The real impact of international outbreak deployments

When public health emergencies arise, the international community responds quickly when assistance is requested. Teams of public health experts deploy to affected countries, working alongside local professionals to help contain the spread and save lives. But a critical question remains: do these emergency responses actually strengthen countries' ability to handle future outbreaks?
 
Until now, we've relied on post-deployment reports and anecdotal evidence to measure the impact of international deployments on public health emergencies. Now, research from UK-PHRST and Africa Centre for Disease Control and Prevention provides the robust evidence our field has been seeking. 
 
In 2023, researchers interviewed key officials from health ministries, National Public Health Institutes including Incident Managers, deployees and civil society representatives from across African Union Member States. The goal was simple: to understand what lasting impact, if any, international public health deployments have on strengthening countries’ outbreak response capabilities.
 
What the research found
 
The study revealed that most international deployments create valuable contributions that extend far beyond the emergency response.
 
In the short-term, deployments helped develop new systems, protocols and processes across a range of disciplines. Importantly, the research also found that many of these contributions translated into longer term benefits such as enhanced surveillance systems, setting up and equipping Public Health Emergency Operations Centres (PHEOCs) and the development of Standard Operating Procedures (SOPs). Outputs such as these were maintained and re-used for subsequent outbreaks. Similarly, physical infrastructure that was newly built, maintained or modified by deployees, such as mobile laboratories or treatment units, were also regularly re-used in future outbreaks. Participants also reflected that local staff retained knowledge and skills of disease outbreaks, applying them to future scenarios.
 
All of these insights provide reassurance that deployments made by international agencies are valued and have both immediate and lasting impacts in-country. But the research also revealed there are ways we can maximise these benefits further.
 
Building sustainable capacity
 
Countries emphasised that their national health systems must be ready to lead outbreak responses. This means having the right conditions in place before deployees arrive to maximise the benefits, maintaining adequate human and material resource, and ensuring that national experts are intentionally linked with and collaborate with their international counterparts during the deployment. By building connections, national experts can become part of wider networks of continental and global experts where knowledge and expertise can be readily shared and accessed.
 
Interestingly, participants called for a “reframing” in how we view international deployments - moving from an altruistic approach to one based on “solidarity”, where improvements in collective long-term health security can benefit everyone.
 
What international agencies must do
 
International agencies acknowledged the need to better understand each country’s unique context and deployment requirements and to continue to be guided by their host countries. Close collaboration with national experts emerged as crucial, alongside maintaining flexible approaches to support, and being open to addressing capacity gaps identified by national governments once deployments end.
 
Furthermore, participants emphasised that international partners should advocate for countries to retain critical national staff with essential outbreak response skills through incentives. Equally important is supporting the establishment of flexible, accessible emergency budgets that countries can easily draw upon when health crises emerge.
 
Taken together, this evidence provides the international community with a way forward towards improving our shared ability to respond to health emergencies, and strengthening global health security.
 
Turning research findings into action
 
Study participants recently gathered with representatives of international and regional public health bodies to review and validate these findings. Together, they developed a roadmap to put the recommendations into practice – creating a good practice guide for transforming short term deployment gains into long-term sustainable solutions in outbreak management. This move beyond the academic findings represents a significant step from individual deployment experiences towards systematic, evidence-based approaches that can benefit everyone.
 
A sustainable future for the global health community
 
These findings are important for a global health community that invests significantly in international deployments and seeks to promote sustainable capacity to manage outbreaks nationally, regionally and globally.
 
Future development in this area could focus on the need for all stakeholders to incorporate structures that capture, build on and integrate learning and evaluation findings from previous deployments into ongoing outbreak occurrences. There is potential to review how resources are distributed and place greater emphasis than has occurred to date on addressing post-deployment capacity gaps to enable ongoing improvements. Additionally, more systematic evaluation and sharing of deployment results could enable countries in similar contexts to learn and benefit from one another.
 
Closing the gap between learning and practice from one deployment to another will ensure even greater sustainable returns on investment for all involved. When we invest in emergency response, we should also invest in lasting change that protects communities for years to come.
 
This blog was written by Dr Femi Nzegwu, Monitoring, Evaluation and Learning Lead at UK-PHRST and Assistant Professor at LSHTM.  

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