As the US confirmed its first case of Ebola, Anthony Banbury, Special Representative of the UN Ebola mission has warned that the longer the virus is left to spread amongst human hosts, the chances of mutation increase, causing it to become airborne. The virus is, for now, spread through the contact of blood or bodily fluids by someone who is already infected, however in worst case ‘nightmare’ scenarios, the disease could mutate to infect hundreds of thousands worldwide, with little chance of containment.
Ebola – facts and figures
At over 3300 fatalities in over 7000 declared cases in west Africa, the fatality rate of Ebola currently stands at 52%. With a mortality rate of over 90% once an individual contracts the virus, and rates of infection as high as 5 new cases an hour in some countries, this figure is only going to grow unless drastic measures are taken to contain the spread, with the WHO estimating that 20,000 people will fall victim to the disease before this is achieved.
There is no cure, and no vaccine for Ebola. The only way to treat the virus is to prevent people from getting infected, and treating the symptoms with an early diagnosis if they are. The UN has estimated it will cost $1 billion to fight to keep the virus contained to just the tens of thousands over the next 6 months. Medicines Sans Frontier (MSF) and the World Health Organisation (WHO) have declared the situation out of control, and have reached the limits of output at their current capacities.
The spread of the Ebola virus is confounded by the fact that three of the affected West African countries ranked 174,177 &178 out of 186 countries worldwide in the human development index, so what we are effectively seeing is a situation in which one of the worlds most deadly viruses is plaguing three of the countries least equipped to manage. The lack of quality training means that staff are also not always equipped to deal with the influx of patients.
Peripheral health units (PHU’s) are the front-line of healthcare in these countries. They provide critical medical care to the communities they’re based in; offering emergency care, immunisations, malaria treatment and maternity facilities. However they are not always readily available, with some clinics located over a 10 km walk from the community it was set up to cater for. Even then, the PHU’s suffer from a lack of supplies and adequately trained staff.
This is where the international community can help to bring the virus under control. In the short term, emergency humanitarian assistance is needed to treat the existing cases and contain the immediate spread.
Ebola is not the only disease to ravage the region; Sierra Leone and Guinea both suffered an outbreak of cholera less than two years ago that claimed the lives of almost 400 people. In the longer term, effort has to be focused on building the capacities of the sanitation and health services of these countries to respond to such emergencies.
This prevention is however, much easier said than done. Preventative capacity is not solely based on scientific and technical knowledge, rather at its core, it is fundamentally about how well different aspects of the sanitation and health services compliment each other and interact with local dynamics of the communities, especially in a region were there are many social stigmas surrounding disease, and deep rooted preferences for traditional and shaman healers. We are seeing that with each new epidemic and outbreak, the situation is becoming more desperate and the need for a structured and sustainable treatment programme becomes all the more critical.