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West Africa's Ebola Death Toll Continues to Climb: WHO
The international body has now confirmed nearly 20,000 infections in Liberia, Sierra Leone, and Guinea
Dec 20, 2014
The Ebola death toll in the three West African countries most impacted by the virus has climbed to at least 7,373 of 19,031 known infections, the World Health Organization revealed in data released Saturday.
Western Sierra Leone is the "hotspot" of the ongoing outbreak, according to the WHO, which notes that this country has the highest infection rate, followed by Liberia and then Guinea.
However, Liberia accounts for far more Ebola deaths, leading some to question the accuracy of the WHO's statistics on infection rates.
Nonetheless, the data shows an increase in overall cases, which are up by 500 since WHO data was last released on December 17.
The numbers were released following news Friday that Sierra Leone's top-ranking doctor had succumbed to Ebola, making him the 11th of the country's 120 doctors to die from the disease, according to the Guardian.
Meanwhile, humanitarian aid workers have criticized the global community for its failure to respond adequately as West African governments and grassroots initiatives such as the Citizens Alliance to Stop Ebola in Liberia struggle to stem the ongoing emergency.
"The international response to the Ebola crisis in West Africa has been slow and uneven leaving local people, national governments and non-governmental organizations (NGOs) to do most of the practical, hands-on work," the NGO Doctors Without Borders//Medecins Sans Frontieres declared earlier this month.
The lackluster global response comes despite the fact that Western-driven economic policies played a key role in gutting West African public health systems.
"People are still dying horrible deaths in an outbreak that has already killed thousands," said Dr. Joanne Liu, MSF international president. "We can't let our guard down and allow this to become double failure, a response that was slow to begin with and is ill-adapted in the end."
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US Proposes Major Debt Relief for Ebola-Hit Countries
Nov 14, 2014
WASHINGTON - The United States proposed this week that the international community write off $100 million in debt owed by West African countries hit hardest by the current Ebola outbreak. The money would be re-invested in health and other public programming.
U.S. Treasury Secretary Jack Lew will be detailing the proposal later this week to a summit of finance ministers from the Group of 20 (G20) industrialised countries. If the idea gains traction among G20 states, that support should be enough to approve the measure through the International Monetary Fund (IMF), where the United States is the largest voting member.
"The plan is for that money to be re-invested in social infrastructure, including hospitals and schools ... to deal with the short-term problem of Ebola but also the long-term failure of the health systems that allowed for this outbreak." --Jubilee USA's executive director Eric LeCompte"The International Monetary Fund has already played a critical role as a first responder, providing economic support to countries hardest hit by Ebola," Lew said in a statement to IPS.
"Today we are asking the IMF to expand that support by providing debt relief for Sierra Leone, Liberia and Guinea. IMF debt relief will promote economic sustainability in the worst hit countries by freeing up resources for both immediate needs and longer-term recovery efforts."
These three countries together owe the IMF some 370 million dollars, according to the U.S. Treasury, with 55 million dollars due in the coming two years. Yet there are already widespread fears over the devastating financial ramifications of Ebola on Guinea, Liberia and Sierra Leone, in addition to the epidemic's horrendous social impact.
Last month, the World Health Organisation warned that the virus now threatens "potential state failure" in these countries. The World Bank, meanwhile, estimates that the virus, which has already killed more than 5,000 people and infected more than 14,000, could cost West African countries some 33 billion dollars in gross domestic product.
Of course, much of the multilateral machinery is often too cumbersome to respond to a fast-moving viral outbreak. Yet there is reason to believe that the U.S. plan could have both immediate and long-term impacts.
That's because the plan would see the IMF tap a unique fund set up in the aftermath of the 2010 Haiti earthquake, which facilitated the cancellation of nearly 270 million dollars of Haitian debt to the IMF. Called the Post-Catastrophe Debt Relief (PCDR) Trust, it is aimed specifically at responding to major natural disasters in the world's poorest countries.
Originally, the PCDR Trust was capitalised with more than 420 million dollars. Today, a U.S. Treasury spokesperson told IPS, the trust has some 150 million dollars in it - money that would be available almost immediately.
"Our proposal is for the IMF to provide debt relief for these Ebola-affected nations from this trust," the spokesperson said. "The U.S. would like to see around 100 million dollars put toward this effort, however the precise amount will need to be determined in consultations with the IMF and its membership."
The IMF, meanwhile, says it is preparing to consider the proposal. In September the Washington-based agency made available 130 million dollars in immediate support to Guinea, Liberia and Sierra Leone.
"We are very glad that some donors have expressed an interest in increasing support for the Ebola-affected countries. We are reaching out to all donors to see how we might be able to take this forward ... using all the tools available to us," an IMF spokesperson told IPS.
"[Debt relief] decisions are made according to the merits of the particular case and this would be approached in the same way. We would expect the Board to be briefed soon on this topic."
Ebola's "natural disaster"
For development and anti-poverty advocates, debt obligations on the part of poor countries constitute a key obstacle to a government's ability to respond to critical social needs, both in the short and long term.
In the West African epicentre of the current Ebola outbreak, many analysts have held chronic low national health spending directly responsible for allowing the epidemic to spiral out of control. And when looking at feeble public sector spending, it is impossible not to take into account often crushing debt burdens.
For instance, Guinea spent a little more than 100 million dollars on public health in 2012 but paid nearly 150 million dollars that same year on internationally held debt, according to World Bank figures provided by Jubilee USA, an anti-debt advocacy network that has spearheaded the push for the United States to make the current proposal.
"As bad as Ebola has been, some of these countries have far greater challenges with deaths from malaria than from Ebola," Eric LeCompte, Jubilee USA's executive director, told IPS.
"The amount is incredibly important because it cancels a significant portion of the debt completely. And the plan is for that money to be re-invested in social infrastructure, including hospitals and schools ... to deal with the short-term problem of Ebola but also the long-term failure of the health systems that allowed for this outbreak."
LeCompte was also involved in the creation of the Post-Catastrophe Debt Relief Trust, in the aftermath of the Haitian earthquake. His office has advocated for the fund's monies to be used since then - for instance, to react to flooding in Pakistan and Typhoon Haiyan in the Philippines.
But he says these and other proposals have been rejected by the IMF's membership, on the rationale that these countries were developed enough to be able to mobilise financing in other ways. (The IMF says PCDR funds are for response to "the most catastrophic of natural disasters" in "low-income countries", when a third of a country's population has been affected and a quarter of its production capacity destroyed.)
Not only are Guinea, Liberia and Sierra Leone among the poorest countries in the world, but the Ebola outbreak there has a potentially direct impact on the rest of the globe.
"This is a very clear opportunity to point to the 150 million dollars left in that fund and to note that Ebola is every bit the same as the Haitian earthquake in terms of being a regional calamity," LeCompte says.
"The difference is that this is also a long-term investment in the very problems that allow Ebola to spread. So we'd be not only addressing the current issue, but also the next disease outbreak in that region."
It is unclear whether there is a mechanism in place to top up the PCDR Trust in the future. The IMF states that "Replenishment of the Trust will rely on donor contributions, as necessary."
But for his part, LeCompte says the fund has the potential to fill a significant gap: offering a pot of money, immediately available, that could be quickly mobilised to deal with true crises afflicting the world's poorest countries, from hurricanes to major financial defaults.
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Ebola Outbreak Threatens Food Crisis in West Africa
UNITED NATIONS - The widespread outbreak of Ebola in West Africa, which has resulted in over 4,500 deaths so far, is also threatening to trigger a food crisis in the three countries already plagued by poverty and hunger.
Dr. Shenggen Fen, director-general of the Washington-based International Food Policy Research Institute (IFPRI), told IPS the crisis is expected to be confined mostly to the countries directly affected by the spreading disease: Liberia, Sierra Leone and Guinea.
Oct 23, 2014
UNITED NATIONS - The widespread outbreak of Ebola in West Africa, which has resulted in over 4,500 deaths so far, is also threatening to trigger a food crisis in the three countries already plagued by poverty and hunger.
Dr. Shenggen Fen, director-general of the Washington-based International Food Policy Research Institute (IFPRI), told IPS the crisis is expected to be confined mostly to the countries directly affected by the spreading disease: Liberia, Sierra Leone and Guinea.
Asked whether the food shortages will also reach countries outside West Africa, he said Ebola is triggering a food crisis through a series of interrelated factors, including farmer deaths, labour shortages, rising transportation costs, and rising food prices.
"Within these countries, where undernourishment has long been a problem, the food crisis may persist for decades," he warned.
And because Sierra Leone, Guinea, and Liberia are all net food-importing countries, the Ebola-triggered food crisis is unlikely to spread to other countries in the region or beyond, Dr. Fan added.
Global food prices tend to have transmission effects on regional or national food prices, but for small markets (on a global scale) such as these three countries, the transmission effect of food prices is unlikely to pass beyond their own boundaries - so long as the disease itself is not transmitted, he said.
According to the latest figures released by the World Health Organisation (WHO), there are over 9,000 cases of Ebola, including 4,262 cases in Liberia, 3,410 in Sierra Leone and 1,519 in Guinea.
The death toll is highest in Liberia (2,484), followed by Sierra Leone (1,200) and Guinea (862).
U.N. Spokesperson Stephane Dujarric told reporters Monday the WHO has officially declared Nigeria free of Ebola virus transmission, after 42 days without a single case.
WHO called it "a spectacular success story that shows that Ebola can be contained".
"Such a story can help the many other developing countries that are deeply worried by the prospect of an imported Ebola case and are eager to improve their preparedness plans," he said.
Dujarric said the announcement comes only a few days after Senegal was also declared Ebola-free.
He said the trust fund set up by Secretary-General Ban Ki-moon to battle the deadly disease now has about 8.8 million dollars in deposits and 5.0 million dollars in commitments.
In total, 43.5 million dollars have been pledged and the secretary-general continues to urge countries to turn these pledges into action as soon as possible.
He expressed regrets over the Ebola-related death of a UN-Women staff member in Sierra Leone. His spouse is currently receiving treatment.
"All measures to protect staff at the duty station in Sierra Leone are being taken as best as possible under the current circumstances," Dujarric said.
This includes decontamination of the U.N. clinic, disposal of the isolation facility and contact tracing, he added.
In a statement released Tuesday, IFPRI painted a grim picture of the situation facing all three countries.
Schools in Sierra Leone have closed, shutting down critical feeding programmes for children. And restrictions on the consumption of bush meat, the suspected source of Ebola, have eliminated a traditional source of protein and nutrition from local diets.
"In addition, the costs of staple foods including rice and cassava are rising precipitously in the affected areas as crops are abandoned and as labor shortages grow," the statement added.
Food that would be imported from these areas is not making its way to other regions, either.
"So, as we weigh the dangers of this dreaded disease, we must not forget the very real threats it poses to food security," the group warned.
"The global community must come together to ensure that there are safety nets to protect not only those infected with the disease, but also those whose access to food is severely affected," IFPRI added.
Asked to identify these safety nets, Dr. Fan told IPS social safety nets are needed to protect not only those infected with Ebola, but also those whose access to food is severely affected.
These safety nets, which could be in the form of cash or in-kind transfers (context-specificity is important here), should be accompanied with nutrition and health interventions.
For example, a conditional cash transfer programme linked to health can help improve access to nutritious foods, particularly when prices are high, while promoting health service use, he added. "This is important, because investing in the nutrition and health of vulnerable populations could lower the mortality rate of diseases like Ebola, as nutritional status and infection are intricately linked."
In the post-Ebola era, Dr. Fan said, combined social protection and agricultural support interventions will be crucial to build resilience to future livelihood shocks.
Asked how many people will be affected by this impending food crisis, he said with Ebola claiming lives of thousands of people in Sierra Leone, Guinea, and Liberia, the mounting food crisis is impacting thousands more still.
Recent efforts by the World Food Programme (WFP) to provide food assistance to around 1.3 million people in these three countries indicate an idea of the scope of the current crisis.
The Food and Agriculture Organisation (FAO) is also providing food assistance to nearly 90,000 farming households to abate the food security crisis, he pointed out.
As the harvest season is beginning, labour shortages are putting the food security of tens of thousands of people at risk in particularly affected areas, he declared.
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What West Africa Can Teach the US About Ebola
Nigeria and Senegal have declared victory on Ebola even as healthcare workers in Texas contract it.
Oct 20, 2014
When the Texas Health Presbyterian Hospital missed a crucial diagnosis of the Ebola virus and released Liberian Thomas Eric Duncan to go home, it unleashed a sequence of events that is still unfolding rapidly.
As in the great AIDS panic, the introduction of the Ebola infection into the American populace has resulted in confusion, speculation, and hysteria. Even perfectly healthy individuals, such as American reporters who have been to the West African region, find themselves being shunned because of irrational fears.
For better or worse, the response of the authorities to this crisis will go down in history. Certain categorical declarations will particularly stand out--and in some cases return as painful ironies. As an example, in late July, Stephen Monroe--the deputy director of the CDC's National Center for Zoonotic Infectious Disease--stated, "Ebola poses little risk to the U.S. general population," adding that, "the likelihood of the outbreak spreading outside of West Africa is very low."
In an effort to tamp down fears over Ebola, CDC director Thomas Frieden asserted in October that "Ebola is scary. It's a deadly disease. But we know how to stop it." It is unclear whether the "we" refers to the CDC, health facilities more generally, or some other entity, but this firm and sweeping assertion was called into question as news broke of the first and then a second case of Ebola transmission to Thomas Duncan's caregivers at Texas Presbyterian Hospital.
Earlier this month, David Lakey, commissioner of the Texas Department of State Health Services, famously said of Dallas, "This is not West Africa. This is a very sophisticated city." Still not sophisticated enough, apparently, to prevent one fumble after another.
U.S. Lapses
The supposed "mystery" as to how these caregivers contracted Ebola when they were supposedly shielded from transmission by their personal protective equipment (PPE) is actually no mystery at all.
As a physician at a wound care center in Southern California, I go through 10 to 20 units of protective gear every day, one for each patient. A quick, self-administered test on removing my PPE revealed that I did it with less than 100 percent safety. It is, quite frankly, not easy.
With Ebola, even 99 percent safety is not good enough. Many hospitals in the United States use PPE for procedures such as wound repair and colonoscopies. And in many wards and intensive care units, healthcare staff don PPE for cases of MRSA or VRE. But not only does the care required in such "ordinary" protection pale beside the vigilance involved in Ebola exposure, the PPE itself is quite different.
So the answer to whether "we," as Frieden put it, know how to stop the virus here in the United States might well be a "no" at worst and a "sort of" at best.
Indeed, National Nurses United Executive Director RoseAnn DeMoro has claimed that there is an absence of any protocol at the Texas Presbyterian hospital on how to deal with the deadly virus. Other hospitals have opted for the World Health Organization's Ebola protocol instead of the CDC's because of its extra guidelines for hand sanitation.
The CDC poster for removal of PPE shows the use of only a single pair of gloves and appears highly lacking compared to the painstaking measures described by Australian nurse Sue Ellen Kovack at a Sierra Leonean Ebola treatment center. Of note in her account is the liberal dousing with a chlorine (or bleach) spray from head to toe, a chlorine hand rinse, hand washing at least eight times during the procedure, and the use of two pairs of gloves instead of just one as recommended by the CDC. On October 16, the CDC effectively admitted that its own guidelines were lax and has moved to the more exacting guidelines.
Ironically, rough-and-ready Ebola treatment centers like the tents constructed by agencies like Doctors Without Borders are much better equipped for safety procedures like the chlorine bath than many modern Western facilities. To do this in a technologically advanced U.S. hospital, separate alcoves would need to be built in designated spaces to accommodate a "spraying area." That could be extremely complicated in the average intensive care unit.
Learning from Africa
Perhaps we in the United States are learning a small lesson in humility.
Is it possible, for example, that Nigeria, of all places, might have some wisdom to convey to the United States? Both Nigeria and Senegal moved quickly to quell an Ebola outbreak through meticulous contact tracing, coordinated national action, exhaustive interviews, and activation of an Ebola Incident Management Center. Both countries are now reportedly free of the disease.
Although the story is not yet over, the U.S. government has lauded Nigeria's initial management of the outbreak. Indeed, the CDC has now ordered dozens of high-tech, infrared, no-touch thermometers to be used in screening procedures at U.S. gateway airports--the same ones that are already being used in West Africa.
David Lakey is right: Texas is not West Africa. But every once in a while, the West African example is worth following.
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Ebola and Islamic Extremism: An Ounce of Prevention is Worth a Pound of Cure
Although American officials are making lots of reassuring noises about screening passengers coming from West Africa for signs of the dreaded Ebola virus, the truth is that the only way to totally safeguard against the spread of the disease is to close our borders entirely. And I don't see that happening anytime soon.
Oct 11, 2014
Although American officials are making lots of reassuring noises about screening passengers coming from West Africa for signs of the dreaded Ebola virus, the truth is that the only way to totally safeguard against the spread of the disease is to close our borders entirely. And I don't see that happening anytime soon.
Talk about an unexpected side effect of globalization. Goods and services spread around the globe at the stroke of a keyboard or the roar of a jet engine, but the same mechanisms we celebrate as having pumped up the global economy also, potentially, have a darker side.
What was it Marx said about the bourgeoisie digging its own grave?
I keep hearing the undertone, in the media reporting on Ebola, of the "blame-the-victim" complaint, "What's wrong with these people? Why are they living in such poverty? Why don't they have doctors, nurses, hospitals? Look how their squalor is putting us all at risk?!"
There is truth to this. The poor folks in Liberia, Guinea and Sierre Leone, former colonies of the U.S., France and Great Britain, respectively, have not managed to modernize their societies. This is due to a number of factors, including corrupt leadership (strongmen often propped up by the Western powers), violent civil wars (armed by Western weapons manufacturers and distributors), and banana republic-style economies where Western corporations rule by extraction, extortion and exploitation, without giving anything back in taxes, infrastructure or education for the local people.
This is where the West has made its big mistake. How could we in the so-called developed world be so naive as to think that we could ignore the poverty and suffering of other parts of the globe without that poverty and suffering coming back to haunt us?
If we had invested in schools, medical facilities and housing in Liberia, instead of sending endless supplies of assault rifles and ammunition, we would not be worrying about Ebola now.
Likewise, if we had invested in education and economic development in the Middle East, instead of relying corrupt warlords to keep the population in line, we would not be dealing with a seemingly endless morphing insurgency of Taliban-Al Quaeda-Islamic State terrorists.
It really is true that an ounce of prevention is worth a pound of cure.
In a globalized society, pretending that vast disparities of wealth don't matter is just plain stupid. Imagining that a vicious virus can be contained by airport thermometer checks is as ridiculous as imagining that an international terrorist network can be stopped by a few fly-by bombings.
The world's leaders need to take a lesson from Malala Yousefzai, the 17-year-old girl who won the 2014 Nobel Peace Prize for her steadfast insistence, even after nearly having her head blown off by the Taliban, that girls should be educated.
Study after study has shown that when a society educates and empowers women, it becomes more economically successful and more politically stable.
This week, in my African Women Writing Resistance class, I've been reading and discussing the autobiography of Ellen Johnson Sirleaf, President of Liberia and first woman head of state in modern Africa.
Sirleaf, who won the Nobel Peace Prize in 2011, has been in the news a lot lately, begging for help in containing the spread of Ebola and warning grimly of the consequences of international inaction.
She came to office vowing to take her country back from the warlords and reintegrate child soldiers, to educate girls and boys and build a sustainable economy. She's made great strides, but the stark pictures of the pathetic state of the nation's health care infrastructure make it clear how far Liberia, like other poor African nations, still has to go.
The bottom line is this: if we want safety, we have to build towards it, step by step, from the ground up. We can't ignore poverty and then get mad when impoverished sick people dare to infect us, or when desperate people turn to radical Islam as a way out of their misery.
There is no excuse, in our globalized world, for the dramatic disparities of wealth and poverty that exist today. Those of us lucky enough to live comfortably in the U.S. or Europe should be using our privilege to advocate for those less fortunate.
Not just out of altruism. Out of self-preservation, too.
If we had been helping Liberia and other West African nations build good social infrastructure, instead of extracting profits from diamonds, rubber and gun sales, we would not be worrying about the spread of Ebola today.
If we had been educating children in Syria, Yemen and Iraq instead of supporting corrupt dictators and ignoring the plight of ordinary people, we would not be facing the spread of Islamic extremism today.
How many innocent humans will have to die before we begin to understand that simple adage? An ounce of prevention is worth a pound of cure.
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