Ebola shows that epidemic preparedness is about public health education as much as outbreak control

As WHO has acknowledged many times in the past, in outbreak situations information is often the only effective disease-control intervention. But if it is administered too late, in the wrong way, or without a foundation of trust, it may not work at all.

For this reason, health system resilience and public health preparedness should be considered one and the same. Preparedness must not be limited to the technical aspects of disease surveillance, drug and vaccine stockpiling, or border controls. Real disease control starts with public health education. And deep trust built over time.

There is an unspoken social contract that underlies public health: professionals provide reliable advice, and individuals make (mostly) reasonable choices, while accepting a certain amount of coercion to avoid severe health threats. But this pact is fragile. And wholly dependent on people’s confidence in their advisors. Individuals that comprise populations at risk must believe that the advice they receive is for their own – or the population’s – benefit, otherwise no instruction, no matter how important, will be heeded.

It has become starkly clear in this Ebola epidemic what can happened when there is no trust. Rumours carry more weight that evidence. And professionals – with all their technical knowledge – are powerless to stop disease. Public health education should not just be an after-thought. It is the very cornerstone of health system resilience.


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