HARI SREENIVASAN: Next: After
the containment of the Ebola
outbreak, scientists are looking
around the corner for the next
serious threat to global threat.
Judy Woodruff recently sat
down with Liberian-Born
Dr. Raj Panjabi at
Spotlight Health in Aspen,
Colorado, to discuss the
challenges of preventing
the next pandemic.
Warning: Some of the images in
this report may be disturbing.
JUDY WOODRUFF: Dr. Raj
Panjabi, thank you very
much for joining us.
What do you think the
world learned from the
last Ebola outbreak of
just a couple of years
ago, and do you think
we're ready, the world is
ready for the next one?
DR.
RAJ PANJABI, Last Mile Health:
You know, I think there are
many lessons that have been
learned from the crisis and
still are, but probably one of
the most central, fundamental
lessons is this basic notion
that illness is universal
and access to care isn't, and
that that actually places
all of us at greater risk.
We have known this from
even the first boy who
died in the Ebola crisis,
Emile, a 2-year-old
in the rain forest in Guinea.
He died after having
vomiting, fever and diarrhea
in December of 2013.
It took three months for
the world to realize that
this was an outbreak.
He lived in a forest community
that -- in rural parts of
West Africa where the forest
is dense, but health
workers are sparse.
And so the virus spread during
that time out of control, led
to tens of thousands of people
dying.
JUDY WOODRUFF: One of the things
you did was employ what you
call community health workers
to go out and do what
you're talking about.
What exactly did they do?
DR.
RAJ PANJABI: Well, community
health workers are people from
villages like Emile's where
a middle- to high
school-educated person would
be trained for a matter
of months and equipped
to provide medical care door
to door to their neighbors.
Those workers are critical, in
addition to nurses and doctors,
because nurses and doctors
are concentrated in cities.
They don't reach rural areas.
When I first came back,
I grew up in Liberia.
I fled during the civil war.
I came back as a
medical student.
And what I found is that
there were just 51 doctors
for four million people.
It would be like the city of
San Francisco having just 10
physicians for the entire city.
So, if you got sick in the
city, you might stand a chance.
But, in rural areas, you didn't.
So, community health workers
have been critical to providing
health care, where doctors don't
reach, and linking
patients to care.
What we did, for instance,
when an outbreak happened in a
rural part of the country, was
to train and equip health
workers from those communities
to go door to door to work with
doctors and nurses to
find the sick and get
them into treatment units.
JUDY WOODRUFF: We have been
hearing about community health
workers for a long time.
What's different about
how they work now, the
role that they play?
DR.
RAJ PANJABI: I think what's
new now is a recognition
that this is perhaps one
of the most undervalued
labor assets in the
health work force.
Long-term, they have been
treated as volunteers.
So, in other words, they don't
get paid to do their work.
Most are underequipped and
many have been barely trained.
What's different now is the
recognition, as in the case of
Liberia, after the Ebola crisis,
taking a former volunteer
community health work force
and upgrading it, hiring those
workers, employing them,
training them, equipping
them with the right
gear and medicines to
go door to door and
provide health care.
JUDY WOODRUFF: A larger
question of epidemic pandemics.
It seems we pay a lot of
attention to them when we're
in the middle of the crisis and
it's on everybody's
mind, people are dying.
It's a very visual thing.
But then we quickly forget.
We move on.
Our attention span is short.
How confident are you that the
world is truly prepared for
the next pandemic and the one
after that?
DR.
RAJ PANJABI: Well, we have
done more to become prepared
after the Ebola crisis.
We're not yet close to where
we need to be to be prepared
for the next epidemic.
The data shows this.
We know that the cost of
inaction is larger than the cost
of action; $6 trillion is the
estimated potential
economic loss of a pandemic.
But we're only spending 50 cents
per person per year in providing
surveillance and preparedness
against preventing
the next epidemic.
JUDY WOODRUFF: We know that
this is one of the things that
funding by the United States
can make a big difference,
as to your point.
DR.
RAJ PANJABI: Yes.
JUDY WOODRUFF: The
legislation that is moving
through the Congress
right now, or what appears
to be moving through the
Congress, could make some
significant cuts in that area.
DR.
RAJ PANJABI: Yes.
JUDY WOODRUFF: What
effect would that have?
DR.
RAJ PANJABI: Well, I think,
make no mistake, the cuts
would be devastating.
And one of the untold stories
of U.S. foreign aid is that
it's had such a dramatic impact,
largely because of investments
in health care systems like
Liberia's and poor countries.
If there had not been an effort
to invest U.S. foreign aid
before, during and now after
the Ebola crisis, you
wouldn't have been able
to surge front-line
local health workers who
went door to door to find the
sick and get them into care.
At that very moment when the
CDC told us that there could
be as many as 1.4 million cases
of Ebola in Liberia and Sierra
Leone, in the country I grew
up and the one next to it,
that very week, in Dallas,
Texas, America diagnosed
its first case of Ebola.
So it's not a theory that
epidemics that happen
to people across the
world can impact us at
home quite literally.
So I think this is the real
story about foreign aid
is, it's actually not aid.
It's investment.
It's a win-win.
It saves lives abroad
and it keeps us safer
at home in America.
And that's something we
should all be proud of,
actually, as Americans.
JUDY WOODRUFF: Dr. Raj
Panjabi with Last Mile
Health, thank you very much.
DR.
RAJ PANJABI: Thank you, Judy.