Every week, The WorldPost asks an expert to shed light on a topic driving headlines around the world. Today, we speak with Georgetown Universityís Daniel Lucey and Lawrence Gostin about the global response to the Zika virus.

The World Health Organization was widely criticized for†delays†and†mismanagement†in its response to the Ebola crisis that ravaged three West African countries in 2014.†

The Ebola virus has†killed over 11,000 people, mostly in Liberia, Sierra Leone and Guinea, since 2013. Liberia and Guinea have recently been declared Ebola-free, although experts warn the virus can quickly re-emerge.

Now, a new public health crisis is emerging in the Americas. The Zika virus, first discovered in Ugandaís Zika forest over 60 years ago, spread in recent years to the South Pacific and the Americas.†The virus, which is transmitted by mosquitoes and, like Ebola, has no vaccine or cure, was initially not thought to be very dangerous, mostly causing a mild rash or fever. But a large outbreak of the virus in Brazil last year was linked to an explosion in reported cases of microcephaly, a condition that causes babies to be born with abnormally small heads. The possible connection between the Zika virus and microcephaly, which has yet to be confirmed,†led Brazil to declare a national emergency in November.

The virus has spread rapidly, with reported cases in 23 countries and territories in the Americas. Earlier this month, the U.S. Centers for Disease Control and Prevention†issued an alert advising pregnant women to consider postponing travel to countries with the Zika virus.†

On Thursday, the WHO announced†it will convene a special emergency committee on the Zika virus on Monday, the first step towards possibly declaring a public health emergency. †A few days earlier, Georgetown Universityís†Daniel Lucey and Lawrence Gostin had†published a paper in the Journal of the American Medical Association urging the WHO not to delay its response to the Zika virus any further. The WorldPost spoke to Lucey, a senior scholar at the O'Neill Institute for National and Global Health Law at Georgetown, and Gostin, the institute's director, about the lessons of the Ebola crisis.


CHRISTOPHE SIMON/AFP/Getty ImagesThe virus was believed to be relatively benign until†the outbreak in†Brazil was linked to a sharp increase in cases of microcephaly, which can cause shrunken brain size in newborns.†What lessons do you hope the WHO has taken from the Ebola crisis that can be applied to the emerging Zika pandemic?

Lucey: The WHO director general Margaret Chan delayed very, very long the convening of the special emergency committee with regard to the Ebola epidemic in West Africa. I was working with Ebola patients in Sierra Leone and Liberia during the outbreak in 2014, and it really made a searing impression on me as to the real world, on-the-ground and in this case catastrophic consequences of decisions that are made -- or not made†--†in places like the WHO headquarters in Geneva.

That was a large part of what motivated me to write the article with my colleague, Professor Gostin, urging the WHO director general to convene a special emergency committee. She delayed doing it again with Zika, although hopefully not with such catastrophic consequences as with Ebola.


Fatih Erel/Anadolu Agency/Getty ImagesThe World Health Organization director general, Margaret Chan, announced on Thursday that the WHO would convene a special emergency committee on the Zika virus next week.It was already evident several weeks ago that the Zika pandemic is worth paying attention to. †The question will arise as to how much earlier should the committee have been convened, particularly if there are waves of epidemics of microcephaly in other countries affected by Zika. I hope and pray that there wonít be. But if there are epidemics of microcephaly in other Latin American countries, itís a tragedy, and thereíll be more lessons to learn from that.

When she said on Thursday she was going to convene the committee, honestly, I was overjoyed. The committee has very specific responsibilities -- it really galvanizes the international community under the leadership of the WHO headquarters, so the entire world can benefit from harmonized communications and guidance about the outbreak. But itís only the beginning. Itís like the key that you have to turn to unlock the door, and now you have to go through the door.

If there are epidemics of microcephaly in other Latin American countries, itís a tragedy, and thereíll be more lessons to learn from that.Daniel Lucey
Gostin: The critical lesson is not to wait until a crisis spins out of control. Act rapidly, decisively and with leadership. When the Emergency Committee on Zika meets, actions will speak louder than words. These actions are vast mobilization of funding and international support to drastically reduce the mosquito population in Zika-affected areas, intense surveillance, determining conclusively the link between Zika and infant malformations and accelerated research for a vaccine.

Are there other ways the WHO and the international community have applied some of the lessons of the Ebola crisis so far?

Lucey: I think so. For example, Brazil responded in a very timely manner to the growing epidemic of microcephaly, and the Pan American Health Organization (PAHO) has done an excellent job at issuing epidemiological alerts. I think the U.S. CDC issuing a level 2 travel alert was appropriate, balanced advice and a proactive step.

Itís about the speed of response, the resources put in, and making sure the resources are appropriate. You have to frequently reassess the situation. Thatís very important lesson that should be learned from Ebola. After a sharp increase in patients in Liberia it was predictable [that it would spread further], but there just werenít enough diagnostic laboratories or healthcare workers.


ERIKA SANTELICES/AFP/Getty ImagesThe virus has spread to 23 countries and territories in the Americas. Here the†Dominican Air Force†fumigates parts of†Santo Domingo against Zika virus-spreading mosquitoes last week.Zika is very different from Ebola. What new challenges does the Zika virus present to the international community?

Gostin: Zikaís challenges come from the mosquito vector. This mosquito is ubiquitous, found in every region of the world. If we are not proactive and attack the problem with overwhelming resolve, the hazard of Zika will spread worldwide. If we see a wave of fetal abnormalities nine months after Zika outbreaks, it will be an enormous ethical and public health failure.

Lucey: Brazil has a wonderful medical research tradition and healthcare providers. To my knowledge, thereís no shortage of hands-on patient care that there certainly was in West Africa. There is an urgent research issue and it is being addressed.

One challenge is the amount of travel to places where Zika is transmitted. Thereís so many more travelers to the 21 or so countries or territories in the Americas with reports of the Zika virus than there was to the three very underdeveloped, impoverished countries impacted by Ebola.

The critical lesson is not to wait until a crisis spins out of control. Act rapidly, decisively and with leadership.Lawrence Gostin
What lessons should the public health community apply from the development of Ebola vaccines and treatment during the crisis in West Africa to the current response to the Zika virus?

Gostin: †What we have learned is you need two things to speed vaccine research. First, there is the need for enormous funding. Second is the need for public private partnerships to harness the best talent in government and industry.

Lucey: Even though thereís still no licensed Ebola vaccine, one of the good things the WHO did early during the Ebola crisis was to bring together experts who decided that it would be ethical to do investigational studies for treatments and vaccines in the middle of an outbreak, as long as itís done in a transparent, ethical manner with the approval of institutional review boards and ethical oversight from within each of the countries.

It was really a phenomenal thing that so many partners came together to do a study in Guinea. The results of this research are still going through an approval process, but itís a remarkable success story. I think if Brazil and other countries affected by Zika epidemic choose to work with international partners, then they can look back to the recent successful precedent with Ebola vaccines in West Africa.
The interview has been edited and condensed for clarity. Interviews were conducted separately with Daniel Lucey by phone, and with Lawrence O. Gostin via email on Friday.

Read more Zika virus coverage:†

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In Oct. 2015, Brazil alerted the World Health Organization to a sharp increases of babies born with microcephaly, a birth defect in which babies' heads are abnormally small.†In this Dec. 23, 2015 photo, Dejailson Arruda holds his daughter Luiza at their house in Santa Cruz do Capibaribe, Pernambuco state, Brazil. Luiza was born in October with a rare condition, known as microcephaly.†





In Oct. 2015, Brazil alerted the World Health Organization to a sharp increases of babies born with microcephaly, a birth defect in which babies' heads are abnormally small.†In this Dec. 23, 2015 photo, Dejailson Arruda holds his daughter Luiza at their house in Santa Cruz do Capibaribe, Pernambuco state, Brazil. Luiza was born in October with a rare condition, known as microcephaly.†


Felipe Dana/AP

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Health officials in Brazil suspected that the sharp rise in microcephaly was linked to the country's ongoing Zika virus outbreak -- a mild, mosquito-borne disease that is estimated to have infected as many as 1.5 million people in Brazil.†In this Dec. 22, 2015 photo, Luiza has her head measured by a neurologist at the Mestre Vitalino Hospital in Caruaru, Pernambuco state, Brazil. Luiza was born in October with a head that was just 11.4 inches (29 centimeters) in diameter, more than an inch (3 centimeters) below the range defined as healthy by doctors.


Felipe Dana/AP

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Brazilian health officials soon advised women to delay pregnancy if possible, to prevent microcephaly cases. While they say the link between the two conditions is clear, WHO and other authorities say more research needs to be done before confirming the connection.†In this Dec. 23, 2015 photo, Solange Ferreira bathes her son Jose Wesley in a bucket at their house in Poco Fundo, Pernambuco state, Brazil. Ferreira says her son enjoys being in the water, so she places him in the bucket several times a day to calm him.


Felipe Dana/AP

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The zika virus was first identified†in Africa, spread to parts of Asia and then reached the Americas in 2014, researchers suspect. The Aedes mosquito carries the disease.A female Aedes aegypti mosquito acquires a blood meal on the arm of a researcher at the Biomedical Sciences Institute in the Sao Paulo's University, in Sao Paulo, Brazil, Monday, Jan. 18, 2016.


Andre Penner/AP

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Researchers suspect that the Zika virus is also linked to the spike of a rare, autoimmune disease called†Guillain-Barrť syndrome that can result in temporary paralysis.†This January 2016 image provided by the Centers for Disease Control and Prevention (CDC) shows a Zika virus, a mosquito-borne disease that has been linked in Brazil to a large number of cases of microcephaly, a rare birth defect. Infants with microcephaly have smaller than normal heads and their brains do not develop properly.


Cynthia Goldsmith/CDC via AP

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There is no cure or vaccine for Zika virus. The most reliable way to prevent transmission is to destroy the mosquitos that carry it.†An army soldier and a health agent from Sao Paulo's Public health secretary check a residence during an operation against the Aedes aegypti mosquito, which is a vector for transmitting the Zika virus in Sao Paulo, Brazil, Wednesday, Jan. 20, 2016.


Andre Penner/AP

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Zika virus is now endemic in 22 countries and territories. The U.S. Centers for Disease Control and Prevention issued a travel warning to all Americans, and pregnant women in particular, to follow strict guidelines in preventing mosquito bites when traveling to these areas. Pregnant women were also advised to delay travel if possible, while women who want to become pregnant were advised to speak with their healthcare providers before traveling.Army soldiers and a health agent from Sao Paulo's Public health secretary check a residence during an operation against the Aedes aegypti mosquito, which is a vector for transmitting the Zika virus in Sao Paulo, Brazil, Wednesday, Jan. 20, 2016.†


Andre Penner/AP

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The World Health Organization predicts that Zika virus will spread throughout all of the Americas, barring Canada and Chile.†A health agent from Sao Paulo's Public health secretary shows an army soldier Aedes aegypti mosquito larvae that she found during clean up operation against the insect, which is a vector for transmitting the Zika virus, in Sao Paulo, Brazil, Wednesday, Jan. 20, 2016.†


Andre Penner/AP

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Several research institutes and companies are now trying to figure out how to create a vaccine for Zika virus, including the†Sao Paulo-based Butantan Institute, the U.K.'s†GlaxoSmithKline and France's Sanofi. However,†it will be years before anyone develops a reliable vaccine, researchers predict.†A graduate student works on analyzing samples to identify the Zika virus in a laboratory at the Fiocruz institute in Rio de Janeiro, Brazil, Friday, Jan. 22, 2016.


Leo Correa/AP

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