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The lessons of Ebola

As I write this editorial, the World Health Organization (WHO) has just announced that Ebola has been eradicated from Liberia. The curve remains positive to allow Guinea and Sierra Leone to hopefully follow suit in due course.

And what a journey it has been. It is odd how only a few months ago, the world watched with morbid curiosity, (or was that just plain fear?) as this scary new virus was rampaging through Africa. Wall to wall coverage blared from the media. That it was actually rampaging through a small little corner of Africa, was one of those little details they forgot, against the unspoken fear of a global wipe out. And now the latest announcement from Liberia may warrant a paragraph or two in some media, and nothing at all in others. An epidemic ended, is barely news.

We’ve also seen large numbers of International health agencies and experts scrambled to assist the local Governments and Ministries of Health. Sadly we’ve also witnessed some undedifying corruption (particularly in Sierra Leone), in the use of the huge sums of money that were allocated to the epidemic. We’ve seen military officers coming in to build treatment centres, some never to be used as the outbreak tailed off before they could be commissioned.

And in between it all, there have been some genuine heroics from medical teams, burial teams, and community members who slowly but surely rescued the day.

And what was the genesis of it all? The virus? To a point, but the reason it became the story it did and the reason Ebola claimed more than 10 000 lives, was the existence of fragile health sys- tems in the three countries.

The World Bank now estimates (and I’m always terribly skeptical of these figures seemingly plucked from thin air) that the overall ‘socioeconomic effect over two years’ will be $32.6 billion. As my good friend Neil Packenham-Walsh of HIFA2015 opined, if only a fraction of this could have been spent on healthcare pre-paredness, and/or on the health systems in these countries, we wouldn’t have had anything like the problem we did.

And actually it gets worse. Because we now hear that the number of children dying from malaria has shot up in the three countries, simply because the malaria control measures had to be stopped to allow full concentration on preventing Ebola. It seems, more people (and especially children) will have died because of Ebola than died from Ebola.

If there is a silver lining it is going to be in the lessons learned. WHO took a lot of criticism at the outset for its clumsy reaction to the early reports of ‘a problem’, but Margaret Chan is not one to run and hide. She was at the forefront of the SARS response team and was shocked when she realised what was happening under her watch at WHO. She accepted the criticism leveled, took personal control, and the organization recently issued a preliminary report on the takeaway lessons of the Ebola strategy. You can read it on page 15. If just a few of these points are correctly followed, the world will be a better place.


Bryan Pearson

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