The Foreign Service Journal - May 2017
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MAY 2017


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.


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



and political pressure to implement restrictions on travel and


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