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Triage Management, Survival, and the Law in the Age of Ebola

Published online by Cambridge University Press:  24 October 2014

Frederick M Burkle Jr*
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, and Woodrow Wilson International Center for Scholars, Washington, DC
Christopher M Burkle
Affiliation:
Mayo Graduate School of Medicine, Mayo Clinic, Rochester, Minnesota.
*
Correspondence and reprint requests to Frederick M. Burkle, Jr, MD, Harvard Humanitarian Initiative, 14 Story Street, 2nd Floor, Cambridge, MA 02138 (e-mail: fburkle@hsph.harvard.edu).

Abstract

Liberia, Sierra Leone, and Guinea lack the public health infrastructure, economic stability, and overall governance to stem the spread of Ebola. Even with robust outside assistance, the epidemiological data have not improved. Vital resource management is haphazard and left to the discretion of individual Ebola treatment units. Only recently has the International Health Regulations (IHR) and World Health Organization (WHO) declared Ebola a Public Health Emergency of International Concern, making this crisis their fifth ongoing level 3 emergency. In particular, the WHO has been severely compromised by post-2003 severe acute respiratory syndrome (SARS) staffing, budget cuts, a weakened IHR treaty, and no unambiguous legal mandate. Population-based triage management under a central authority is indicated to control the transmission and ensure fair and decisive resource allocation across all triage categories. The shared responsibilities critical to global health solutions must be realized and the rightful attention, sustained resources, and properly placed legal authority be assured within the WHO, the IHR, and the vulnerable nations. (Disaster Med Public Health Preparedness. 2014;0:1-6)

Type
Special Reports
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

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