March 31, 2016 |

Prevent, detect, respond: avoiding the next pandemic

How a grove of cashew trees and a new global health security partnership have deep roots in planning ahead.
A mosque surrounded by trees.
Cashew trees grow around a mosque in Senegal. Photo: PATH/Linda Venczel.

“It’s like planting tree saplings into the ground,” says PATH’s Linda Venczel. “At first they don’t look like much, but give them 20 years and you’ve got a grove.”

It is a metaphor Linda calls on from her Peace Corps days in Senegal, when she planted a hillside of cashew trees. She uses it now to describe the work she’s involved with addressing a new global urgency around cross-border pandemic threats.

“The trees are really code for planning ahead.”

As PATH’s project lead for the new Global Health Security (GHS) Partnership, Linda and her team are working to strengthen the systems to identify disease threats early and prevent outbreaks from reaching a critical state.

“What we’re doing today is essentially developing stronger systems.” Linda continues, “So when another outbreak threatens, we’ll be ready.”

A lab tech wearing head covering and working with equipment.
PATH brings together the public and private sectors to improve access to vaccines. In Vietnam, a locally produced, egg-based influenza vaccine is now in development. Photo: PATH/Matthew Dakin.

The new PATH initiative represents a $3.5 million project across Senegal, Vietnam, and Tanzania that’s funded by the US Centers for Disease Control and Prevention (CDC).

“PATH was chosen based on our decades of experience strengthening systems around the globe and building relationships with partners in these three countries.” Adds Venczel, “It’s an area of public health where we already have boots on the ground and may be the furthest along on implementing programs.” Support may be increased as PATH and our partners work over time to implement the activities.

The work is important as the increasing threat of emerging infectious diseases and cross-border epidemics, such as Ebola, cholera, and now Zika, has country leaders and global health experts coming together to plan ahead and identify where health care, digital infrastructure, and systems need to be strengthened.

What boots on the ground looks like

Philippe Guinot of PATH sits in a circle with a woman and two children.
Philippe Guinot, PATH country program leader in Senegal, visits a health center during a flu vaccination campaign. Photo: PATH/Fatou Kande-Senghor.

Community relationship building has as much importance in these large-scale global conversations as the comprehensive work needed to ensure systems are in place. There were lessons learned during the Ebola disease outbreak that showed the need to foster long-term trust in local communities.

“We saw people who clearly mistrusted the emergency response personnel and continued cultural practices that not only went against health care requests, but spread the occurrence of disease.”  Linda adds, “The need to build those relationships, that trust, is paramount to our success and the health of every community we serve.”

A surveillance worker collects samples of water.
Surveillance and testing are important tools used to identify where diseases like polio might make a resurgence. Finding it before it passes onto populations is as important as immunization programs. Photo: PATH/S. Khan.

3 principles to address the challenges

The GHS work is fueled by three principles that hinge on fostering strong systems and in-country cross collaboration and partnerships.

1. Prevent:

Strong surveillance keeps a close and consistent watch on the diseases that threaten communities. With a robust surveillance system, health teams can rapidly detect and report threats, efficiently monitor trends, and produce data that inform prompt decisions, aiming to catch illness early and prevent outbreaks.

 2. Detect:

Efficient, streamlined, and high-quality laboratories ensure rapid and reliable diagnostics, detecting, tracking, and recording pathogens for a complete picture of disease burden.

3.  Respond:

Integrated data management applies findings from surveillance and diagnostics to promptly highlight areas of concern, ensure information flow throughout the health system, and rapidly trigger informed response.

These GHS branches, the frame around which we prevent, detect, and respond within a strong cohesive system, will not be successful without the workforce that supports them. A wide array of people are needed from volunteers to professionals, health workers, data managers, lab researchers, and program managers.

“Our support of workforce development through the CDC’s Field Epidemiology Training Program,” explains Linda, “provides training, manages field study grants, and coordinates fellowships to strengthen the skills of teams that keep communities safe and healthy.”

A group of health workers with a bicycle standing in front of a jeep.
PATH’s Global Health Security project is informed by decades of experience strengthening systems around the globe and building relationships with in-country partners. Photo: PATH/Doune Porter.

It takes time, but prevention is the pay off

These are challenging systems to put in place, and yet Linda has great hope that a global focus on implementing the three principles will result in healthier communities and a safer, more secure world.

“Like that grove of cashew trees we planted 20 years ago,” says Linda. “Not only did they mature into a canopy of green, but profits from the sale of cashew nuts and their flour pay for services like midwife training and a village fund to provide transportation for people needing to seek health care at the provincial level.”

Linda smiles and concludes, “Those trees are benefiting the community in ways we never imagined.”

 Linda Venczel (L) in a caftan and head covering stands in a flour mill with a man
Recently, Linda Venczel (L) visited the grove of cashew trees she helped plant 25 years ago to find a cooperative run by women through microfinancing started from the nut sales. The cooperative pays for midwife training, garden projects, the millet mill, and many other projects. Photo: PATH.
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  • Portrait of Tracy Romoser. Photo: PATH/Patrick McKern.
    Tracy Romoser is a communications officer and the blog editor at PATH.