As Nipah and Ebola outbreaks reshape the global health risk landscape, multinational corporations are accelerating investments in travel security for employees working abroad. From proactive intelligence gathering to medical evacuation and real-time crisis response, robust duty-of-care programs have become central to business continuity planning. Travelmao spoke with Andy Maybury, Director of Global Assistance at SPS, about the realities of managing infectious disease threats, the challenges of evacuating high-risk patients, and what organizations should do to strengthen preparedness.
Proactive vs. Reactive Duty-of-Care
Maybury notes that most corporate duty-of-care programs fall into one of two categories: those built to respond and those that merely react. “A lot of duty-of-care arrangements are essentially reactive: they manage the fallout once something has already happened to a member of staff. That is the wrong way round for a fast-moving infectious disease,” he says.
A truly effective program must operate on two fronts simultaneously. It needs a proactive early-warning capability that feeds ground-truth intelligence to program directors, enabling them to mitigate exposure before staff travel into an affected area. At the same time, it must actively support employees already on the ground with current information, guidance on reducing exposure and recognizing symptoms early, and a direct line to a medical team that can guide them through an incident. “Programmes that have both are well placed. Those relying on a policy document and a phone number tend not to be,” Maybury adds.
Limited Capacity for Category A Evacuations
When asked how many operators can realistically evacuate a confirmed Category A infectious patient, Maybury is blunt. “On paper, a fair number of air ambulance operators could carry an infectious patient. In practice the number that genuinely can, and will, is small, and it is the aircraft and the clearances rather than the patient that set the limit.”
Operators face their own duty-of-care obligations to crew and may decline to fly into high-risk areas. They require specialist insurance to operate in those environments, and many will not take on the cost or exposure. Every flight also needs clearances from authorities in the outbreak zone and the receiving country, which often will not allow immediate repatriation. Patients—sometimes even a country’s own nationals—may have to route through a third country for a stand-off period before being allowed home.
“Put those together and you are left with a handful of operators able to move quickly: the ones willing to take it on, properly insured, and able to navigate the clearance process in time,” Maybury says. Most air ambulances are configured for a single critical patient, and larger aircraft fitted for more would require additional medical staff, increasing the operator’s exposure and complicating clearances. “In reality, each patient needs their own single-patient aircraft, so simultaneous outbreaks stretch a thin resource very quickly.”
Lessons from the 2014 Ebola Outbreak
Reflecting on the 2014 Ebola outbreak, Maybury identifies three key lessons. First, early detection and diagnostics have improved, with front-line providers now having better tools to confirm cases quickly. However, overall healthcare capacity in less developed settings remains thin, and facilities are often overwhelmed at the peak of an outbreak.
Second, community education on hygiene, safe care of the sick, and early symptom recognition has measurably reduced transmission. Yet deep and historically rooted mistrust of health systems and foreign aid workers persists, continuing to undermine response efforts.
Third, funding for front-line systems remains a challenge. “Supplies still take too long to reach the people who need them, and that gap remains the hardest to close,” Maybury says. On balance, organizations are better prepared than in 2014. The lessons of that outbreak and of COVID-19 have changed how both health systems and evacuation providers respond. “The process is still complicated, but there is now a clear path through it and protocols to manage these cases properly.”
When the Evacuation Window Closes
There is no single moment when the evacuation window closes for all patients. Each case is assessed on its own merits against medical, logistical, and security factors: the patient’s condition, the availability of evacuation resources, and whether the receiving facility has capacity. The window can narrow sharply once borders tighten or clearances slow. “The decision is always case by case, and it is only made well when the medical, operational and security teams advocating for that patient are working the problem together,” Maybury explains.
Distinguishing Genuine Medevac Capability from Reimbursement
Maybury advises multinationals to ask two questions to tell genuine medevac capability apart from a policy that merely reimburses costs after the fact. “Is the programme proactive: am I actually receiving intelligence on emerging outbreaks before my people are exposed? And is it actively responsive: is my assistance provider in contact with my staff on the ground, giving them a direct line to the right specialists to help them reduce exposure, and will they guide each person through every step if an exposure occurs?”
A reimbursement clause does none of that. “It pays an invoice after the event. Genuine capability is the intelligence, the people and the coordination that are in place before anything happens.”
As the travel industry continues to navigate a world of emerging infectious diseases, the message from SPS is clear: proactive, integrated duty-of-care programs are no longer optional—they are essential for protecting employees and maintaining business continuity. For more on how climate risks are reshaping global tourism, see Global Tourism Hits Record $11.6T but Climate Risks Threaten 30% Drop by 2050. Meanwhile, the World Cup 2026 Cyber Threats highlight another layer of risk for travel industry stakeholders.
