Ebola: The Past and the Future

A review of the past year would not be complete without the mention of the devastating Ebola outbreak in the latter half of 2014. The spread of the deadly virus across Guinea, Sierra Leone, and Liberia with isolated cases in other parts of Africa, Europe and the United States shocked the world. In the 21st century, with all of the modern medicine and constant innovation in technology, how was the disease not able to be contained and stopped before causing such damage? Controversy and fear obviously surrounded the outbreak, but even more interesting are the economic and political effects of Ebola, both at present and in the future, and how they will affect the future of global health.

Image courtesy of European Commission DG ECHO, © 2013, some rights reserved.

First, it is important to re-familiarize ourselves with the statistics of this epidemic. According to the World Health Organization (WHO), there have been 24,666 cases of Ebola and 10,179 deaths.[1] The outbreak began in Guinea and then mostly spread to Sierra Leone and Liberia, with devastating effects in densely populated cities like Monrovia. International organizations like Doctors Without Borders, the Red Cross, UNICEF, and countless others rushed to raise funds and organize volunteers and supplies to send to the region to try to combat the disease.[2]

Where did the Ebola virus come from? It is a very serious illness that is often fatal and is contracted by close contact with blood, bodily fluids, etc. of infected animals like chimpanzees and monkeys.[3] The virus can then be further spread between people, again through contact with bodily fluids and even materials like clothes and bedding that have these fluids on them.[4] This made safety precautions when treating or being around people afflicted with Ebola extremely serious due to the fact that any direct contact can result in infection. Another aspect of the Ebola virus is the incubation period, which can range from two to twenty-one days, and people are not contagious until they start displaying symptoms like fever, fatigue, headache, sore throat, vomiting, or a rash.[5]

Sovereign countries, like the United Kingdom and the United States, also rallied to contribute to the fight against Ebola. Back in September 2014, right after the tremendous outbreak over the summer, the Washington Post reported on different countries’ contributions to the fight against Ebola. China had already sent $4.8 million and would be sending $32 million along with more medical staff to Sierra Leone, India donated $500,000 to support the WHO, Britain sent troops and humanitarian experts to Sierra Leone along with $40 million, the European Union (EU) sent $200,000 and mobile labs to the worst affected countries, Russia sent teams of scientists to run a laboratory in Guinea, Cuba sent 165 doctors and nurses, and the United States sent 3,000 troops and funds.[6] The number of medical personnel, medical equipment, the monetary assistance, and the number of troops sent by foreign countries has increased since last fall, but it is just a snapshot of what countries had promised to contribute to rectifying the situation. Those states, along with others, answered the call for an international response to Ebola.

However, like with many international crises different countries felt confident to offer different things, which led to some controversy. When the United States and the United Kingdom began promising to send troops to West Africa to help control the outbreak of Ebola, Australia did not feel the same way. The Pacific nation felt it could send money for supplies and equipment, but sending Australian people into the situation was a different scenario. Australian Prime Minister, Tony Abbott, said “I think it would be a little irresponsible of an Australian government to order Australian personnel into this dangerous situation.” This reaction highlights an issue that is not just related to Ebola, but is common in the international sphere. Different governments and leaders universally recognized the severity of the situation and that action was necessary. However, since countries have different capabilities and means, some felt more equipped to respond in certain manners. Right or wrong, this is a common issue and it is almost impossible for all countries to contribute exactly the same resources or numbers of men.

Now, after touching upon the reaction to the outbreak of Ebola over the past year, we can look at the effectiveness of it. In our ever increasingly global and interconnected society many suggest there is a great deal of concern surrounding future outbreaks, not just of Ebola. People from all over the world are always in contact and travelling around, so a disease could easily be spread. And, in the future, another outbreak could be of a disease with less prominent symptoms, so it would be harder to diagnose. Microsoft founder Bill Gates, who started the Bill & Melinda Gates Foundation that works to deal with global health issues, expressed his concern for the future of global health. Future epidemics, he argued, are most likely to start in poorer countries that lack agencies to monitor disease outbreaks.[7] Also, he pointed out that even when a disease is recognized, like Ebola was this past summer, there is no blueprint for international organizations and countries on how to use and deploy forces, resources, and volunteers to deal with the situation.[8] Bill Gates also brings attention to the fact that future epidemics may not always occur in nations that are friendly and open to Western involvement. In this case, countries like the United Kingdom and the United States, among many others, were able to send support to the region to help control the situation, but this could change in the future. This highlights another issue related to Ebola, mainly that politics can play a role in dealing with crises.

When the disease really began spreading in Liberia last year, many Liberians mistrusted their government’s warnings about the virus and thought they were part of a plot to get money from foreigners.[9] Also, because of the recent conflicts and civil wars in Sierra Leone, Liberia, and Guinea, the people were even more uncertain of their governments’ motives to the point that they ignored the signs of the epidemic. A government cannot function without the trust of its people. These states must focus on improving that perception and relationship between the people and their government for the future. Suspicion also surrounded the efforts of the Western health workers and international organizations. For example, in countries like Sierra Leone, many wanted to bury their loved ones according to tradition, not safety protocol, which led to further transmission of the disease.[10] A greater understanding of the Ebola virus and other global health scares will be imperative to prevent future epidemics.

Politics can play a damaging role in the early fight against a virus like Ebola. It has recently been reported that the WHO waited to announce the Ebola emergency to not anger the countries involved by hurting their mining interests or curbing the Muslim pilgrimage to Mecca in October.[11] The Ebola outbreak led to some foreign investors pulling out of the mining industry in western Africa and employees and contractors stopped coming to work out of fear of becoming infected with the virus. So, when international organizations that are meant to do good in the world and be concerned with international health do not act in a positive way, there is an issue. Governments and international organizations will never have exactly the same goals or opinions on every situation and crisis that emerges. There is a constant balancing act between nations and governments making decisions for themselves while at the same time taking into consideration the globalized, interconnected 21st century and the coordination that must come along with that. Here is another lesson to be learned from the past year: action must be taken in a crisis no matter who it upsets. If the WHO had declared the Ebola emergency sooner, maybe more lives could have been saved.

The Ebola outbreak of the past year does not only have global health warnings, but it also is connected to economics. The western African countries that were hit the hardest – Liberia, Guinea, and Sierra Leone – do not have the largest or strongest economies. Not only was the Ebola virus devastating to the health of the people of Liberia, Guinea, and Sierra Leone, but it also wreaked havoc upon their already weak, post-conflict economies and governments.[12] The mining industry, which makes up a huge component of western African countries’ economies because of their abundant natural resources, was negatively affected, as aforementioned. While some mining firms decided to donate money in the effort to stop the spread of Ebola, a number of companies withdrew their operations altogether from the region. The shutting down of these companies resulted in unemployment, which prevented people form providing food for their families, which only worsened the humanitarian crisis in western Africa. The industry and the economies are working on rebuilding, but only time can help get the situation headed back in the right direction.

The hysteria has died down, but the effects of Ebola are still being felt. According to Doctors Without Borders, there have been new cases of the disease in Guinea and Sierra Leone earlier in March and because a number of hospitals and medical facilities shut over the past year, immunizations and treatments for HIV, among other things, have fallen to the wayside.[13] People, having lost their families, friends, and jobs, are rebuilding and restarting their lives from scratch.

Moreover, the world is battling another health crisis: measles outbreaks. Early 2014 saw a huge outbreak in Kyrgyzstan and so a mass vaccination campaign began on 16 March.[14] According to The New York Times, the US has “had more cases of measles in the first month of 2015 than the number that is typically diagnosed in a full year.”[15] Global health is such a pressing concern for NGOs, governments, and the international community. Furthermore, what is even more surprising with the measles outbreaks is some are occurring in developed countries with strong healthcare systems.

One cannot help but wonder if we have learned anything from this past year and the situation with Ebola and if the WHO will act differently in respect to measles. Public health education and awareness will probably be at the forefront of leaders and international organizations’ minds. With Ebola, a level of mistrust and misunderstanding about how the virus is spread led to a sort of hysteria this past year. Now, with measles and a number of people being at risk because they have not been vaccinated, a similar crisis could easily ensue.[16]

The Ebola outbreak dominated headlines over the past year. Constant updates of donations or volunteers being sent to the region and the updated death toll were always in the news. The concern is still present though. For example, in the Edinburgh airport even now, a number of staff members ask travellers if they have been to West Africa recently. Countries are still on high alert. States are trying to rebuild and regain their strength, while also preparing for another possible global crisis. We will have to depend on the global health community, which is working tirelessly, to engineer new vaccines and treatments for these deadly viruses. We will also turn to organizations like the WHO to help encourage countries and citizens to vaccinate against diseases to prevent these outbreaks. Only time though will show the lasting political, economic, and social effects of this unforgettable outbreak.

[1] “Ebola Data and Statistics: Situation Summary.” World Health Organization. 1 April 2015.

[2] “Non-Governmental Organizations Responding to Ebola.” USAID.

[3] “Ebola Virus Disease: Fact Sheet No. 103.” World Health Organization. September 2014.

[4] Ibid.

[5] Ibid.

[6] Taylor, Adam. “What the world is doing to stop Ebola.” The Washington Post. 16 September 2014.

[7] Gates, Bill. “How to Fight the Next Epidemic.” The New York Times. 18 March 2015.

[8] Ibid.

[9] Mukpo, Ashoka. “The biggest concern of the Ebola outbreak is political, not medical.” Aljazeera America. 12 August 2014.

[10] Daccord, Yves and Elhadj As Sy. “The Red Cross: ‘Ebola Started In Silence and Will End With Our Words.’” Time. 25 March 2015.

[11] “Emails reveal WHO delayed declaring Ebola emergency due to political considerations.” Fox News. 20 March 2015.

[12] Konneh, Amara. “Ebola isn’t just a health crisis – it’s a social and economic one too.” The Guardian. 10 October 2014.

[13] “Ebola crisis update – 23 March 2015.” Medecins Sans Frontieres. 24 March 2015.

[14] “Kyrgyzstan reports hundreds of measles cases daily: WHO.” Outbreak News Today. 22 March 2015.

[15] “Facts About the Measles Outbreak.” The New York Times. 6 February 2015.

[16] Dennis, Brady. “Why measles could be worse for West Africa than Ebola.” The Washington Post. 12 March 2015.

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