Public health has seldom had a spotlight year like 2014. Indications that the Ebola outbreak is stabilizing in Guinea and Liberia are an encouraging sign that even in the poorest parts of the world, public health science can rescue nations. Through the United States' more fleeting experience with Ebola, public health demonstrated how a threat can be contained. Sadly, in Sierra Leone, factors that include poverty, traditional burial practices, and Ebola's staggering contagiousness, require that we expand public health's reach to battle an epidemic that continues to expand.
As we steel ourselves to keep combatting this crisis, it's important to highlight the public health lessons learned over 2014. Such crucial lessons will be critical for nations, health systems, and donors to embrace as Ebola evolves and other challenges emerge in 2015.
First, investment in the science, practice, and leadership of public health is essential to prevent disease. In the United States, Ebola revealed a public health response unfolding over several steps: diagnosis of a possible threat, activation of the public health system, sharing of information, and finally implementation of proven public health techniques. While some of those steps -- identification, monitoring, and treatment -- were not always executed perfectly, the process overall converted a global threat into a more manageable one. That, in itself, is a significant accomplishment.
Second, the science of public health must inform every step of that process, from the monitoring of affected communities to the messages that explain that science to vulnerable populations. That's why it is so important that nations follow the advice of public health leaders -- even in considering how to honor time-honored traditions with modifications that protect health. In Sierra Leone, where burial practices magnify the level of risk, this has been critical. In the United States, leaders knew the public's fears but political concerns sometimes trumped scientific solutions. Where global health is concerned, it is the scientific solutions that best protect the public.
In the United States, some leaders urged the closing of our airports to visitors from countries affected by the outbreak; this would have made it more difficult to identify the potentially ill and those who had come in contact with them. The governors of New York and New Jersey sought to quarantine returning workers who displayed no symptoms, making it more difficult to attract volunteers where need was greatest. In the first case, science ultimately prevailed; neither of these two political solutions was supported by evidence as an effective measure for controlling disease. In the second case, the CDC and the states now call for voluntary quarantines of healthcare workers at greatest risk. The two issues underscore the continuing importance of the public being prepared for the inevitable tension between science and politics--and being able to interpret it properly.
Third, the supply chain that enables the science to be converted into needed protection is vital. That supply chain includes equipment, personnel, and training crucial to containing the disease. In West Africa, this involves specially constructed hospital units, healthcare providers who volunteer for the dangerous duty, and training that enables them to treat the ill and protect themselves as fully as possible. As the concern about Ebola in this country has dissipated, it's easy to undervalue the importance of that infrastructure. But not even the U.S. can afford to be without it. If the holidays are a time to honor the selflessness of those who have volunteered to serve, then the best way that we can show our respect is to fund the supply chain that enables their heroic work.
Fourth, public information and understanding are key. Media coverage in America is a frequent -- and sometimes controversial -- topic of conversation. There is no question that media can incite as much as they inform. But the media played a fundamental role informing the American people about Ebola and enabling the CDC and later the National Institutes of Health to explain what was happening and increase public understanding of the science. It's essential that media continue to provide opportunities for public health leaders to speak directly to the public -- to learn as much from the public health practitioners as they do from the politicians and the pundits.
The public health system in the U.S. performed admirably, if not perfectly, during the short emergence of Ebola here. But we need to continue to support public health globally where it confronts far greater obstacles. While the threat of Ebola is by no means over, what we learned in 2014 should prepare us to combat any outbreaks of infectious disease in the future.