Dynamic Adaptive Epidemic Control
A case study of anticipatory action to cholera outbreaks in Cameroon
A.C. Brouwer (TU Delft - Technology, Policy and Management)
M. Comes – Mentor (TU Delft - Transport and Logistics)
Martijn Warnier – Graduation committee member (TU Delft - Multi Actor Systems)
M. Sirenko – Mentor (TU Delft - Transport and Logistics)
M. van den Homberg – Graduation committee member (Red Cross 510 )
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Abstract
Responding rapidly to epidemic outbreaks presents significant challenges, due to resource, capacity and time limitations. Anticipatory Action (AA) is a newly emerging strategy in the field of humanitarian aid, designed to preemptively address potential crises. By taking impact-reducing actions before a disaster strikes, AA seeks to minimize human loss. However, AA frameworks currently use static prepared-in-advance plans. As a result, AA is not sufficiently able to deal with the uncertainty levels in the onset and spread of epidemics. Effective epidemic control requires plans that can adapt to a constantly changing environment and incoming information, such as the number and location of suspected cases, weather forecasts and population movement, while balancing flexibility with an effective management approach. We show how the (DAPP) framework for decisionmaking under deep uncertainty can be adapted to enhance the common anticipatory action approach with flexibility and effective management for epidemic control. More specifically, we show how DAPP allows to take into account newly available information and change the strategy to minimize human loss. We illustrate it with a case study of cholera in Cameroon, for which the French, Netherlands, and Cameroon Red Cross, supported by EHESP, are developing an early action protocol and a model that assesses the cost-effectiveness of actions for different risk levels and external shocks. Our results suggest that DAPP increase flexibility and coordination in anticipatory action for epidemics and helps optimizing early action strategies, which could have larger implications for global disease control.