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Eleven things you should know about Ebola

Congo Guinea Ebola   AGUI101Mike Phipps offers some elementary facts about the epidemic and what it tells us about western priorities.

1. Ebola is fuelled by poverty. It broke out in west African countries that had been devastated by long civil wars. Given the resultant collapse of the public health system, if it hadn’t been Ebola, it would have been something else. Such epidemics require an alleviation of poverty – redistribution, sanitation, good nutrition and education.

2. There is no magic bullet. It won’t be fixed by sending US troops to carry out rapid vaccination programmes. It requires health professionals to carry out “contact tracing” – identification and quarantining those who have been in contact with those infected, as Professor Allyson Pollock has explained.

3. Ebola is hitting the headlines because it might kill the wrong people. The panic is disproportionate to the actual mortality rates and related more to the fact that rich white people might die from it, given the lack of a cure. But it’s hardly the biggest threat to life in poorer countries. The World Health Organisation reckons 15,000 people may have died from the current outbreak, a higher figure than usually reported in the media. But 1.2 million people die every year from malaria and 1.5 million from TB.

4. The fact that so much health care and research are in private hands distorts priorities. The substitution of so-called philanthropic private sector bodies such as the Gates Foundation or other for-profit companies for a genuine democratically accountable public health service in poorer countries sets back the fight for good health. When Dr Aileen Marty, an infectious disease professor at Florida International University, was asked recently why attempts to develop a vaccine had proceeded so slowly, she explained simply, “There’s no money in it.”

Almost ten years ago, scientists developed a vaccine that was almost 100% effective in protecting monkeys against Ebola. But tests on humans never happened and the vaccine sat on the shelf. “There’s never been a big market for Ebola vaccines,” said one expert. Hence the difficulty in getting large drug companies interested in taking the product forward.

5. Government security measures are counter-productive. In the US, Louisiana state officials told doctors who had been to west African countries recently to stay away from a New Orleans conference on tropical diseases.

6. Ebola panic is a disincentive for health professionals. Buzzfeed reports: “Liberian health workers on the front line of their country’s Ebola response are being required to sign away their legal rights should they become infected with Ebola, or otherwise injured, on the job.”  New employment contracts leave Liberia’s medical staff fighting Ebola with no health insurance or legal recourse even against blatant negligence by local officials or foreign donors. “If an organization donates a faulty pair of gloves or goggles, or if someone makes an error in training local health workers how to put on and take off the personal protective suits that provide the best protection against Ebola, the Liberian government’s contract essentially says: Tough luck.”

7. Ebola is a pretext for destroying civil liberties. “A journalist in Sierra Leone who has criticised the government’s handling of the Ebola outbreak was allegedly beaten then jailed under emergency laws meant to help bring the epidemic under control,” reports The Guardian. Journalists have raised legitimate concerns about corruption by government officials, given the hundreds of millions of pounds of aid now pouring into the country.

8. Ebola panic is an excuse for bureaucratic stupidity. The Spanish nurse who recovered from the virus criticised her country’s officials for executing her pet dog without justification. And in Kentucky, a teacher quit her job in disgust after being told by school authorities to take 21 days’ forced leave and provide a doctor’s note after visiting Kenya, an Ebola-free country, a nine hour flight away from the virus’s epicentre.

9. Ebola is a feminist issue. Liberian health officials estimate 75% of Ebola deaths are women. This is because women are the primary carers in the country and therefore far more likely to be in regular contact with those infected. And while heath professionals are slowly getting the protective equipment they need, this does not apply to mothers, wives or daughters.

10. Ebola underlines the need for a strong public sector. Joseph Stiglitz has commented: “We do not turn to the private sector to control the spread of a disease like Ebola. Rather, we turn to institutions – the Centers for Disease Control and Prevention (CDC) in the United States, the World Health Organization (WHO), and Médecins Sans Frontières.”

11. Ebola generates the usual patronising generalisations about Africa. “There exists a paternalistic way of thinking about Africa, likely exacerbated by the Band Aid singles, in which it must be ‘saved‘, and usually from itself,” writes Guardian journalist Bim Adewunmi. “It’s easy to forget, for example, that the virus made its way to Nigeria – Africa’s most populous country and, for many, a potential Ebola tinderbox – and was stamped out only by the efforts of a brave team of local healthcare workers.”

5 Comments

  1. Rod says:

    Thanks, Mike.

    A very pertinent post – it needed to be said.

  2. Chris says:

    No white-bashing, please. Socialists don’t do that.

  3. Barry Ewart says:

    Mike hits the nail on the head re poverty and poor health services and because of much higher wages the West can always poach African health workers. Another crucial point was “there’s no profit in it.” Someone once told me a lovely story a few years ago – some intelligent aliens landed on Earth and they wanted to learn about the human race. They looked at the World and saw diseases and health conditions then looked at the warehouses of multi-national drug companies and said, “Why don’t you give these to the those people?” “Oh we can’t do that we have to sell them to make a profit ” was the reply. I think we need to take the pharmaceutical industries into democratic public ownership as well as addressing global poverty and poor health and sanitation to meet human need. Addressing global need could also stimulate the economy, for example we could make toilets for the 2.5b people in the World that don’t have them. We need to address the root causes. Yours in international solidarity.

  4. Saleh Mamon says:

    Thanks Mike. Excellent points. Just to add to expand on point 10. The IMF and WB imposed structural adjustment on all countries in Africa based on neoliberal policies. This required the dismemberment of public services and privatisations. As a result these countries have little in terms of public health infrastructure. It is a shame that a country like Sierra Leone has one health worker for 5200 persons. In UK there ratio is 1:77. This is a matter of policy and not chance.

  5. Mike says:

    Thanks, Barry and Saleh – excellent feedback.

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