Leadership

5 ways to help stop Ebola

Daniel Runde
William A. Schreyer Chair in Global Analysis, Center for Strategic and International Studies (CSIS)
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It will take a vast and complex global coalition to defeat the outbreak of Ebola in West Africa, and the World Economic Forum has a particular contribution to make as a platform for communication and collaboration.

One of the central concerns of the Forum’s Outlook on the Global Agenda 2014 is a “lack of global leadership” – a void that the United States needs to fill. With its resources, significant share ownership in many development banks (including the IMF) and its airlift-and-assistance capabilities, the US is the forerunner in the race against Ebola.

So what is President Barack Obama doing about it? So far, he is sending as many as 4,000 troops to help construct emergency treatment facilities, in a gesture that could be an opportunity for bipartisan cooperation and US leadership, if the Republicans in Congress cooperate. But the US government response will not be enough on its own.

The Ebola outbreak is an unprecedented global crisis, and requires the US to lead a complex coalition of countries, as well as medical personnel (voluntary and paid), private-sector actors, multilateral agencies, and faith groups. After all, ending the crisis in Monrovia and Freetown means security in Miami and Madrid.

If West Africa is to get Ebola under control, it needs five things:

  1. More doctors and nurses from outside the region. Treating Ebola is extremely labour-intensive: it requires as many as four members of hospital staff to treat one patient, not to mention ambulance drivers, nurses, doctors, psychiatrists, burial teams and medical gear disposal teams. But universities in the US are preventing medical and nursing students from travelling to West Africa to help.
  2.  More personal protective equipment (PPE) for personnel on the frontline. The growing panic in the US has led to the hoarding of stockpiles of this equipment at US hospitals. Dupont makes one form of PPE, and is among the largest manufacturers globally. There are other manufacturers, but each version of the equipment requires slightly different protocols in terms of how to put it on and dispose of it.
  3. Continuing economic aid from multilateral development banks. Economies and societies affected by Ebola have ground to a halt: schools are empty, banks and markets are closed, mining operations have been shut down. Funding is needed to revive trade and make sure the outbreak does not lead to socio-economic collapse.
  4. The world’s media must avoid creating the impression that “we are well on our way to defeating Ebola”. We are not. The number of cases is hard to tally, especially in rural areas where increasing stigma around the disease and the refusal of some insurance companies to pay for the burial of Ebola victims (having classified their death as an “act of god”) leads people to lie about having the virus.
  5. Faith leaders of all creeds need to engage their faithful. They must encourage communities to face their fears, and make clear that Ebola is not a result of sin, as some have claimed, but a virus that requires adherence to strict hygiene measures.

A global coalition

We should not underestimate the seriousness of Ebola, and the need for a coordinated response. If it isn’t defeated in West Africa, millions of people could die and massive uncontrolled movements of people could be triggered. It could lead to the economic collapse of a number of states and the global transmission of a deadly disease.

With a 50-70% death rate, Ebola is extremely lethal. Avian flu has a death rate of only 3%. It is thought that around 14,000 people have Ebola today, and this is widely recognized as an underestimated figure. In a worst-case scenario, the number could explode to 1.4 million by early 2015, according to the US Center for Disease Control.

Ebola was first identified in the 1970s, a virus mostly affecting rural areas. But increasing urbanization in Africa has allowed for greater levels of transmission, and made it harder to track down and isolate the people who become infected. There is no current vaccine or cure.

Solving Ebola requires a “70/70” approach: this means finding and isolating 70% of those infected, and carefully burying 70% of those who die from the virus in a way that will prevent it from spreading. In this approach, different actors have different responsibilities, but they will all have to be networked and coordinated if they are to meet these targets.

First-world response

First and foremost, the US Congress should pass Obama’s emergency bill to fund an Ebola response as quickly as possible. There continues to be a shortage of doctors, nurses and other emergency professionals in the field; and the US and other developed nations need to encourage as many trained doctors and nurses to join the fight.

The fears of the wider US public are understandable, but the government can’t answer them with travel bans and quarantines, as this stops medical personnel and supplies getting to where they are needed most. The US military has been deployed to build 17 health facilities, each with 100 beds, although there is some discussion about reducing this number and building long-term health infrastructure instead. Facilities treating 1,700 sick people could require as many as 6,800 personnel, if the 4:1 personnel-to-patients ratio holds. Many, many more people will be needed.

The role of the press

The media must be aware of the narrative it creates around the Ebola outbreak, and cannot sound the all clear prematurely. Even with positive developments, such as President Ellen Johnson Sirleaf recently announcing an end to the state of emergency in Liberia, the global Ebola coalition needs to vigilant and active. Disease tracking in rural areas is patchy at best, and the incentives to not report or underreport are increasing. The problem could still be more serious than we realize, and could spiral out of control without continued focus and resources from the international community.

By issuing information on Ebola’s transmission, infection and early symptoms, the media could play a role in raising awareness and understanding. It could also offer a call to arms for the world’s medical professionals, helping to recruit them to affected areas. Finally, the press could highlight the work of religious leaders who disseminate accurate information about the virus and promote effective hygiene. Engagement with these leaders and their communities has been shown to have real impact.

What businesses can do

Charitable contributions are not necessarily the priority; instead, business innovation, business operations and skilled volunteers are more urgently needed. As well as more protective equipment, West Africa needs a renewed focus on technological innovation and research into vaccines and cures. This is already underway, and should be accelerated.

Cash donations are welcome, but medical staff and airlift services are more practical. Airlines are important, too: there has already been a marked decrease in flights to the three countries most affected by Ebola, but travel is necessary as it keeps these countries connected to the rest of the world. Mining and agribusiness, both critical for a number of West African economies, should also explore ways to restart operations on the ground.

Pastoral care

The role of religion is often overlooked in secular societies, in the West and elsewhere. Health professionals need to work with faith leaders on the ground to comfort the dying and replace fear and superstition with facts. Also, the thousands of Ebola orphans are going to require faith communities to take them in.

More about Ebola
Why travel bans won’t stop the virus
Why do some people survive?
How to help a post-viral West Africa
The ethics of fighting Ebola

Author: Daniel Runde holds the William A. Schreyer Chair in Global Analysis and is the director of the Project on U.S. Leadership in Development at the Center for Strategic and International Studies.  Daniel is also a member of the World Economic Forum’s Global Agenda Council on the United States.

Image: Volunteers of German army Bundeswehr, wearing protective suits, are seen during an Ebola training session at the Marseille barracks in Appen, October 23, 2014. REUTERS/Fabian Bimmer

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