempting to comply with their new international obligations. The authors also examine in detail the background, drafting, adoption, and implementation of the IHR while arguing that the very existence of these regulations reveals an important new understanding: that infectious disease outbreaks and their management are critical to national and international security. The book will be of great interest to academic researchers, postgraduate students, and advanced undergraduates in the fields of global public health, international relations, and public policy, as well as health professionals, diplomats, and practitioners with a professional interest in global health security.
Prevention of infectious diseases by vaccination is one of the most significant achievements of modern medicine. During the 20th century, the average human life span in the developed world was about 70 years and it is expected to increase, with a significant portion of this increase directly attributed to vaccination. Since the first empiric vaccination trials, knowledge and technology have enormously evolved and new vaccination strategies are emerging on the market. Indeed, in spite of the great success, conventional vaccination strategies sometimes may result ineffective and, above all, may raise safety concerns. The aim of this book is to provide an overview of some of the technology platforms that have been realized or are currently under development to try to address unsolved and new issues in the field of vaccine development. Common denominator of all thematic areas described herein is the multidisciplinary teamwork. Most of the enabling technologies have been established by putting in the “melting pot” expertise in fields that, at first glance, may appear very far apart. I hope that this collection of articles will make the readers aware that vaccinology is rapidly taking a new direction, ceasing to be an empirical science.