The 3 hardest-hit countries with Ebola, Guinea, Liberia, and Sierra Leone, are among the poorest in the world. All 3 have only recently emerged from years of civil war and conflict that left health infrastructures badly damaged or destroyed.
Prior to the outbreaks, these countries had only 1 to 2 doctors to treat a population of nearly 100 000 people. That number has been diminished as more than 600 health care staff have been infected.
At the start of the outbreak, weaknesses existed throughout the health systems. Laboratories were few in number and concentrated in cities.
The World Bank, headed for the first time by a doctor, wants to create a cadre of outbreak specialists who could be sent anywhere to end deadly epidemics. A similar idea, floated by a World Health Organization panel three years ago in the wake of the swine flu pandemic, didn’t get enough support. The WHO says the idea might not be practical and countries should ideally have the capacity to respond themselves.
The Ebola outbreak, which has so far sickened more than 20,000 people in eight countries, shows major weaknesses in global health security.
The newly appointed United Nations Special Representative on Ebola resuming soon as the head of the United Nations Mission for Ebola Emergency Response (UNMEER), Ould Cheikh Ahmed, recently said that the world needs to put up a decisive fight against the deadly disease. Cheikh Ahmed, who is to take over from Anthony Banbury, stated during a town hall meeting with UNMEER staff in Accra, Ghana, that the Ebola issue is a global crisis, adding that there is a difficult time ahead. He also said that eradicating the virus is achievable. “This is a global crisis. We definitely have a difficult time ahead of us, but we can achieve it. We have no plan B; we have to get rid of this virus. This is within our reach, but we should not be complacent. We need to keep going until we don’t have even one case, because even one case is too many. The work ahead remains very hard but we really have no other choice.” He said.
The World Bank’s observations on the current epidemic and its proposals for global health security will be discussed at a meeting of the WHO’s 34-member executive board at its Geneva headquarters on Jan. 26. The WHO has come under fire for grasping the magnitude of the Ebola threat too late, which raised questions about its ability to respond to important disease outbreaks.
“There is a genuine risk that governments will use the Ebola outbreak as a basis for further undermining the WHO’s authority, which would simply be disastrous,” Kamradt-Scott said.
However, with the establishment of African Centre of Excellence for Genomics of Infectious Diseases (ACEGID) in Nigeria, what is called ‘Rapid Response Diagnostics Test’ (RRD), has been developed to detect incidence of Ebola virus within 15 minutes, according to the Vice Chancellor, a Professor, at Redeemer’s University (RUN), Debo Adeyewa.
“Only two laboratories are recognised in Nigeria for accurate diagnosis of Ebola virus by the American Centres for Disease Control (CDC) and ours is one of such. As a mark of strategic role ACEGID is playing in the EVD control, the United Nations Development Programme recently commissioned a rapid assessment survey on Ebola containment success factors in Nigeria and requested that our ACEGID director should grant audience to the consultants on the project in recognition of the key role of ACEGID played during the containment of the EVD. Presently, the ACEGID team is not only the toast but the pacesetter and cynosure of the other African Centres of Excellence.” He said.
The capital cities of all three nations (Guinea, Liberia, Sierra Leone) have been heavily impacted since June 2014 and remain so. In Freetown, the capital of Sierra Leone, they state that cases still may not have peaked.
WHO states that the case reproduction number has decreased to near 1 as a national average. This means that each Ebola patient infects one other person. This number needs to fall under 1 for an outbreak to end.
By December 2014, the number of treatment centre beds exceeded the number of patients reported each week. However, the distribution of these beds was uneven and some districts in each country continue to have severe gaps in coverage. Similarly, there were 200 teams available to perform safe burials but cultural resistance leads to them being under-used.
WHO says the “uneven” success of control measures to date and shifting geographic spread shows that the disease poses a “continuing threat” and “huge challenge”.
Kemi Ajumobi
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