Patricio Lepe Carrión

World Public Health Systems: The Medical Response to Outbreaks (Sistemas de Salud Pública en el Mundo: la respuesta médica a los brotes)

por Abigail Washford  (


Pandemics of any treatable disease can be catastrophic when not contained quickly. Early detection is key to stemming the spread of disease and treating patients who have already contracted the illness. While highly developed countries are best at responding to large outbreaks using advanced communication infrastructure and systems that catalogue and relay medical information, lesser-developed countries still look to improve their emergency response during healthcare crises in several important areas.

A lack of information drives much of the problem in third-world countries suffering from widespread diseases. Many times, people don’t know to watch for the symptoms or to protect themselves against potentially harmful situations. When treating infected patients, doctors and nurses are often forced to work with limited information. If the disease is fairly new or unknown in that part of the world, they may have little training and few resources specific to that problem.

In developed countries, the ability to warn others about the disease is essential to saving lives. For example, during the 2009 H1N1 pandemic in the U.S., the Centers for Disease Control (CDC) alerted the public about both the symptoms and dangers. The World Health Organization (WHO) and the National Respiratory and Enteric Virus Surveillance System (NREVSS) provided weekly virological updates about the disease progression, reported cases and resulting deaths. This information was invaluable for communities in treating and containing the infection before it could spread further.

Many smaller countries, however, lack the funds to monitor and prevent diseases before they spread. When Puerto Rico was struck by the dengue fever this year, the country did not have much money to invest in prevention. Donald Shepherd, who studied the economic impact of dengue fever on the country, was concerned about the price tag. “The economic cost of dengue averages $40 million per year,” he said. “For the moderate size that Puerto Rico is it’s a substantial amount of money.”

Reports of widespread infections that come from developing countries are, sadly, frequently inaccurate. This arises from the lack of communication among hospitals, standardized health records and information dispersal. Information from industrialized countries can help but often arrives too late; similarly, vaccines might not be targeted for that climate or people group. Some countries do not have the resources to stockpile the needed medications, and once the small supply is gone, they resort to secondary, less effective measures of treatment. In fact, the CDC estimates that 96% of deaths in a future pandemic will come from underdeveloped countries.

But the future is not grim. Making a few key changes will greatly improve the ability of third-world countries to prevent and treat disease outbreaks. The first change is to improve the infrastructure: standardized health records, public alerts and frequent updates from those tracking the disease. Providing better health care is next. Not all hospitals provide face masks or gloves, nor do all of them have sufficient quantities of medication. The last step is improving international support. Epidemics are, by definition, not limited to a particular place, age, race or gender. The international community can do much for itself and its neighbors in assisting the smaller countries in the ways they need most.


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