The West African Ebola emergency and reconstruction; lessons from Public Health England

Johnstone, Paul; Eder, Marcus; Newton, Autilia; Bentley, Neil; Rufus, Ian

doi:10.1093/bmb/ldz005

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…This enabled the UK response to build on existing infrastructure while facilitating service provision and training of national staff in surveillance, diagnosis and clinical management of Ebola cases [ 15 , 19 ]. PHE also established laboratory capacity in Sierra Leone [ 20 ] and British military personnel contributed to building and staffing six Ebola treatment centres, including one dedicated to treating healthcare professionals, in addition to supporting overall coordination, logistics and training of health care workers [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

An innovative and integrated model for global outbreak response and research - a case study of the UK Public Health Rapid Support Team (UK-PHRST)

2021

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Background Despite considerable institutional experimentation at national and international levels in response to calls for global health security reform, there is little research on organisational models that address outbreak preparedness and response. Created in the aftermath of the 2013–16 West African Ebola epidemic, the United Kingdom’s Public Health Rapid Support Team (UK-PHRST) was designed to address critical gaps in outbreak response illuminated during the epidemic, while leveraging existing UK institutional strengths. The partnership between the government agency, Public Health England, and an academic consortium, led by the London School of Hygiene and Tropical Medicine, seeks to integrate outbreak response, operational research and capacity building. We explored the design, establishment and early experiences of the UK-PHRST as one of the first bodies of its kind globally, paying particular attention to governance decisions which enabled them to address their complex mission. Methods We conducted a qualitative case study using 19 in-depth interviews with individuals knowledgeable about the team’s design and implementation, review of organisational documents, and observations of meetings to analyse the UK-PHRST’s creation, establishment and initial 2 years of operations. Results According to key informants, adopting a triple mandate (response, research and capacity building) established the team as novel in the global epidemic response architecture. Key governance decisions recognised as vital to the model included: structuring the team as a government-academic collaboration which leveraged long-term and complementary UK investments in public health and the higher education sector; adopting a more complex, dual reporting and funding structure to maintain an ethos of institutional balance between lead organisations; supporting a multidisciplinary team of experts to respond early in outbreaks for optimal impact; prioritising and funding epidemic research to influence response policy and practice; and ensuring the team’s activities reinforced the existing global health architecture. Conclusion The UK-PHRST aims to enhance global outbreak response using an innovative and integrated model that capitalises on institutional strengths of the partnership. Insights suggest that despite adding complexity, integrating operational research through the government-academic collaboration contributed significant advantages. This promising model could be adopted and adapted by countries seeking to build similar outbreak response and research capacities.

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Section: Introductionmentioning

confidence: 99%

An innovative and integrated model for global outbreak response and research - a case study of the UK Public Health Rapid Support Team (UK-PHRST)

2021

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“…This includes sharing of resources, expertise, behavioral norms, core ethical values, and effective governance influencing health system performance ( 42 , 83 ). Especially in the case of NPHIs and global health, data sharing and capacity building support between organizations is a critical element for the preparedness against global health threats ( 14 , 38 , 39 ). The data sharing process increases not only the capacity for disease detection but also the managerial capacities of the institutions involved in the process ( 70 ).…”

Section: Resultsmentioning

confidence: 99%

“…Different authors described that many institutions and countries need financial support from international organizations ( 5 , 9 , 10 , 22 , 37 , 38 , 49 , 59 , 84 , 85 ), especially in the areas of institutional change and reform management, human resources management, health promotion, performance measurement, staff recruiting and training ( 38 , 59 , 84 ). National policymakers and elites may encourage international donor support due to the need of financial resources, stimulating reforms and improving services and management systems ( 5 ); yet the inflow of international funds may inadvertently encourage opportunistic behaviors ( 84 ).…”

Section: Resultsmentioning

confidence: 99%

Strengthening national public health institutes: a systematic review on institution building in the public sector

Brugnara,

Jaramillo,

Olarte-Peña

et al. 2023

Front. Public Health

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IntroductionStrong and efficient institutions are vital to the development of well-functioning governments and strong societies. The term “institution building” encompasses the creation, support, development, and strengthening of organizations and institutions. Still, there is little aggregated evidence on “institution building” considering a wider system-thinking approach, best practices, or development cooperation specifically in the field of public health. In 2007, the International Association of National Public Health Institutes (IANPHI) created a guiding Framework that countries may use for developing National Public Health Institutes (NPHIs). This Framework is currently being revised.MethodsIn this context, we conducted a systematic review to facilitate this revision with recent evidence on institution building and its potential contribution to NPHI. We followed the PRISMA guidelines for systematic reviews, searching for relevant publications in seven scientific databases (Pubmed, VHL/LILACS, EconLit, Google Scholar, Web of Science, World Affairs Online, ECONBIZ) and four libraries (World Bank; European Health for All database of the World Health Organization European Region, WHO; Organization for Economic Cooperation and Development, OECD; and the African Union Common Repository). The search was carried out in October 2021. We used the “framework analysis” tool for systematically processing documents according to key themes.ResultsAs a result, we identified 3,015 records, of which we included 62 documents in the final review. This systematic review fills a major gap of aggregated information on institution building in the field of public health and National Public Health Institutes. It is to our knowledge the first systematic review of this kind. The overriding result is the identification and definition of six domains of institution building in the health sector: “governance,” “knowledge and innovation,” “inter-institutional cooperation,” “monitoring and control,” “participation,” and “sustainability and context-specific adaptability.”DiscussionOur results show that the described domains are highly relevant to the public health sector, and that managers and the scientific community recognize their importance. Still, they are often not applied consistently when creating or developing NPHIs. We conclude that organizations engaged in institution building of NPHIs, including IANPHI, may greatly benefit from state-of-the-art research on institution building as presented in this study.

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“…Highly trained scientists are required to get a new assay working in local diagnostic laboratories. Use of new tests involves many highly skilled manual steps and interpretation, and the initial job of a scientist is not only to run the assay but also to optimise it for a diagnostic laboratory and train others 1213. Over time, testing is increasingly automated, and skilled staff move from a hands-on role to supervision, including quality assurance 1415…”

Section: Skills Bottleneckmentioning

confidence: 99%

Preparing for the next pandemic: reserve laboratory staff are crucial

Skittrall

Bentley²,

Wreghitt³

et al. 2022

BMJ

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The West African Ebola emergency and reconstruction; lessons from Public Health England

Cited by 4 publications

References 3 publications

An innovative and integrated model for global outbreak response and research - a case study of the UK Public Health Rapid Support Team (UK-PHRST)

An innovative and integrated model for global outbreak response and research - a case study of the UK Public Health Rapid Support Team (UK-PHRST)

Strengthening national public health institutes: a systematic review on institution building in the public sector

Preparing for the next pandemic: reserve laboratory staff are crucial

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