Las fiebres del ébola

Ebola Fever

24.10.2014

Clearly, quite a few people in the European Commission, the World Health Organisation (WHO) and other United Nations agencies must have blushed at their organisation’s inaction and lack of response

It is not clear whether a temperature of 38°C or 38.6°C indicates a fever high enough to raise suspicion of Ebola infection in people coming from affected countries. But it is clear that the Ebola crisis has taken the temperature of our society on several fronts, including our preparedness for a health crisis and our ability to manage such a crisis. Given the level of health inequity between Northern and Southern countries that we are willing to tolerate, the hot flush of embarrassment must be felt not only by Spain—with two confirmed Ebola cases—but by all of the governments and organisations responsible for leading the international response to the drama unfolding in Ebola-stricken countries. Clearly, quite a few people in the European Commission, the World Health Organisation (WHO) and other United Nations agencies must have blushed at their organisation’s inaction and lack of response. Rather than being a passing summer fever, Ebola is a disease that will be with us for a while. The misfortune was that this disease “only” affected poor countries—countries where other epidemics (malaria, tuberculosis, HIV, etc.) claim many more lives than Ebola every day. The recent appearance of Ebola cases in rich countries has “coincided” with a greater awareness of the problem, an increase in philanthropic aid, the appointment of crisis committees, and splashy headlines. There’s nothing new under the sun.

What measures has the international community taken to protect countries that lack the resources required to manage cases of Ebola?

We haven’t handled this very well. But I don’t think that at this stage there is anything to be gained by finding someone to blame. Obviously, there are people who were responsible for how the crisis was managed and mistakes were made, but we should remember that we are all part of the apparatus that has led to this situation. Each one of us plays a role to some extent. Moreover, I agree with the WHO that now is not the time to analyse the quality of the response; it’s time to roll up our sleeves, to provide relief to the affected countries, and to implement and improve the protocols.

In any event, several unanswered questions deserve our attention. What measures has the international community taken to protect countries that, unlike the United States and Spain, lack the resources required to manage cases of Ebola? What efforts are being made to ensure that, when the first Ebola case is found in Niger, Malawi or Mozambique—the country where I am writing this post—the infection does not spread like it has in Sierra Leone and Liberia? I get the impression that prevention and warning measures have been focused more on the countries in a state of panic than on the countries where there is the greatest needThe fact that Ebola has not yet been reported in those countries is probably because there are cases yet to be diagnosed or perhaps it’s just a matter of chance. It is in those countries that the risk that the infection could spread and cause a catastrophe is really high. I get the impression that prevention and warning measures have been focused more on the countries in a state of panic than on the countries where there is the greatest need. The lack of qualified healthcare workers has been cited as a key problem which is slowing down the response. Various countries have sent teams of health workers to the affected region—including a team of 165 from Cuba. How many healthcare professionals have been sent by European Union countries? If this were a different kind of conflict, how many soldiers would have been sent? We also need to decide whether people affected by Ebola should be repatriated, taking into account the available evidence, the existing precedents, and new precedents being created.

Ebola fever has highlighted the real problem of global health issuesEbola fever has highlighted the real problem of global health issues. Rather than affecting a single country or sector, global health problems engulf and overwhelm the entire planet, crushing economies, devastating fragile health systems in some countries, and spreading panic and alarm on a scale not seen in years. And Ebola won’t be the last such problem. Global health problems require a flexible and coordinated global response which not only delivers medical care and controls the spread of the outbreak but also does everything possible to close the resulting socioeconomic gap. At the same time, we need more proposals like the one developed by the ISGlobal Think Tank—proposals that are less sporadic, more sustainable, and focused on creating a global social protection system that, among other things, guarantees minimum universal health coverage and reduces the vulnerability of populations facing healthcare emergencies like the current Ebola crisis. We also need to ensure that the international cooperation and health agendas prioritise proposals of this sort.

The current situation should be seen as an opportunity to correct the shortfalls and weaknesses of the international community’s response to global health problems, which go beyond the Ebola epidemic. Let’s focus on what we should learn from this experience and do our homework. This is a shared responsibility. If we fail to act now, we will not only miss a great opportunity but also perpetuate and widen the gap in health equity.