Bill Gates is Right about Epidemics! And Project Management is the Answer!

Gates has an article in today’s (March 18, 2015) New York Times titled “How to Fight the Next Epidemic: The Ebola Crisis Was Terrible. But Next Time Could Be Much Worse.” Whether it’s his businessperson’s experience with urgent projects or simply commonsense, much of what he points out is similar to what I have been saying for many years: the standard project management techniques we use in planning projects worth a few $100K are being ignored in preparing for emergencies worth thousands and millions of human lives!

Gates starts his article with: The Ebola epidemic in West Africa has killed more than 10,000 people. If anything good can come from this continuing tragedy, it is that Ebola can awaken the world to a sobering fact: We are simply not prepared to deal with a global epidemic… Of all the things that could kill more than 10 million people around the world in the coming years, by far the most likely is an epidemic.”

That is completely accurate. But should we say that the hundreds who died unnecessarily because of the slow response after Hurricane Katrina, or the thousands that would die after a major Bay Area (or Haiti!) earthquake, or even those ten thousand Ebola victims in West Africa aren’t important because they don’t number in the millions? Because as Katrina showed, we are also unprepared for even more mundane disasters.

Gates continues: “The problem isn’t so much that the system didn’t work well enough. The problem is that we hardly have a system at all… (O)nce it became clear that a serious emergency was underway, trained personnel should have flooded the affected countries within days. Instead it took months.”

It took months. On a corporate project, time is money. On an emergency response project, time is human lives. Unfortunately, as deficient as the project management discipline is at estimating the dollar cost of critical path delay, estimating the mortality cost for time is even less practiced. And the process of project scheduling to reduce mortality is totally unknown by most planners in non-corporate, non-military disciplines, especially healthcare in general and public health in particular.

This has been a big issue for me for a long time. I am happy to help manufacturers and software distributors and banks and insurance companies improve their project skills and results – I believe that improved efficiency in pretty much any industry benefits everyone. But my heart sinks at the thought of how many people die every year due to project management incompetence in other fields.

In my new book Managing Projects as Investments: Earned Value to Business Value, I use as one example an immunization program, and show how critical path analysis, utilizing critical path drag and with drag cost measured in human lives, can potentially reduce mortality significantly. Another example is in my chapter “Time is a Murderer: The Cost of Critical Path Drag in Emergency Response” from the Handbook of Emergency Response. The chapter is provided here on my website with the permission of the publisher, CRC Press. That example is based on response to an earthquake, where victims lie trapped in the rubble and every passing hour leads to more deaths.

But the process of optimizing a critical path is essentially the same whether the effort is to implement a new corporate ERP system or to save lives after an earthquake or a disease epidemic.

Just for the record, here are some suggested steps:

  1. Prepare generic plans for each genre of emergency response in WBS template form, with as many templates as seem appropriate for different types of emergency.
  2. Itemize the resources needed for various levels and types of epidemic.
  3. Establish roles and responsibilities, with a database of those individuals from which the appropriate personnel would be selected, immediately informed, and then replaced if they are not available.
  4. Optimize the schedules for these templates so that the aid/suppression effort reaches the critical area with the critical resources as fast as possible.
  5. Train key headquarters personnel to customize, as quickly as possible, the WBS template to the incoming information as to the specific nature of the emergency. As Bill Gates points out in his article, each epidemic and each locale will require somewhat different reactions. But that’s little different from professional services organizations that use WBS templates for systems deployments and then customize them for each specific implementation, pulling off unnecessary branches, twigs and leaves and occasionally adding a unique twig here and there. When it’s a bubonic plague outbreak in a Western city, the headquarters personnel would quickly create the appropriate plan for a contagious disease, with a known treatment protocol, in an urban environment in a Western country. And the appropriate activities would populate the plan, complete with resource needs and schedule, and the plan would immediately be disseminated to the appropriate personnel.
  6. Finally, train and practice, practice, practice! Train all personnel to understand a WBS and a precedence Gantt chart. And then periodically conduct exercises, consisting of:
  • Reports reaching headquarters with only partial information;
  • Requests for specific additional information;
  • Selection/customization of the template;
  • Dissemination of the customized plan; and
  • Implementation of whatever team actions are deemed appropriate, including assembly of personnel and equipment.

This is all standard project management procedure. I sincerely hope that Mr. Gates’s article (which I urge you to read) will stimulate epidemic response plans based on such processes.

Fraternally in project management,

Steve the Bajan

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