Ebola – What We Have Learned?

By on 16/01/2015
Ebola - the gloves are off. Photo: World Health Organisation

The Ebola crisis shows no signs of abating. It may have moved off the front pages of most Western news media, but the death toll continues to rise, and so do the economic problems. What have we learned since Global Government Forum last reported on the responses last October?

The key metric of course is that people are still dying. In the three main affected countries, Guinea, Liberia and Sierra Leone, there have been more than 21,000 reported cases of Ebola. The death toll currently stands at 8,371.

Equally sobering is the statistic that, so far, 838 healthcare workers are known to have contracted Ebola. Of them, 495 have died.

The statistics illustrate one of the major problems with how we’re tackling Ebola. There isn’t yet a cheap, reliable, point-of-care testing. Mostly we rely on the patient’s temperature, and that only starts to rise when the patient is showing signs of Ebola. It can take up to 21 days after the person has been infected for medics to be able to detect the disease via rising temperature or blood tests. For that timeframe there is no system in place to quarantine, treat or otherwise deal with that potential Ebola suspect. We still basically rely on a thermometer.

Ebola, Suspects And Costs

Ebola is not very contagious until those signs start to show, but even in the United States, with its state-of-the-art medical facilities, they’ve had potentially contagious people at large to go where they will. This has two outcomes. One is that in the USA alone, there are a suspected 1,400 Ebola suspects who don’t have a definite diagnosis – that’s a lot of potential cases mixing with healthy people. The second outcome is the cost. In the case of just one false negative, of a US doctor, the estimated cost of the whole programme was $20 million. How many false negatives can a health service survive?

Fragility Is Self-Reinforcing

Blood tests have a good detection rate, once the disease has become apparent, but there’s a disjoint between these tests and where most of the cases are. For the tests you need big laboratories. They need highly trained staff, expensive machines and massive infrastructure – and they need reliable electricity and water. These are not the conditions found in all of West Africa, although the World Health Organisation says it has 23 laboratories working across the three countries, with another five about to come on stream.

In our last report on Ebola, we quoted Kaifala Marah, the Finance Minister of Sierra Leone, pondering this exact point:

‘Ebola has made me appreciate and begin to understand that fragility is self-reinforcing, because if we had had the right infrastructure, the right institutions, and the right human capacity to be able to confront Ebola, we would not have suffered as we have.’

A recent World Health Organisation report highlighted that a ‘sizeable number’ of states in the region did not even have minimum standards in place for such basic standards as preparedness and risk communication.

WHO Response

Back in October, at the time of our first post on Ebola, the WHO said that it would publish a full review of its handling of the outbreak – this has yet to happen. The WHO has come under some criticism over its handling of the outbreak. It has responded by pointing out that some governments have made the situation worse. International Health Regulations, the WHO says, have been flouted by governments closing their borders and discriminating against travellers from Ebola-infected regions.

The WHO response is to suggest that it should be restructured and given more power and funds so that it can better tackle global health emergencies. It would do this by expanding its mandate and having teams of rapid-deployment experts on standby.

Long Tail Effects

Alongside the concerns over health and mortality in the affected countries come concerns over the ‘long tail’ economic effects. The World Bank this week released figures showing that 50% of the heads of households in Liberia are unemployed. Across Liberia and Sierra Leone, 80% of family-grown food harvests are smaller, simply due to lack of workers to help with the harvest.

The effects of Ebola cut a swathe across both the personal and the industrial sectors. Coffee production in Guinea is down 50%. Cocoa production down by over 30%. Projects like hydroelectric plants and palm-oil mills are all on hold across the affected countries.

The World Bank notes the negative effects kicking in of ‘investor aversion’. Back only last October, the growth projection for the region was downgraded from about 5.5% to 5%. The World Bank now gives 2015 growth estimates of 3% for Liberia, -0.2% in Guinea and -2% in Sierra Leone.

It takes a grim view of the economic situation if the disease is not brought under control. Over the next two years it gives a ‘high Ebola’ cost to the affected countries of $32.6 billion.

The Price Of Ebola

Clearly, Ebola has the potential to destabilise the economies of several countries in West Africa, and if it spreads further it could create equal harm elsewhere. There has been a human and financial cost even in countries apparently far removed from the crisis.

As yet there is little sign that the epidemic is coming under full control and is contained. And let us not forget that those dying from Ebola die in an extremely unpleasant way. It seems that organisations like the WHO, operating on the ground with UNICEF and partners, are working hard but feel they do not have the resources to be an emergency service. Medical procedures for early detection of the disease can result in many false negative or positive results.

Ebola and its consequences may have disappeared off the front pages of Western newspapers, but it certainly hasn’t disappeared or abated on the ground. Perhaps money invested by countries outside the immediate risk area is money well invested. Whether it’s spent through organisations like the WHO or the IMF, money spent dealing with Ebola in the countries of origin is going to pay off. Given the cost to wealthier nations of just one suspected or confirmed Ebola case being treated in the home country, dealing with this in Africa makes both financial and humanitarian sense.

About Graham Scott

Graham is an experienced editor and publisher and an award-winning writer. He has travelled extensively and is interested in world cultures.

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