As the world faces the twin specters of Hantavirus and Ebola, many fret over the lack of medical countermeasures to combat these diseases. Vaccines, antivirals, and other medicines have saved lives and in the case of smallpox, prevented diseases from affecting entire populations. Developed countries have grown dependent on these life-saving countermeasures, so much so that when diseases cause outbreaks, epidemics, and pandemics, they race to develop and deploy these medicines as quickly as possible.
Developed countries often consider themselves to be in the best position to ensure the health of their citizens, as they believe they possess the means by which to manufacture, procure, and acquire what they need, and oftentimes, they do. Operation Warp Speed stands as a shining industrial example of what can happen when a country like the United States decides to put huge resources and effort towards producing a new medical countermeasure. The United States was also not the only country to produce a vaccine against COVID. But even Operation Warp Speed took about a year to develop COVID vaccine, and that was with preexisting research serving as a starting point. In the meantime, illness and death occurred.
This is not the only way to handle widespread disease, however. Other answers as to how to deal with disease outbreaks can also be found elsewhere, in countries that are far from developed and which struggle with perpetual lack of health care, public health, medical countermeasures, and essential medical supplies. Despite this dearth, people in these countries live.
These countries learned long ago how to survive without even basic medical supplies. If they get them, of course, they will use them to significant effect, but they do not give up and let everyone die if they do not have them at hand and none are coming. They do the best they can with what little they have. But their people also understand that their survival is critical not only for their own families, but for their communities, countries, and regions.
They do not disappear. They do not falter. They do not give up.
They fight the diseases that surround and infect them, and they fight to reduce the emotional toll that outbreaks take on everyone they know and love. Their individual and collective resilience is intentional, not incidental. They work hard to respond immediately with whatever they have at hand. In so doing, their sense of personal agency allows them to avoid the sense of despair that others in more developed countries display when faced with events that they cannot fix or eradicate immediately.
Responses to these threats should begin with the belief that individuals and communities can do better than survive while ramping up national and regional response efforts. Nations around the world can fight the unseen enemy of disease by advancing and depending upon resilience as a core tenet of national security policy and practice.
Resilience in these countries – in any country – occurs at a variety of levels. At the national level, governments prepare for shocks by stockpiling equipment and ensuring sufficient surge capability is available for medical emergencies. In the developing world, where countries struggle with subsistence expenses, these investments are often lacking. Clear communication and transparent decision making are also vital to reassuring a populace, provided they can receive those messages, which is not always the case.
At the state, local, tribal, and territorial government level, coordination between accessing national resources and policy and distributing them on the ground is key. Ease of communication, sound logistics, and accessible local government are key here. Again, these elements of resilience are often lacking in less developed countries.
At the community level, however, resilience begins with family, the core building block that allows people to overcome obstacles. Families are the root of social organization in the developing world, and the most likely source of resilience in the community. Families divide tasks, mitigate risk when gathering resources and resting, and provide physical and mental support to their members.
Especially in conflict situations, however, families are not always together. That is why individual resilience – genetic and epigenetic, but also environmental and learned – is so important for these countries. The physical ability to survive is extreme. Harrowing situations and recovery from stress also prepare a population to survive the stress of a pandemic.
For us in the West, that suggests a focus on total health as a key part of disease resilience. Some people are born lucky and some are not with regards to stress – their genetics offer more or less resilience. But everybody has the ability to focus on behavioral resilience. What people eat, their physical fitness, how healthy they stay – all of these impact a population’s ability to overcome.
One of the key lessons from the COVID-19 pandemic was that it was particularly dangerous for the at-risk population with comorbidities, as well as those who were old. Their state of physical health impacted illness and death rates dramatically. That is part of the reason why a new health economy has sprung up around previously niche topics like clean food and food as medicine. The return of the Presidential Physical Fitness Test is another important heuristic marking the shift to a population that is individually, as well as nationally, resilient.
Americans should never have to choose between the two, and neither should others in Africa who face diseases like Ebola more often. But if the worst happens, all should look to prepare first and rest on resilience, just in case.