The Ebola Outbreak: an international perspective

ALEXANDER CHU LOOKS AT THE RECENT OUTBREAK OF EBOLA IN WESTERN AFRICA AND THE FAILURE OF THE INTERNATIONAL COMMUNITY TO QUICKLY ACT

With the amount of confirmed cases over 9000, the World Health Organisation (WHO) and affected West African governments are still scrambling to respond to the burgeoning Ebola outbreak. Fears of its potential spread beyond the west African region – specifically Liberia, Sierra Leone, Guinea, and Senegal – is an immediate concern for the global community as the United Nations public health agency declared the outbreak an international emergency on 8 August.

While the containment and aid effort is finally starting to gain momentum – the WHO announced yesterday that the outbreak is over in Nigeria, with the last confirmed case occurring 42 days ago – the outbreak has been primarily the result of a poor and inadequate initial response by the international community.

Well before the outbreak became malignant, both the Centre of Disease Control (CDC) and WHO were fully aware of the problem. The question then is: what happened to their policy of early containment? Lack of initial commitment, organisation, and cooperation by the WHO and affected national governments caused the crucial window of early containment to fly past without any action. As a result, world leaders, particularly those of western countries, have been strongly criticised by humanitarian aid organisations and affected governments for their inaction.

On 2 September, Joanne Liu, president of Médecins Sans Frontières, the first international humanitarian aid charity to respond to the outbreak, spoke at the United Nations briefing session. Liu told the UN that the world was losing valuable time, and ultimately the battle, against the Ebola virus.

Liu’s claim supports the notion that many world leaders are more interested in protecting their own citizens and national public health rather than combatting the threat at its origin. Thus, it was no surprise when William Pooley, a British nurse, and Dr. Kent Bradley, an American physician, were both evacuated to their respective countries after contracting Ebola.

Furthermore, it is also no surprise that the WHO’s initial response was futile. The agency’s constituent members have drastically cut their financial contributions over recent years in order to fund their own domestic public health schemes.

While it is understandable that national governments have an inherent obligation to protect the well being of their citizens, it is also their responsibility – as members of the global community – to play a role in resolving the root causes of potentially global problems. Although the global cooperation solution may seem simple (and, quite frankly, obvious), it is domestic politics that impede the ability of the international community to respond effectively and decisively in times of need.

In addition to a weak initial response, poor infrastructure and a lack of government information are also factors contributing to the outbreak. Altogether, this misinformation and lack of information transparency pose a significant impediment to the containment process.

The three hardest affected countries – Guinea, Sierra Leone, and Liberia – all have poorly developed public health infrastructure. With no known vaccine, a lack of educated and prepared health workers, and a dearth of basic medical supplies, health workers are restricted to palliative care, putting themselves at risk.

At the same time, affected governments failed to issue early public safety warnings and general information about the disease. Many misinformed citizens are now reluctant to be treated and, in turn, have infected family members. As a result, the WHO believes that the amount of confirmed cases is actually significantly higher than documented.

Despite the amount of medical supplies, aid workers and treatment centres committed to the containment effort, the current effort is still insufficient. The WHO, regional players, and humanitarian charity organisations are now tasked with mustering up enough resources and personnel to contain any further spread.

At the same time, the outbreak serves as an important lesson for the international community. While it is important to build and buttress national public health infrastructure, it is also imperative to maintain a strong and consistent international response organisation that can act immediately with regional and national governments in the event of a crisis. The Ebola outbreak serves as a grim reminder of the consequences of a lack of international cooperation.