The Foreign Service Journal, May 2017

THE FOREIGN SERVICE JOURNAL | MAY 2017 37 Fighting Pandemics State’s new, multitiered pandemic response mechanism is the result of understanding and applying lessons learned during the past decade. Nancy J. Powell, a retired career ambassador, led the State Department Ebola Coordination Unit in 2014 and was senior coordinator for avian influenza from 2005 to 2006. She is the 2017 recipient of AFSA’s Lifetime Contri- butions to American Diplomacy Award. Gwen Tobert was a member of the Ebola Coordination Unit and is the Pandemic Response Team lead in the Office of International Health and Biodefense in the State Department Bureau of Oceans and International Environmental and Scientific Affairs. I n the past decade, we’ve fought multiple global dis- ease outbreaks, from avian influenza to Zika. One of the most important lessons we’ve learned is that there will be more pandemics in the future, and they are likely to be increasingly complex, particu- larly if they occur in areas where medical services are already challenged. Beyond the front page stories of human suffering, there can be significant economic and political stability costs if pandemics are not quickly controlled. In a world of increasing connectivity, it took only weeks for the 2014 outbreak of Ebola in a remote border area of three West African countries to reach Dallas, Texas, via a traveler from Liberia. After arriving in Dallas, the man began developing symptoms and went to the hospital, where two nurses became infected and many others were exposed before doctors recog- nized his illness as Ebola. The incident sparked public hysteria FOCUS ON GLOBAL HEALTH DIPLOMACY and political pressure to implement restrictions on travel and trade. The 2009-2010 H1N1 swine flu outbreak infected more than 60 million Americans, according to an estimate by the U.S. Cen- ters for Disease Control and Prevention, and 87 percent of the resulting deaths occurred in those under 65 years of age. Direct economic impacts are difficult to calculate, but numerous studies indicate that a severe pandemic influenza outbreak could cost billions of dollars in GDP loss. If not quickly addressed, infectious disease outbreaks can have significant consequences for our national security, as well. Looked at through this lens, it is easier to see why the State Department must take a leading role in coordinating the U.S. government response to international public health emergen- cies. Indeed, as with many deals reached and crises averted in the international arena, there is a diplomat behind each deployment of health-care workers and each development of a new vaccine. Diplomats bring partners to the table. They expedite pro- cesses. They keep trade flowing and share the latest information from the field. And when the doctors and television cameras go home, diplomats stay behind, advocating social and economic recovery to return countries to a positive development path. Dur- ing the 2014 Ebola crisis, more than two dozen State Department bureaus and offices, in addition to embassies across every region, contributed to the response and recovery effort. Yet, despite some successes and ongoing efforts to improve early warning and response systems, the international com- munity and the United States remain woefully unprepared to BY NANCY J . POWE L L AND GWEN TOBERT LESSONS LEARNED