The U.S. government recently announced the largest global public health campaign to date in hopes that this unprecedented effort will help to control and end an unprecedented outbreak of Ebola. Since the outbreak was recognized in March of this year, the U.S. has spent over $100 million to provide support to the affected West African countries. The White House announced four key goals to enhance these efforts: (1) control the epidemic in West Africa, (2) mitigate the ripple effect of Ebola on the political, economic, social and other systems in the region, (3) engage and coordinate a broader global response, and (4) fortify global health infrastructure in West Africa and other vulnerable regions of the world.
To facilitate these goals, the U.S. military will provide expertise in control, logistics, training and engineering. New treatment facilities and isolation units will be built, providing over 1,000 additional beds. The U.S. will expedite distribution of needed personnel, medical supplies and other aid by air and ground. A site will be established to train up to 500 health care workers per week. In addition, USAID is supporting a Community Care Campaign to provide over 400,000 households with home health care kits and information on how to protect themselves and their families.
The big question on everyone’s mind: will this gallant effort be effective? While hopes are high, it is important to consider why this outbreak spiraled out of control in the first place. This is the first time West Africa has seen Ebola. The local health infrastructure has been devastated by decades of overwhelming conflict and violence, to the point that most families must care for their sick at home. Suddenly, people dressed in what has been described as “space suits” come knocking door-to-door asking to haul away the sick, many of whom do not return. This has added to an existing mistrust of outsiders and rumors that Ebola is not real and that strangers have malicious intentions. In order to protect themselves from the threat they perceive, the sick run away, crossing borders and bringing Ebola with them. Families hide their ill loved ones so that they are not carted away, never to be seen again, and the disease spreads among the locals. This makes it very difficult to trace Ebola case contacts, which is critical in stopping the virus from spreading.
There is no doubt that the additional infrastructure, trained health workers, hospital beds and supplies are desperately needed in West Africa. But it seems the key to stopping the outbreak lies in the ability of the Community Care Campaign workers to effectively communicate with the locals. Solving this problem will absolutely require the cooperation of the communities who are afflicted. The only way to do this will be to build trust, something that usually requires the development of a relationship over time. But time is now a precious resource. The U.S. has committed to an enormous undertaking and hopefully with the help of other nations around the world the spread of Ebola will be stopped.
However, we must remember that there will be other outbreaks. Not just of Ebola, but of other contagions, as well. Will we be prepared next time? The fourth goal of the U.S. government’s plan, which is to fortify global health infrastructures, addresses this point. It is not just West Africa with a fragile, insufficient and vulnerable public health system. We need to make sure that every area of the world with weak infrastructure has resources and information, and that the world will be ready to respond to an unexpected crisis.
The U.S. cannot do this alone. On Tuesday, President Obama stated that “the world has a responsibility to act — to step up, and to do more.” In addition to stopping and preventing deadly scourges such as Ebola, let us hope that the world will notice that these communities have lived with the constant scourge of neglected tropical diseases. These diseases devastate communities, and even when they do not kill, they disfigure and disable their victims. Over one billion people worldwide are infected with at least one of these maladies. It is time that the U.S. and the world step up and do more, especially for those suffering from debilitating conditions, such as Ebola, Chagas disease, intestinal worm infections, lymphatic filariasis (elephantiasis) and many other conditions that have long been neglected.
Jennifer R. Herricks, Ph.D., is a postdoctoral fellow in disease and poverty at Rice University’s Baker Institute for Public Policy and the National School of Tropical Medicine at Baylor College of Medicine. Her research focuses on the relationship between poverty and disease, especially neglected tropical diseases.