When an outbreak emerges, how quickly it is contained often depends on decisions made years earlier. This was the central lesson I took away from the Global Health Security Conference in Kuala Lumpur. As Country Director for VillageReach in the Democratic Republic of Congo, I joined a session on outbreak preparedness in complex settings and was struck by how directly the discussions reflected the challenges we face every day in DRC.
The current Ebola outbreak in DRC is a reminder that containing the disease depends on much more than emergency teams reaching the area. It depends on whether specimens reach laboratories quickly, whether data reaches decision-makers in time and whether communities receive accurate information and care.
How quickly a country detects and responds to Ebola can determine whether an outbreak is contained or allowed to spread. When a health worker identifies a suspected case, a specimen must be collected and transported to a laboratory. Results must reach decision-makers quickly because response teams must mobilize and communities need accurate information. Every hour matters.
When these systems work, outbreaks can be detected early and contained before they spread. When they do not, delays increase, opportunities are lost and lives are put at risk.
Yet despite decades of investment in global health security, too many countries continue to rely on fragmented systems that struggle to move specimens, data and information quickly enough to support effective outbreak response.
At the conference, one message came through clearly despite the wide range of topics: preparedness cannot begin when an emergency is declared. It must already exist within the health system long before the first case is detected.
The Tabac Congo Health Center in Tanganyika Province, DRC, receives essential medicines to strengthen patient care as part of the outbreak response. Photo credit: Patrick Kahondwa
The Cost of Fragmented Systems
Outbreaks expose weaknesses that already exist in health systems.
In many settings, laboratories are concentrated in urban centers while communities at greatest risk live far from diagnostic services. Specimens must travel long distances over difficult terrain. Data systems may not communicate with one another. Health workers may lack timely access to information needed to identify and respond to emerging threats. The result is delayed diagnosis, slower response and greater risk of transmission.
These challenges are often most severe in under-reached communities where access to health services is already limited. And the consequences extend beyond Ebola. The same gaps that slow outbreak detection also affect routine diagnosis, disease surveillance and access to care.
When systems fail during an outbreak, communities pay the price.
Members of the VillageReach team at the Global Health Security Conference in Kuala Lumpur: (from left) Tapiwa Mukwashi, Sierra Petrosky, Freddy Nkosi and Luciana Maxim. Photo credit: Freddy Nkosi.
Building Preparedness Through Primary Health Care
The good news is that countries do not need separate systems for every disease threat.
Throughout the conference, I heard a consistent message: the most effective preparedness strategies build on the same systems that support routine health care delivery. Investments in specimen transport, laboratory networks, data systems and primary health care strengthen a country’s ability to respond to Ebola. They also improve routine service delivery, creating benefits long after an outbreak has ended.
When these systems work together, countries can detect health threats earlier, respond more quickly and maintain services during times of crisis.
This is particularly important as governments and partners seek more sustainable approaches to health security. Disease-specific systems may deliver quick results, but they are often difficult to sustain and can create parallel structures that weaken existing systems.
Integrated, government-led systems offer a more durable solution. By strengthening the infrastructure that supports multiple diseases and health priorities, countries can improve preparedness while simultaneously improving routine service delivery.
Investing in What Moves Fastest
One message I heard repeatedly throughout the conference was that speed saves lives. The faster specimens reach laboratories and data reaches decision-makers, the greater the chance of containing an outbreak.
Across Africa, governments and partners are increasingly using integrated approaches that connect laboratories, leverage existing transport systems and improve data visibility. These investments demonstrate that systems designed for routine health services can also strengthen outbreak preparedness.
In Guinea, VillageReach has supported the development of a nationwide integrated sample transport network that not only helped the country maintain its polio-free status but also strengthened the broader surveillance and diagnostic systems needed to respond to future outbreaks. These approaches allow routine health systems to scale up quickly during emergencies without creating parallel structures.
Health Workers at the Ebola Treatment Center.
A Call to Donors and Governments
As discussions at the conference repeatedly emphasized, resilient health systems and health security are inseparable. The current Ebola outbreak in DRC illustrates why.
When specimens move slowly, when data is fragmented and when health facilities are not well connected, detection and response are delayed. Conversely, when those systems are strong, countries are better able to act quickly, protect communities and contain transmission.
For governments, this means continuing to invest in primary health care systems that are responsive, connected and capable of supporting outbreak detection and response. Health security should be built into the systems that communities depend on every day, including through the development, regular testing and continuous updating of national outbreak and pandemic preparedness plans. o
For donors, it means supporting the foundations that make rapid response possible: specimen transport networks, data systems, laboratories, supply chains and frontline health workers. These investments may be less visible than emergency interventions, but they are often what determine how quickly a country can detect and respond to a threat.
Partners also have an important role to play by supporting government-led approaches, strengthening local capacity and helping countries build systems that can respond not only to Ebola, but to a wide range of health threats.
The conference reinforced a lesson that is highly relevant for DRC and for countries across Africa: preparedness begins long before an outbreak. It is built through systems that move specimens, connect laboratories, support frontline health workers and ensure communities can access care.
Strengthening these systems is one of the most important investments governments, donors and partners can make—not only for the next Ebola outbreak, but for the health threats we have yet to face. The choice is not whether to invest in preparedness, but when. Every outbreak reminds us that delaying those investments comes at a far greater cost.