The current outbreak of Ebola virus hemorrhagic fever is still occupying the headlines. The recovery of the two Americans treated with ZMapp at the Emory Center in Atlanta was an event that raised hopes that an effective remedy had finally been found.
The increase in cases, however, has so far shown no sign of abating, and the size of this outbreak is already greater than the sum of all previous ones. Despite this, I still believe that the attention and especially the concern with which the media describe the current situation is unjustified. In fact, to date there has been no transmission of the virus outside the geographical scope of the outbreaks. Moreover, it is very likely that the arrival of the virus in a non-African country, and one with a standard of living suitable for maintaining an efficient health service, would be contained and eliminated quickly.
Can we rest easy then? Not precisely.
Citing a recent Lancet editorial "Ebola a failure of international collective action," found in the bibliography, outbreaks, are struggling to get back under control. The reasons lie in the lack of adequately staffed and equipped health facilities in the affected countries. This lack of organization and preparedness to respond to the emergency leads to neglect of the fundamental epidemiological aspects concerning surveillance and control of the sick and contacts on the ground. There are many difficulties in implementing programs to inform the population to avoid behaviors at risk of infection. It is also not always possible to control the movement of populations crossing borders, coming from countries already affected. Above all, the political and financial reasons that are driving the epidemic's fortunes are coming to light.
Although WHO-WHO is leading the international response to the crisis, it has been rather slow to get going at first. Médicins Sans Frontières (MSF) had already declared on June 24, 2019 that the situation appeared "out of control," calling for a more massive deployment of resources. On July 31 alone, WHO-WHO invested $71 mln in the deployment of hundreds of health workers in West Africa. To be fair, WHO has experienced severe budget constraints in recent years. The budget for responding to critical events and and outbreaks of epidemics has dropped dramatically by 50 percent: down from $469 mln in 2012-2013 to $228 mln in 2014-15. The financial support of the WHO-WHO intervention is a crucial aspect of the fight against Ebola. In fact, WHO-WHO appears to be the only force capable of rescuing and strengthening the fragile health network in countries on Africa's west coast. Even the World Bank has invested $200 mln to contain this outbreak and strengthen the health systems of the affected countries. Certainly well other figures, and from multiple sources, and in a permanent form, should be used to equip those regions with a network of suitable facilities.
And then as M.Chan states in his very recent editorial in NEJM, in the bibliography, to the people who ask why the Ebola epidemic is so severe, so large and so difficult to treat, the answer consists of only one word: "poverty!"
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61377-5/fulltext
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(14)70785-6/fulltext
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61371-4/fulltext
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61322-2/fulltext
http://www.nejm.org/doi/full/10.1056/NEJMp1409859?query=featured_home
http://www.nejm.org/doi/full/10.1056/NEJMp1409858?query=featured_home
http://www.nejm.org/doi/full/10.1056/NEJMp1409903?query=featured_home
http://www.nejm.org/doi/full/10.1056/NEJMp1409817?query=featured_home
