World Health Organization director Dr. Margaret Chan and the top UN official responsible for coordinating the UN’s response to the Ebola outbreak, Dr. David Nabarro, held a series of meetings in New York and Washington, DC this week to brief officials–and the press–about the ebola outbreak in West Africa. Their remarks provide a stark warning about the current state of the fight against ebola. But we should not despair—not yet at least.
Here are three big takeaways from their remarks this week.
1) The outbreak is out of control. There are over 2,500 cases of ebola and over 1900 deaths–and it will get worse. Senegal confirmed its first case this weekend, which was imported from Guinea by a student who evaded detection. In Nigeria, the outbreak had been confined to Lagos — and pretty much under control in that city. But today, the WHO warned that an infected individual escaped quarantine in Lagos and travelled to Port Harcourt. There, he spread the infection to a doctor, who in turn likely spread it to many more people–including his patients and family members. There are now three confirmed cases in Port Harcourt.
In Liberia, the situation is as grave as ever, with the country’s health system in freefall. Things are comparably better in Sierra Leone and Guinea where there’s relatively greater awareness about how ebola is spread, but it is still placing an exacting burden on those country’s relatively rudimentary health system. In the meantime, the international community has not been able to effectively respond to the disease. “The outbreak is racing ahead of control efforts,” Dr. Chan forthrightly stated in a press conference today. And in a report last week, the WHO predicted that as many as 20,000 people may succomb to the disease before it’s brought to heel.
2) The Outbreak Can Be Brought Under Control. Ebola is not very easily spread. It is not airborne like flu. Rather, its spread through bodily fluids. The reason that so many health workers have been infected is that they are dealing directly with bodily discharge of affected patients. Similarly, ebola spreads within families because of close contact.
“This is doable with the institutions we have,” said Dr. David Nabarro, the UN’s ebola response coordinator. “But the scale up that is needed is in order of three to four times of what is in place.” In other words, the WHO, CDC, UN system and national governments can curb ebola. They just need more money and resources to do the job — and fast. How much? Dr. Nabarro estimated at least $600 million. That is a great deal of money, but from a budgetary perspective of donor countries it’s a drop in the bucket. Still, the money has not been coming in fast enough. Doctors need to get paid, patients need their hospital bills covered and basic protective equipment needs to be bought and distributed. Several hundred more international experts need to be deployed to affected countries.
The pace at which personpower and resources are harnessed for the ebola fight is the key determinant of whether or not this can be controlled. If sufficient money and manpower arrives quickly, the outbreak can — and will — be contained.
3) There are Very Big Barriers to Bringing It Under Control. The funding issue is key. If the money does not come quickly, the outbreak will get worse. Another huge impediment to ebola control efforts has been irrational fear of ebola which has resulted in the cancellation of nearly all commercial airline flights to Liberia, Guinea and Sierra Leone.
International experts who want to travel to Liberia to help fight ebola have no way of getting there. “We have experts mobilized by the WHO that are doing pro-bono work to provide infection control, but we are not able to deploy them,” said WHO director Margaret Chan. To make matters worse, some countries in the region have closed their airspace and airports to any planes returning from countries, including UN Humanitarian Air Service flights. CDC chief Thomas Frieden, the WHO’s top epidemiologist Keiji Fukuda, and the UN’s David Nabarro have all had flights to the region cancelled. These are arguably the three most important people on the planet to the fight against ebola!
The big takeaway: Ebola is out of control, but can be brought under control if the international community rapidly scales up its response and removes harmful barriers to getting the job done.
Bonus content: A view from Liberia of the Ebola crisis. I speak with journalist Jina Moore: