The Guardian
http://www.guardiannews.com/
Accessed 4 October 2014
The Observer view on the Ebola outbreak
Observer editorial
Saturday 4 October 2014 19.03 EDT
The world needs to face up to this global crisis
The world’s most deadly Ebola outbreak, which has killed more than 3,000 people in west Africa and set belated alarm bells ringing throughout the international community, has its probable origin in a remote village in Guinea, close to the border with Liberia and Sierra Leone. On 26 December 2013, a two-year-old boy fell sick with a mysterious illness whose symptoms local people and medical workers had never seen before. Within two days, the boy was dead. As more people in the area succumbed and others began to flee, perplexed staff from the French-founded medical aid charity, Médecins Sans Frontières (MSF), developed a nightmarish suspicion.
“Samples [were sent] to the Institut Pasteur in Paris,” a World Health Organisation (WHO) investigation reported. “The first news was shocking: the causative agent was indeed the Ebola virus.” Who could ever have guessed that such a notorious disease, previously confined to Central Africa and Gabon, would crop up in another distant part of the continent? The news from subsequent virological analyses was even worse: this was Ebola Zaire, the most lethal in the family of five distinct Ebola species.
The finding was recorded on the WHO’s website on 23 March. Since then, for a variety of causes, some wholly preventable, some less so, the often imagined but never seriously confronted prospect of a lethal, global pandemic with no readily available cure, spiralling out of control, has drawn ever closer. “Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it,” MSF’s president, Joanne Liu, told the UN last month. “The WHO announcement on 8 August that the epidemic constituted a ‘public health emergency of international concern’ has not led to decisive action. States have essentially joined a global coalition of inaction,” she said.
The reasons why this most devastating strain of Ebola suddenly sprang up in west Africa remain uncertain, but the under-resourced, often panicky and chronically unco-ordinated reaction to its arrival there has been only too painfully obvious. Last week’s report that the Aids pandemic originated in Kinshasa, capital of the Democratic Republic of Congo, in the 1920s is instructive. In that case, researchers say, increased urban population density, disrupted societal norms leading to sexual promiscuity, and railway travel – the by-products of Belgian colonialism – encouraged the spread of HIV.
Similarly, in Guinea, Sierra Leone and Liberia, recent, prolonged periods of armed conflict and population upheavals, coupled with the unchecked exploitation of natural resources by international timber and mining companies, have altered regional ecology, rendering it more vulnerable physically as well as politically. Due to loss of habitat, fruit bats, widely believed to be the natural reservoir of the virus, moved closer to human settlements. People hunted and ate infected forest animals such as monkeys, squirrel and antelopes, the WHO report found. “Though no one knew it at the time, the Ebola virus had found a new home in a highly vulnerable population.”
Whatever its causes, it is evident now that the rapid and accelerating spread of Ebola – the virus is infecting five additional people every hour in Sierra Leone and a similar number in Liberia – is the avoidable result of a lack of hospital beds, isolation wards and basic facilities. It is the result, also, of too few doctors and nurses, of underprotected health workers who are themselves falling ill in large numbers, of traditional healing and burial practices, of generally underfunded healthcare systems, of corrupt misappropriation of foreign aid earmarked for healthcare and, crucially, of the lack of a vaccine in the face of a mutating virus. Of the 20,000 new cases predicted by the end of November, 70% on current trends will result in death. By the end of January, the Centres for Disease Control in Atlanta warns, there could be 1.4m new cases.
West Africa’s particular circumstances apart, the Ebola outbreak has now become a matter of truly international concern, not least because, as last week’s unseemly panic in Texas has shown, the epidemic potentially threatens us all. After a slow start, the Obama administration showed a lead in sending 3,000 troops to Liberia to boost its health defences. But its efforts are proceeding at a snail’s pace, reflecting a too familiar lack of preparedness.
The UK, despite parliamentary criticism last week, has been at the forefront of international efforts, concentrating £125m in assistance on Sierra Leone, building a new treatment centre outside Freetown and mobilising 400 NHS volunteers. David Cameron’s commitment to maintaining Britain’s overseas aid and development budget has never looked more sensible. France has been supplying direct assistance to Guinea. But in the face of a potential world-wide crisis, where is the rest of the world?
The European Commission makes all the right noises, but its financial contribution has been paltry. One of its main concerns appears to be how to airlift EU nationals in the affected countries. Germany, Europe’s supposed powerhouse, has only belatedly joined the fight. Meanwhile, other big international players are conspicuous by their absence. What of China, with its extensive commercial interests in west Africa? What of Russia, with its noisome pretensions to great power status? What of the other Brics countries, whose aspirations to a global role are so often heard? It is long past time they stepped up to mark and did their bit.
The scary truth of the Ebola pandemic is that, starting with the WHO last March, the world’s leading governments and institutions were, for the most part, caught napping. They thought (as did much of the western media) that this outbreak was another grisly but isolated act in Africa’s ongoing human tragedy. They thought it would not affect us. Now it is plain that it will, they badly need to get organised. They must act together, and quickly, not just to beat Ebola now, but in order to better deal with future pandemics when they come, as they surely will.
Peter Piot, the German scientist who discovered Ebola and a veteran of many battles against killer viruses, describes in an interview that we publish today how a “perfect storm” of mischance, miscalculation and mutation makes this epidemic unlike any that has gone before. We should all heed his words: “This isn’t just an epidemic anymore. This is a humanitarian catastrophe. We don’t just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought it could get this bad.”
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