What Ebola Taught Us: The Old and the New Open Access

Crawford, Renee (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/qn59q481f?locale=en
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Abstract

In late 2013, an Ebola virus outbreak began that quickly grew into an epidemic of extraordinary magnitude, killing more people than all previous outbreaks combined. Although the epidemic was unprecedented, the world had previously experienced several acute public health emergencies requiring international coordination. However, in each case, coordination had proved problematic, and this latest event was no exception. The purpose of this project was to identify persistent vulnerabilities within international public health emergency response and to identify areas for future research and improvement. A literature review and key informant interviews were conducted. Data were analyzed using MAXQDA qualitative data analysis software. Results showed a number of issues, including a shortage of personnel and resources, policy barriers that hinder long-term international response, itemized funding streams that limit flexibility to direct resources, challenges to deploying responders internationally, cultural and political clashes within responding agencies and a lack of confidence in those agencies. Most troubling is that data point to the world remaining ill prepared to handle sustained responses and global pandemics. The study identified major vulnerabilities persistent within global public health response and offers recommendations and opportunities for further focused research to fully understand why these challenges persist.

Table of Contents

Table of Contents

List of Acronyms............................................................................................................................ 8

I. Introduction.............................................................................................................................. 10

Background.................................................................................................................................. 10

Uniqueness of the 2013-2015 Epidemic............................................................................................ 12

Problem Statement........................................................................................................................ 14

Purpose Statement........................................................................................................................ 16

Research Questions....................................................................................................................... 16

Significance.................................................................................................................................. 17

Journal Selection........................................................................................................................... 17

II. Literature Review...................................................................................................................... 18

Review of the Literature................................................................................................................. 18

Fear and Stigmatization................................................................................................................. 18

Risk Communication...................................................................................................................... 19

The Media.................................................................................................................................... 21

Surveillance and Reporting............................................................................................................. 22

Lack of Resources..........................................................................................................................24

Lack of Enforcement......................................................................................................................26

Delayed Response........................................................................................................................ 28

Summary and Relevance............................................................................................................... 30

III. Methods................................................................................................................................. 32

Data Collection............................................................................................................................ 32

Instruments.................................................................................................................................33

Setting........................................................................................................................................33

Sample.......................................................................................................................................33

Ethical Considerations and Emory IRB Approval................................................................................34

Data Analysis...............................................................................................................................35

Results...................................................................................................................................... 35

Successes...................................................................................................................................35

Turning Points.............................................................................................................................36

Logistics and Coordination.............................................................................................................37

Communication............................................................................................................................38

CDC Policy Barriers.......................................................................................................................39

Political and Cultural Clashes..........................................................................................................40

Summary....................................................................................................................................41

IV. Discussion.............................................................................................................................. 43

Strengths and Limitations..............................................................................................................45

Public Health Implications..............................................................................................................45

Conclusions and Recommendations.................................................................................................46

V. Journal Article..........................................................................................................................48

References..................................................................................................................................67

Appendix A: Interview Guide.........................................................................................................72

Appendix B: Codes and Subcodes...................................................................................................74

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