Ebola in Africa: Going Beyond Hysteria

Published on 9th September 2014

When in March this year Guinean authorities reported the first positive tests for Ebola in the West African region, the news came as a surprise for scientists and were treated  passively by most. After all, Ebola had killed over a period of thirty years more than two thousand people, since it was discovered in Yanbuku, in the DRC. Never did it surface outside the Great Lakes and it has never been perceived as a threat to an entire country.

Was this a circumscribed phenomenon like what we have witnessed many timed before? Be it as it may, nobody felt it was out of control by the time we were all meeting in Malabo, in June. Three months later, we are in the highest alert.

About a century ago, when the Spanish flu became a pandemic, it is projected that about 40% of the population was ill. An estimated fifty million died. People were fine in the morning and would die by the nightfall. Closer to our time, we saw the reactions we got when HIV AIDS was first discovered. It was total panic with countries not issuing visas, putting ineffective controls in place and reacting as if it was transmittable through thin air.

In fact even closer to our times, we remember the SARS, or severe acute respiratory syndrome alert, that came after an outbreak in China and Southeast Asia about ten years ago. That syndrome was indeed prone to airborne contagion, yet nobody remembers airline crews refusing to fly to affected countries. A more commonly known transmissible airborne disease is tuberculosis. Again, nobody heard, even remotely, about measures being taken to quarantine people, let alone regions or countries due to tuberculosis.

The reason it is important to reflect on history is because we cannot afford a serious threat like Ebola to be de-contextualized. It brings us back to the stigmatized Africa. In the process, there will be no focus of the efforts to deal with the issue they should. The economic and social consequences of such misguided perceptions are already devastating
Ebola has been stopped every time an outbreak was announced, thirteen times in fact, except this time. We need to understand why. We need to be bold about learning from the current mishaps that contributed to the emergency this time around.

We can mention the fact that affected countries have poor health systems. We can mention the fact that information flow is poor and there is almost total absence of good communication. We can regret the decadent health infrastructure, particularly in remote rural areas. We can add our concern about the huge deficit of medical personnel available to combat any pandemic. We are right to be outraged that only 1% of the pharmaceutical research is devoted to diseases that affect Africa, which is 25%v of the world’s burden. All of this is true and sadly well known.

The reason influenza only kills about half a million a year or SARS only about 12% death rate compared to Ebola 54% is certainly the existence of a well-developed capacity in Western of Southeast Asia countries. It is not because of the nationality or origin of the affected.

Today, there are reported Ebola cases in seven countries with over 2000 deaths and estimated 20 000 cases. There is nothing, absolutely nothing, in the current form dealing with the situation that can effectively impede tomorrow say half the African countries having reported cases. For each Africa countries putting in place draconian measures that are not medically justified, they have to think of themselves being under the same measures, in not so distant future, as a very likely possibility.

This brings us to the issue of solidarity. More than solidarity, it is about common sense. Ebola can only be tackled through massive investment to address on an urgent basis the contributing factors to the outbreak. Countries in the epicenter are over-stretched and they need the whole of Africa to put a stop to misinformation and a call for action for a million dollars immediately. WHO has a clear roadmap for the process. The minimum to expect is that Africa comes in solidarity for this emergency package to be implemented without more hesitations. Time is pressing. That is the real solidarity.

The economic impact of the Ebola outbreak will be significant. Estimates by Economic Commission for Africa confirm that several points GDP reduction are to be expected in Guinea, Liberia, and Sierra Leone. Due to a combination of factors, significant reduction of mining operations, disruption of agricultural cycles with direct impact of upcoming harvest, restriction to domestic and cross-border trade, substantial reduction of air travel, postponement of already negotiated foreseeable investments, spectacular diversion of public funding towards combating the epidemic, impact on fiscal space and finally, inability to pursue initiated reforms.

Remaining countries where cases have been detected so far have not been heavily affected. But that can change quickly, like we have seen in Nigeria, with the effects created in the oil industry operations in Port Harcourt.

Investors are influenced by the panic mode that has been spreading through the media. They think it is a risk to deal with entire countries. It is as if the Ebola bodily fluids transmissibility had gone from individuals to countries. This is fuelled by the concentric circles of quarantine, neighborhood shut downs and border closures, all highly publicized by the international media. The gear used by the medical personnel that can afford it reminds us of the images of Chernobyl and Fukushima. It does not help that Bloomberg advances an estimate of a 13 billion dollar loss, based on what can only be a scanty data.

A complete assessment is being done by ECA, which expects the overall economic impact to continue to affect business risk perception associated with Brand Africa. At the time the continent was making strides to change the narrative, these developments are devastating.

Economic consequences are never far from social ones. Humanitarian actors are complaining that instead of opening arms for their work, they are being restricted. The ethnic or regional stigmatization has had tremendous costs for segments of the population that were already isolated geographically. Individuals suspecting the symptoms may not be sure they have Ebola, but are sure that devil is in the hospitals. Behavioral issues such as what one eats, hoe one conforms to hygiene protocols or plain human right for care and decent death, require a humane and compassionate attitude. More than half of the victims have been women. Food prices increases and local markets disruption or closure, and threatening fragile consumption patterns.

We are only going to win this fight if we deal with its spread. As much as vaccines can and should play their role, at this stage that is not the centre of response. The serum of the Ebola survivors is already being considered the most immediate resource for the victims that reach a medical unit. But even that commands considerable means and capabilities. We need to have such facilities first. There must be a special emphasis on containment, prevention, and preparedness. It is unprecedented to have such a high number of medical personnel, as many as 120 so far, dying from a transmissible disease. It is only possible if one does not possess basic equipment.

Africans are used to hysteria. The world is showing that it has unlearned for inflectional diseases, rather than learn from accumulated knowledge. Ebola is just the last episode in a long course on hysteria faced by the continent. This time around, instead of succumbing to it, Africans need to fight back.

It is said that charity starts at home. If that is true, it should mean that in this instance, the fight against the deadly Ebola outbreak is treated with scientific evidence, proper focus on prevention, complete understanding of transmissibility, and emergency calls for means equivalent to what is spend on peacekeeping.

Africa should be ready for this challenge in the name of a true rising Africa.

By Mr Carlos Lopez
UN Under-Secretary General and Executive Secretary of ECA.

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