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Fighting Ebola – Too Late as Usual

August 15, 2014

Ebola

The World Health Organisation has acknowledged that the threat posed by Ebola is “vastly underrated”, according to the BBC. Well yes – any virus that carries off 80% of those infected and has spread to four west African countries, killing over a thousand people in the process, should most certainly be taken seriously. The more so because we are a month away from the Haj, when millions of pilgrims gather in Mecca from all over the Muslim world. The Saudi authorities have done their best to mitigate the risk of infection by issuing no visas to residents of Guinea, Sierra Leone and Liberia, and discouraging its own citizens from visiting those countries. I would imagine that they are watching anxiously as the disease progresses in Nigeria, west Africa’s most populous country, where an outbreak has recently been reported.

Given their vast experience in dealing with infection control among the pilgrims, one would hope that the Saudis will be as successful at keeping the lid on Ebola as they have been in controlling another deadly virus – MERS Coronavirus – which first showed up within the Kingdom. But they must be nervous, as we all should be, since people returning from the Haj will be heading for all corners of the globe.

What surprised me in one respect about Ebola – but not in another – is that we have known about the virus for nearly 40 years. The first outbreaks in 1976 carried off over 400 people. So as an ordinary Joe with little knowledge of epidemiology, the drugs industry and the World Health Organisation, I would be very interested if  someone with expertise on these subjects could answer the following questions:

  1. Why has it taken 38 years for “us” – governments, the WHO and the drug companies – to wake up to the threat of Ebola?
  2. What has prevented the drug companies from producing an effective vaccine years ago? Lack of funding? A sense that the necessary research would not be cost-effective  because the governments whose citizens are affected  – in other words African governments – would not be able to afford the treatment?
  3. What is the point at which a global or regional health emergency becomes so acute that the WHO, or its member governments, start commissioning the development of treatments rather than leaving it up to drug companies to decide whether or not to invest in the necessary R&D?

According to its statement, the WHO is “coordinating a massive scaling up of the international response, marshalling support from individual countries, disease control agencies, agencies within the United Nations system, and others”. All fine and good, but the simple fact of the matter is that here is a virus that kills the majority of those infected. Preventive measures can reduce infection, but cannot cure those already infected. Surely the massive cost of preventive measures would be unnecessary if “we” had had the foresight to ensure that work on developing an effective vaccine had started many years ago, once we recognised the devastating potential of an Ebola epidemic, or worse still, of a pandemic?

Perhaps I’m being naive. Perhaps work has been going on since 1976 to develop a vaccine. Perhaps the task is a challenging as developing a vaccine for AIDS, for which research has been going on for decades. In any event, there’s no point looking back for lessons to be learned until the current outbreak has been brought under control. Hopefully  the experimental ZMapp treatment will prove effective.

If and when the drains-up does take place, I will be watching to see whether there’s any kind of debate over why the health of millions depends on the efforts of private companies whose efforts are driven by profit, or on organisations such as the Bill and Melinda Gates Foundation that exist because of the philanthropic vision of wealthy individuals.

“We” spend billions of public money every year in dealing with the effects of natural and man-made disasters, from earthquakes and floods.  “We” spend billions attempting to mitigate the effects of climate change. Some of “us” spend millions on relief efforts to save minorities threatened by homicidal fanatics in Iraq and billions on the wars that preceded the current crisis. Yet Ebola suddenly (but not suddenly) raises its ugly head, and “we” struggle to deal with its consequences.

Are we really that dumb, or am I indeed just hopelessly naive?

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