Paving a United Path from a Deadly Disease

By Olivier Bucyana (@Olivierbu1)

This post also appeared on allafrica.com 

With close to 5,000 deaths and nearly 10,000 reported cases since last December, the current outbreak of Ebola has exposed both the weaknesses of our health care systems and our inability as Africans to work together in times of crisis.

The first Ebola outbreak occurred in what is today the Democratic Republic of Congo in 1976 and infected more than 300 people, with a mortality rate estimated at 88 percent. Since then, the virus has emerged and been contained more than a dozen times across sub-Saharan Africa, although in some cases only after exacting a heavy price.

Africa’s Response

Fifty or more years after gaining independence, most African nations continue to rely on the West to solve their own crises. When it comes to the Ebola outbreak, African governments have been slow in responding.

There is deep irony in this lag, as the social and economic consequences of Ebola extend far beyond the borders of those affected countries. The World Bank estimates the cost could be as much as U.S. $32.6 billion by the end of next year. Although the IMF’s growth forecast for this year remains strong, it has nonetheless dropped from 5.5 to five percent.

At the end of October, an African Union delegation went into the Ebola-affected countries on the ground. But a mere visit to pay respects is simply not enough. The handful of medical staff deployed and the meager pledges put forth by African governments are also not enough.

Regional institutions, such as the West African Health Organization – whose role, amongst others, is to facilitate cooperation amongst member states to tackle health problems threatening the region – have been quiet. A collective, well-coordinated response by African governments and African regional institutions is needed.

One of the State’s primary roles is to ensure its citizens have access to a good health care system. The Ebola outbreak reveals the extent to which this is lacking in the affected countries, and that it is a result of much deeper and underlying governance issues.

Compare the current governance system of Guinea, Liberia or Sierra Leone to that of a country like Nigeria, and to a lesser extent Senegal. Both the latter experienced Ebola cases, but quickly managed to contain them – particularly Nigeria, which had at least 19 confirmed cases.

So what did Nigeria and Senegal do differently? Nigeria took swift and coordinated action, including early detection and tracing of contacts, with the support of federal and state institutions working in collaboration with a network of NGOs.

For example, they provided law enforcement agencies with temporary access to mobile phone records, which helped track people who may have been in contact with infected patients. By providing training to healthcare workers and running nationwide campaigns, with civil society organizations at the forefront, they were able to contain the outbreak.

Senegal may have been lucky to have only one reported case, but civil society came together just the same to help sensitize the public, through the use of a #SenStopEbola campaign, for example.

There is a lot to learn from both Nigeria and Senegal, just as there is from the Democratic Republic of Congo, a country that has faced and contained multiple Ebola outbreaks over the decades. It may be worth exploring more experience-sharing ventures between countries like Nigeria and Senegal and Guinea, Liberia and Sierra Leone so that we can all benefit from our failures and successes.

 

Ebola Outbreak in Democratic Republic of Congo (formerly Zaire) in 1995

Ebola Outbreak in Democratic Republic of Congo (formerly Zaire) in 1995 – Source: Wikipedia

 

 International Response

It took a thousand or so deaths – nine months after the first outbreak – before the United Nations Security Council finally declared Ebola a threat to international peace and security, in September. And only then did the world sit up and take note.

Since then, Ebola has become the subject of the latest “a la mode” media hype and international aid has increased accordingly. Funds have been pouring into Guinea, Sierra-Leone and Liberia – with the United States contributing U.S. $200 million, Britain $18.8 million and China $8.3 million to the United Nations’ Ebola Relief fund.

France and Italy have contributed $7.4 million and $2 million respectively, and Cuba – a country with a long history of providing health workers during crises – has sent more than 250 doctors and caregivers. International institutions and non-governmental organisations are also contributing to the Ebola fund.

The Ebola outbreak has exposed some of the weaknesses in the way financial support has been used to strengthen national health systems. Typically, foreign aid that is destined for health issues has focused on specific diseases – mostly HIV/AIDS, malaria and tuberculosis. Rarely have funds been used to provide training to doctors and nurses or build more clinics and hospitals. While providing aid to address specific diseases is welcomed (and has been successful to some extent) it shouldn’t be at the expense of strengthening health care systems as a whole.

Since the early 2000s, both Sierra Leone and Liberia have been slowly recovering from their respective conflicts, which have left palpable markers on nearly every aspect of life, including the health sector. This latest Ebola epidemic has stretched already strained and fragile health economies, serving as clear reminders that both countries require more than quick-fix Band-Aid solutions.

This epidemic has shown that there is a serious lack of capacity on the part of the countries in question to respond to the needs of their citizens. Medical care, but also logistics and public awareness, are at the center of this fight. A well-developed and long-term plan – one that includes increasing the number of health workers, hospitals and clinics, and ensuring the media are appropriately tooled and resourced to provide the public with pertinent and reliable information – is needed when facing future outbreaks and epidemics.

Conclusion

The Ebola outbreak has shown that we still live in uncertain times in West Africa. Though many of our post-conflict societies have been steadily improving over the years, politically, socially and economically, this epidemic reveals just how precariously built these houses may be.

But it doesn’t have to stay this way. We can collectively – as Africans – use the opportunity to come closer together, to bind and unite our wills and strengths so we can learn from our past failures and prevent, or at least limit, the impact the Ebola outbreak has had throughout West Africa and beyond.

We have many of the ingredients in place for us to work together and to succeed. We have the regional institutions and we have the experience. We just need the will and the commitment to deploy resources more effectively.

And solutions to our crises are not always outside the continent. As Sisonke Msimang, the writer and activist, eloquently said: “For some reason in the minds of the leaders of those countries most affected by the current Ebola outbreak, Kinshasa is further away from Monrovia and Conakry and Freetown than Washington”.

 

 

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