Editorial: Lessons to be learnt


Ebola virus photo - Photo Credit - Frederick Murphy

Ebola virus: Photo: Frederick Murphy

Nearly nine months after the Ebola virus first struck in Guinea, grim statistics reveal that in the four West African countries of Guinea, Liberia, Sierra Leone and Nigeria, the disease is far from being tackled. The Ebola outbreak has rather become the “largest, and most severe and complex” ever in its history. As on September 5, at least 3,967 cases and 2,105 deaths were reported from the four countries. The number of cases and deaths has spiked over the last fortnight. There was a sudden spurt of deaths, numbering 400, during the period from August 28 to September 3, and the month of August alone accounted for over 40 per cent of all Ebola cases found since December 2013. This clearly reflects the fact that the number of diseased people has reached a critical mass capable of sustaining the spread and allowing the outbreak to “race ahead of the control efforts.” There is every reason to believe that the count of the number of infected cases belies the ground reality. What is particularly poignant is that the community’s confidence in health workers continues to remain low, and people are largely unwilling to seek medical attention. At times, patients are reported missing from healthcare facilities. As a result, according to WHO, the actual number of cases that remain undetected would be two to four times what has been reported. There is a heightened possibility of Ebola spreading to the neighbouring countries. WHO estimates that it may take six to nine months to contain the outbreak, which is estimated to have infected up to 20,000 people.

Unlike the severe acute respiratory syndrome (SARS) outbreak in February 2003 and H1N1 influenza that was declared a pandemic in June 2009, the Ebola virus disease spreads only through direct contact with the body fluids of a diseased person. Its spread could thus be checked easily, but the weak public health systems in the four countries lack the infrastructure to handle the crisis. WHO, which could have played a far more proactive role before the situation reached crisis proportions, was hamstrung. Tragically, the world health body’s funding and, in turn, its priorities are largely dictated by the commercial interests of the developed countries. The kind of quick response by the developed countries soon after the SARS outbreak, was completely missing in this instance. As a recent The Lancet report pointed out, the Global Health Emergency Workforce with a $100 million funding that was proposed in 2011 by WHO, would have enabled the body to act on time, but it never materialised. The important message from this experience with Ebola is that a global system with sufficient funding that can contain any future outbreaks before they spiral out of control, has to be put in place.

Published in The Hindu on September 10, 2014