(EV4GH 2014; China Program Manager, COMDIS Health Services Delivery Research Consortium, University of Leeds, UK; PhD candidate, Institute for International Health and Development, Queen Margaret University, Edinburgh, UK)
In recent months Ebola has become a public health emergency of international concern. In response, China, a country with over 50 years’ history of providing medical aid in Africa, has sent small teams of public health emergency experts to three Ebola-affected West African nations — Guinea, Liberia and Sierra Leone. This is the first time that China has dispatched expert taskforces to foreign countries in response to a public health emergency.
The emergency response teams, which include public health and intensive care experts, work closely with the Chinese Medical Teams already present in these countries to strengthen the prevention and control of Ebola, for a limited period of time. Chinese Medical Teams are rotating every 2 years and based in 49 developing countries – 42 of the countries to which teams are dispatched are in Africa (as of 2013). Each team consists of a number of medical and auxiliary staff who provide medical services and train local medical workers.
The dispatched teams also get generous emergency relief support from China, and do not only contribute to the containment and control of Ebola, e.g. via personal protection and hospital infection control, but also assist with the medical treatment of Ebola. In addition, they carry responsibility for the prevention and control of Ebola among the Chinese population in these countries.
However, given the long history of Chinese medical aid in Africa, and the country’s rich domestic experience in responding to public health emergencies such as SARS and H7N9, China could play an even bigger role in supporting West Africa to combat Ebola.
Firstly, improved sharing of the successful experiences in controlling SARS, H7N9 and other emerging infectious diseases with Ebola affected nations in West Africa is a must. It was not until the SARS outbreak in 2003 that China’s public health system was greatly strengthened – with improved funding, infrastructure and human resources. Hopefully, the affected nations will also benefit from the response to the Ebola outbreak to improve their health systems. As a priority, China can share with them its successful experiences in improving emergency response systems, including, for instance, improved public health and medical responses and effective collaboration between both responses, strengthened health infrastructure and disease surveillance as well as information sharing, multi-sector and international collaboration. No doubt the dispatched teams will talk about these domestic experiences during their work in the affected nations. However, more financial and technical and even longer term support could be provided to affected nations to improve their public health systems. Having said this, China will no doubt also learn from its participation in the Ebola response.
Secondly, Chinese Medical Teams, which tend to have a good reputation among local patients, should help to improve public awareness of the disease, and regain people’s trust and confidence in the health care response and staff, which is perceived as the biggest challenge in the battle to contain Ebola.
Thirdly, strengthening international collaboration will be crucial to reduce aid duplication and stop the international spread of Ebola. The dispatched teams need to overcome language and cultural barriers in the wider collaboration with international and local experts in a foreign environment.
Providing public health and system support to African partners is relatively new for China. The Ebola outbreak further suggests the importance of investing in public health and research initiatives in Africa. The current medical teams need to be reshaped, with enhanced public health training and the inclusion of public health experts to better contribute to health systems strengthening in Africa.