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Issue #1661      October 22, 2014


Ebola: We live in one world

For a period in the 1980s in the US there were limited outbreaks of tuberculosis. Those infected included wealthy individuals in gated communities where undocumented workers from Mexico and other South American countries worked as cooks, child minders and cleaners on pittance wages. Infectious diseases recognise no borders or class lines, but it is a class question.

The countries that are struggling to deal with the Ebola outbreak in West Africa are poverty stricken former colonial possessions with poor health systems. The governments of the rich Western countries were at first uninterested in yet another looming deadly health disaster in a part of the third world.

In June, as it emerged that Ebola was spreading fast, a political and economic risk analyst in Sierra Leone, OB Sisay, wrote to the UK’s Chief Medical Officer after his arrival in London to raise the lack of safety procedures at the airport. Two weeks later he received a response reassuring him that there had been no reports of cases having been “exported” to countries outside of West Africa.

So the attitude of the West was; as long as its not affecting us, let them rot. But suddenly the dynamic changed when a victim was “exported”, to the US, and its much vaunted health system struggled to cope with one single case, (at time of writing around 4,500 in Africa had died).

At this point in time, two US health workers have been infected. It is no longer a purely “African disease”.

The situation raises many issues and questions.

The absence of a proven cure makes Ebola an almost hopeless disease for a person to have. Why hasn’t a vaccine been developed? There is a medicine for treating Ebola, though not a cure. Zmapp, was developed by an American firm but it has not yet approval for safety and efficacy.

In the midst of this crisis, the question of the cost of medicine should not be allowed to be an impediment, but it is expected that high cost and patents will rise and access to medicine in turn will decrease. If a patent is granted for Zmapp, for example, the company will charge a high price, and other companies will be prevented from producing other versions: price gouging for profit by the big pharmaceutical companies.

During the avian flu outbreak in Asian countries a few years ago, the Indonesian health authorities were angry when a global drug company proffered vaccines at high prices. It turned out that the vaccines had been made with the content of influenza virus samples that Indonesia had freely supplied through a World Health Organisation influenza scheme.

Economically, the outbreak is devastating for the countries affected. The numbers have not yet been calculated on the cost to the health care systems, training, testing, waste disposal and all the hospital beds sitting unused in isolated areas.

There is also the danger of economic isolation: “By default or design, it really is an economic blockade,” said the Sierra Leone finance minister about his country, which has all but been cut off from the outside world. Interestingly, shares in airline stocks have fallen as investors began to panic about the potential travel bans for airlines from West Africa to the EU and US.

We live in one world; globalised air travel only serves to confirm it. The response to this growing crisis by the rich nations will reveal if they too see we live in one world. So far their response is a disgrace. Just $18 million from Australia, and a refusal by the government to organise medical assistance teams and specialist personnel such as doctors and nurses to go. On the other hand, countries such as the US and Australia are extremely adept at mobilising for war.

Perhaps the Abbott government’s next three word slogan will be “Stop the planes”.

Next article – Refugee policy unethical for doctors

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