Lab Matters Fall 2016 - Page 8

feature STRENGTHENIN LAB SYSTEMS UNDER by Nancy Maddox, MPH, writer How does an outbreak begin? In the case of the 2013-2016 Ebola epidemic, it started with Emile Ouamouno, a two-year-old boy who lived, and died, in a Guinean rainforest village, hard by the borders of Liberia and Sierra Leone. Emile’s mother, three-year-old sister and grandmother were next to succumb. By late 2014, over 13,000 cases were reported in West Africa, and international responders poured into the region. “T hey came in emergency mode,” said Alpha Diallo, PhD, HCLD/PHLD(ABB). But eventually, he said, “as Ebola virus disease cases dwindled, the [mobile, international] laboratories closed. And as they closed, they left nothing behind them. ... Somebody said, ‘Everybody came in a tank, like a war zone. And after the war, they took their tanks back.’” Yet even as the Ebola epidemic was ramping up, in early 2014 world leaders in Geneva, Switzerland, and Washington, DC were celebrating the launch of an ambitious effort to stop outbreaks from happening—the Global Health Security Agenda (GHSA). As part of that effort, Diallo—a Guinean-born scientist who previously managed the Washington, DC Public Health Laboratory Division—was recruited to return to Guinea as APHL’s in-country team lead and senior laboratory advisor. The “biggest and most obvious” lesson from the Ebola epidemic, according to the World Health Organization (WHO), is that “countries with weak health systems and few basic public health infrastructures in place cannot withstand sudden shocks, whether ... from a changing climate or a runaway virus.” 6 LAB MATTERS Fall 2016