Ebola – Not just an African Problem

Weak African Health Systems

As the Ebola outbreak continues to grow, there are mounting concerns over its potential spread beyond West Africa. Statistically, the chances of contracting Ebola remain low outside infected areas. Nevertheless, the disease represents a serious global threat to public health that demands global investment and action now.

A growing health concern

We are currently facing the worst outbreak of Ebola in recorded history. According to the World Health Organization (WHO), new cases are still being identified four months after the epidemic broke out in Guinea. Dr. Tom Frieden, Director of the U.S Centers for Disease Control and Prevention recently said that the situation is out of control. So far, three Americans have been infected with the virus and one of them has died. At the time of writing, one American victim had been transferred to a US hospital for treatment, with a second transfer planned.

An unfolding public health challenge

Given the seriousness of the disease, people are understandably worried about its spread to the US. Thankfully, for most Americans, the chances of becoming infected by Ebola remain remote. Yet beyond the fear, there are larger public health issues at stake.

Soon after the first case in the current outbreak was reported, a Canadian returning from Liberia sent health officials into a flurry with fears that he might have the Ebola virus. Although in good health when he travelled, the man was admitted to an intensive care unit in Saskatchewan, Canada with classic symptoms of the Ebola disease.

That health scare, and others that followed, were a wake-up call to all those who regard the West African outbreaks as an “African problem.” They serve as a reminder that people—and therefore their infections—are not bound by geographical borders. Fighting these devastating illnesses is a moral responsibility, regardless of who is affected by them.

Local is the new global

Of course not everyone will agree with me. But to those who claim we can’t afford foreign aid, I respond that we cannot naively afford to think of health threats as “foreign” and “domestic.”

As a physician from Nigeria who is now researching the spread and control of infectious diseases at the University of Michigan, I was horrified, but not surprised, by the Canadian passenger’s plight. If anything, I’m surprised that this hasn’t happened sooner.

Ebola is spread when people come in direct contact with blood or secretions from an infected person, or when they are exposed to contaminated objects like needles. This means patients should be treated in isolation. Victims of Ebola suffer redness of the eyes, skin rash, fever and debilitating internal bleeding. Up to 9 out of 10 people who get Ebola die from the disease.

We live in a connected world with all the ingredients for an Ebola pandemic. Persons infected with this virus may appear healthy for up to three weeks. Indeed, in this age of high-speed global travel, an infected person could tour the world three times over—all while unknowingly spreading the disease. And given the fact that air travel has become cheaper, it is more likely than not that if this outbreak is not brought under control soon, the disease will spread into other parts of the world including the United States.

Early warnings

But this reality has taken much too long to sink in for Western audiences, despite numerous early warnings. In 2002, when the deadly flu-like illness known as SARS (Severe Acute Respiratory Syndrome) first broke out in China, it seemed like a distant problem. But within a year it caused nearly 800 deaths, at least eight of which occurred in the United States. According to Center for Disease Control and Prevention (CDC) data, this country fared even worse during the H1N1 swine flu pandemic of 2009. Of the nearly half a million deaths, the U.S lost more than 12,500 people.

As I write this, the death toll in the West African Ebola outbreak has risen to 729. And experts are saying it’s a uniquely challenging outbreak.

What makes it even more challenging though is that, in the nearly 40 years since the Ebola virus was first identified, we still do not have effective drugs or a vaccine to fight it. The virus is thought to be rare, and its victims are often poor people living in rural areas of Africa without well-functioning health systems. And as a result, there is little incentive for major pharmaceutical companies to invest in medical solutions when there is little chance of a financial return.

Foreign aid: There’s nothing foreign about it

For diseases such as this where there is little private sector input, foreign aid is critical to curb impacts. Yet there is a belief amongst some in the global north that foreign aid is not a good investment. A recent Kaiser Family Foundation survey showed that 61% of Americans thought that too much is being spent on foreign aid. (The same survey indicated that most people significantly over-estimate how much foreign aid is given).

But here is what is misunderstood about foreign aid: there is nothing foreign about it. As far as infectious diseases with a potential for worldwide spread are concerned, foreign aid is as much about self-protection as it is about altruism.

Take the example of small pox. Were it not for the concerted global effort led by the western world, this disfiguring disease may have wreaked havoc on the world’s population. But small pox was eradicated by ‘foreign aid,’ which supported the development of the first universally successful vaccine.

With the same resolve, we can put an end to malaria, tuberculosis, HIV and even Ebola.

By making greater investments in research for early diagnosis, treatment and the creation of vaccines for ‘African’ diseases such as Ebola, we can make the type of progress that we have made with heart disease, diabetes and cancer. After all, we are much more connected than we realize.

This piece was originally published by 2020 Science. Parts of this article draw on an earlier opinions piece published in the Detroit Free Press.


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