1. Managing Pandemics Health

2. Health: Managing Pandemics OUTLINE What is a pandemic? Long term disease management: Malaria Sudden pandemic outbreaks: Ebola Conclusions

3. Health: Managing Pandemics WHAT IS A PANDEMIC? “A disease or virus that spreads across a broad geographical area and can spread worldwide” Some examples of pandemics: Different types of influenza HIV/AIDS Ebola Malaria

4. Health: Managing Pandemics LONG TERM DISEASE MANAGEMENT: CASE STUDY: MALARIA One of the most infectious diseases faced by humanity in our history Death toll from malaria continues year on year In 2013, there was an estimated 198 million cases of malaria and 584,000 people died (WHO, 2015). Mortality rates are dropping but access to treatment and prevention is still unavailable for millions of people

5. Health: Managing Pandemics BASIC FACTS ABOUT MALARIA Evidence suggests that malaria could have originated before human life and has evolved with humanity Evidence of malaria has been found in Egyptian mummies, preserved over 3000 years ago Caused by single-celled parasite that is carried by mosquitos and transmitted by their bite Malaria is preventable and treatable but still causes many deaths 90% of deaths resulting from malaria occur in Africa (WHO, 2014) There have been efforts to eradicate malaria but 97 countries still have ongoing malaria transmission (WHO, 2014)

6. Health: Managing Pandemics GEOGRAPHY Mostly occurs in tropical and subtropical areas Generally occurs in poorer parts of the world Sub-Saharan Africa is the most affected continent but other affected areas include parts of Asia, Latin America, some parts of the Middle East and some southern parts of Europe

7. Health: Managing Pandemics REASONS WHY… Weather conditions are favourable for year-round transmission Socio-economic instability makes eradication difficult Access to treatment and preventative measures can be difficult in some areas because of lack of access to services Costs for drugs, travel to clinics, absence from work etc… are too high for individuals and families Costs of supplying and staffing health facilities, public health interventions and economic damage etc… too high for government Detrimental impact on economic growth (exacerbates existing issues)

8. Health: Managing Pandemics ACTIVITY 1 WHY AFRICA? Understand why malaria is more prevalent in certain areas of the world

9. Health: Managing Pandemics ERADICATING MALARIA Between 2000 and 2013 the global malaria rate dropped by 47% (WHO, 2015) World Health Organisation agreed its Global Malaria Strategy for 2016- 2017 Aims to: – Eradicate malaria in at least 35 countries in 2030 – Reduce malaria cases by 40% by 2020 and at least 90% by 2030 Strategy involves three elements: 1.Ensuring access to malaria prevention, diagnosis and treatment services 2.Accelerating efforts towards elimination and malaria-free status 3.Strengthening malaria surveillance

10. Health: Managing Pandemics ACTIVITY 2 ERADICATING MALARIA Consider the difficulties of implementing an eradication programme and to improve general researching and synthesising skills

11. Health: Managing Pandemics SUDDEN PANDEMIC OUTBREAKS: CASE STUDY: EBOLA OUTBREAK 2014 In August 2014, the World Health Organisation declared the Ebola epidemic in West Africa, that began in March 2014, to be an international health emergency, requiring a coordinated global approach (CNN, 2014)

12. Health: Managing Pandemics BASIC FACTS ABOUT EBOLA First identified in 1976 in two simultaneous outbreaks – one in Nzara, Sudan and the other in Yambuku, Zaire (Democratic Republic of Congo) Highly infectious In the 2014 outbreak, 1 in 2 people who contracted it died (National Geographic, 2014). Virus is contracted through direct contact with: Bodily fluids from someone who has Ebola or who has already died from it Contaminated objects – e.g. needles and other medical equipment Infected animals – contact with blood, fluids or infected meat

13. Health: Managing Pandemics BASIC FACTS ABOUT EBOLA Ebola is only able to spread from someone when they are showing symptoms of Ebola Symptoms appear between 2 and 21 days after exposure Can be difficult to diagnose as many of the symptoms are similar to flu-like diseases Not airborne or waterborne, can only be spread by contact with an infected person, object or animal

14. Health: Managing Pandemics ACTIVITY 3 MANAGING THE SPREAD OF EBOLA Understand the difficulties in managing a sudden pandemic outbreak such as Ebola

15. Health: Managing Pandemics TREATING EBOLA Experimental treatments have been trialled but currently there are no known cures for the virus No licensed vaccine to protect against Ebola, but some potential vaccines are being considered (WHO, 2015). Treatment for those infected involves treating the symptoms presenting and minimising the risk of further contamination to others

16. Health: Managing Pandemics MANAGING EBOLA Compared to diseases such as malaria, number of Ebola cases are comparatively small Difficulty treating and preventing disease has led to widespread concern International Medical Corps response involves: Providing care and treatment for patients whilst isolating them Providing specialised training for local and international health workers Strengthening local non-Ebola health care and mitigating secondary impacts of the crisis Helping rebuild local health systems and addressing longer- term needs Helping communities to rebuild their healthcare systems is key (International Medical Corps UK, 2015)

17. Health: Managing Pandemics ACTIVITY 4 LEARNING FROM EBOLA Understand how the Ebola outbreak can help with managing sudden pandemic outbreaks in future

18. Health: Managing Pandemics LONG TERM VS SUDDEN OUTBREAKS All pandemic can be devastating to local and international communities Limited resources means that it is difficult to balance long term planning and management of diseases such as HIV/AIDS and malaria in an attempt to eradicate them completely and have the sudden resources needed when sudden outbreaks such as SARS or Ebola occur.

19. Health: Managing Pandemics ACTIVITY 5 LONG TERM VS SUDDEN OUTBREAKS Understand the difficulties in determining where resources should be sent to manage global health crises

20. Health: Managing Pandemics CONCLUSIONS Managing any pandemic is difficult Balancing the desire to eradicate a disease with the necessity to manage sudden outbreaks poses problems Local and international difficulties of managing disease outbreaks Wider implications of sudden outbreaks An understanding of the reasons diseases can be more prevalent in some areas than others