Do you remember the Ebola Crisis? probably not until you read the title of this essay. Yet, in 2014 the outbreak of the Ebola virus in West Africa reverberated fear across the globe, sparking worldwide concern over the severity and potential proliferation of the disease beyond the borders of sub-Saharan Africa. Despite its discovery in 1976 and its relative dormancy as a significant national or international health concern for a number of decades, the reemergence of Ebola resulted in over 10,000 deaths (WHO, 2018) and crippled further the reputation and socio-economic environment of many African countries. Particularly devastating in Guinea, Liberia and Sierra Leone, Ebola threatened to become an epidemic of monumental proportions, and eventually surfaced in Europe and the United States. However, the widespread media attention and global apprehension towards Ebola gradually fizzled out following its containment in 2016. Yet, little reflection has been given to the thousands of individuals infected and suffering from the ruinous effects of the disease several years after the outbreak, or given to the societal impact Ebola has had on our world.
The spread of the Ebola virus
Firstly, the rapid escalation of the Ebola virus – especially in West Africa, demonstrates that least economically developed (LEDs) countries within sub-Saharan Africa are incredibly ill-equipped in counteracting the outbreak of potentially deadly diseases. Owing to the poor structural conditions in Guinea, Liberia and Sierra Leone, public health systems were simply inadequate in diagnosing, and ultimately addressing Ebola from the outset. While poor political systems played a factor, this was also undoubtedly influenced by the ineffective policy regimes of international lenders in sub-Saharan Africa, including the World Bank and the International Monetary Fund (IMF). ‘Structural adjustment’ has imposed strict conditionalities on governments across the continent in order to meet debt repayments and to provide additional access to loans, restricting the availability of resources for basic public services – including the provision of healthcare.
The poor institutional capacity in the worst effected areas helped in delimiting the national responses to Ebola, with dysfunctional health systems not only providing inadequate services for communities, but also being a source of infection themselves. In stark contrast, Ebola was quickly eradicated in Western Europe and the United States as a result of the effective and extremely secure public health measures in place in response to viral haemorrhagic fevers (such as Ebola). There were only seven suspected cases of Ebola in these areas, with only one fatality. This is in comparison to over 28,000 cases of Ebola in sub-Saharan Africa between 2014-2016, with over 39% of cases resulting in death. Although the national response in other sub-Saharan African countries should be heralded – particularly in Nigeria where localised interventions were particularly effective (Saxena, 2014), Ebola had a calamitous impact on Guinea, Liberia and Sierra Leone, who were already struggling to recover from the effects of civil war.
The international response
The weaknesses in the domestic response to Ebola in sub-Saharan Africa was further exacerbated by the initial indecisiveness of the international response to the outbreak, which not only failed to understand the extent and the seriousness of the disease, but also lacked potency in coordinating an effective, collaborative response before its rapid escalation. The World Health Organisation (WHO) admitted that budget restrictions, political appointments and competing health crises resulted in the African Regional Office becoming the weakest of the WHO regional offices at a technical level, with several aid workers and experts blaming the organisation for failing to prevent the outbreak from become an epidemic (Jose M. Martin-Moreno, 2014). Moreover, although Ebola had potentially dangerous consequences for European countries, the EU were also sluggish in mobilising human, financial, medical, and military resources in the regions worst affected (GianLuca Quaglio et al., 2016).
With that said, the role of NGOs – especially Médecins Sans Frontières (MSF) played an incredibly important role in managing logistics on the ground during the initial phases of outbreak, as well as campaigning for greater involvement by international actors as the Ebola crisis intensified. Their work not only supported local efforts in reducing the spread of the disease, but it also raised global awareness and forced international actors into action in sub-Saharan Africa. This eventually resulted in the United Nations, the African Development Bank, the African Union, and the World Bank, as well as a whole host of other international organisations, governments, and individuals providing millions of dollars in financial aid and other forms of support. Furthermore, the excessive media attention following the outbreak of Ebola also increased public consciousness, which further helped in galvanising international attention and cooperation between external organisations and affected countries (José Joaquín Mira, et al, 2015). However, it may have also strengthened the less-than-desirable perceptions of Africa as a haven for ‘exotic’ diseases, and entrench the negative, insolvent images of the continent.
Today, survivors of Ebola continue to suffer from a variety of health issues despite the end of the epidemic over a year ago, including visual problems, abdominal and epigastric pain, insomnia and headaches (GianLuca Quaglio et al., 2016). For those individuals and communities who have perished and continue to live with the destructive effects of Ebola, it is important that the world takes a step back to reflect on outbreak and remind ourselves of the humanity of inhabitants in the poorest areas of the world. In the future, the weak institutional capacity across poorer sub-Saharan African countries must be improved and supported both by national and multilateral actors and organisations in attempt to redress the many failures during the Ebola crisis, and build upon the cross-border partnerships in anticipation of future public health crises. In a world where information, technology and societal values are becoming more widely dispersed and inclusive, it is time that we consolidate and fortify our global approach to local problems.