A Sri Lankan centre for infective disease control and prevention

The need of the hour:

BY Dr B. J. C. Perera

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

On 01^st July 1946, the Communicable Disease Center (CDC) of the United States of America opened its doors and occupied one floor of a small building in Atlanta, Georgia. Its primary mission was simple, yet highly challenging. It was to prevent malaria from spreading across the nation. Armed with a budget of only 10 million US dollars, and fewer than 400 employees, the agency’s early tasks included obtaining enough trucks, sprayers, and shovels necessary to wage war on mosquitoes.

It later advanced, slightly changed its name, and transformed itself into the much-acclaimed and reputed Centres for Disease Control and Prevention (CDC). It became a unique agency with an exceptional mission. They work 24/7 to protect the safety, health and security of America from threats there and around the world. Highest standards of science are maintained in this institution. CDC is the nation’s leading science-based, data-driven, service organization that protects the public’s health. For more than 70 years, they have put science into action to help children stay healthy so they can grow and learn, to help families, businesses, and communities fight disease and stay strong and to protect the health of the general public. Their are a bold promise to the nation, and even the world. With this strategic framework, CDC commits to save American lives by securing global health and America’s preparedness, eliminating disease, and ending epidemics. In a landmark move, the CDC even established a Central Asia regional office at the U.S. Consulate in Kazakhstan in 1995 and have been involved in public health initiatives in that region.

More recently, the European Centre for Disease Prevention and Control (ECDC), was established. It is an agency of the European Union, aimed at strengthening Europe’s defences against infectious diseases. The core functions cover a wide spectrum of activities such as surveillance, epidemic intelligence, response, scientific advice, microbiology, preparedness, public health training, international relations, health communication, and the scientific journal Eurosurveillance.

Still later on, the African CDC (ACDC) was born. It strengthens the capacity and capability of Africa’s public health institutions, as well as partnerships, to detect and respond quickly and effectively to disease threats and outbreaks, based on data-driven interventions and programmes.

All these organisations are autonomous, independent, and are confidently dedicated to hold science to be sacred. They play a major role in advocacy and work in a committed advisory capacity. With the cataclysmic effects of the current coronavirus pandemic COVID-19, the contributions made by these institutions are priceless. What is quite important is that they are able to provide specific recommendations based on the latest scientific information available for countries and nations in their regions, even taking into account the many considerations that are explicit and even unique to their regions. All these organisations have been provided with optimal facilities and human resources. The real value of their contribution is related to just one phenomenon: AUTONOMY.

Well…, isn’t it the time for us to start a Sri Lankan Centre for Infective Disease Control and Prevention (SLCIDC)? It should be formulated as an agency constantly striving, day in and day out, to safeguard the health of the public. Science and unbending commitment to evaluation of research on a given topic should be their operating mantra. It would work as a completely apolitical organisation and what we can recommend is that it would be directly under the President of the Democratic Socialist Republic of Sri Lanka, unswervingly reporting to and accountable to the President. It would consist of medical doctors, scientists and researchers but no politicians of any sort, no non-medical or non-scientist persons, no hangers on and no business persons. All appointments to the SLCIDC will be made by the President of the country, perhaps in consultation with medical professional organisations.

The prime duty of the SLCIDC would be to assess the on-going situation of any infective issue that has any effect on the health of the public. The organisation will undertake in-depth examination and assessment of a given situation caused by an infective organism. They need to have all relevant data from within the country as well as from outside the country. There will not be any vacillation of the opinions expressed by them and their considered views should not be coloured by any consideration apart from science and research done locally and worldwide. Their considered opinion would be conveyed directly to the President of the country. They are free to issue statements to keep the public informed about the results of their deliberations.

We believe that it would be a step in the right direction; perhaps even a giant step for our nation, not only during the current coronavirus pandemic but also on any major problems of an infective nature that might occur in the future.

This writer wishes to acknowledge a colleague, a Consultant Physician, who first mooted this idea during a friendly conversation.