How to Beat Ebola

Ebola is a frightening disease. It spreads from person to person through contact with bodily fluids, and symptoms include vomiting, diarrhoea and bleeding. It has an average fatality rate of 50 per cent if left untreated. (Covid-19 has a crude fatality rate of 2.7 per cent.)

First detected in 1976 in a village near the Ebola River in the Democratic Republic of Congo (then known as Zaire), the disease is believed to have a zoonotic origin (probably fruit bats). But colonial extraction and chronic dispossession in recently independent nations were also among the causes, as they contributed to a lack of preparedness for emerging epidemics.

There have been several Ebola outbreaks in both West and East Africa over recent years, often straining local health departments. But with nationwide public health funding, political stability, vaccine trials and intra-African co-operation, it’s possible for a country to contain an outbreak of the disease and recover quickly from it.

When the Ugandan Health Ministry reported an Ebola case on 30 January this year – the country’s eighth outbreak since 2000 – they were neither surprised nor unprepared. Patients were treated at Mulago National Referral Hospital and Mbale Regional Referral Hospital. Health officials worked with locally trained physicians and co-ordinated with other African doctors as well as some international non-profit organisations. More than two hundred people who had contact with Ebola sufferers were quarantined, and their cases followed up. On 3 February the Ugandan Health Ministry and the World Health Organisation began a clinical trial for a vaccine targeting the Sudan variant of the Ebola virus. The lead researchers are from Makerere University and the Uganda Virus Research Institute.

Uganda declared the outbreak over on 26 April. In total there had been fourteen reported cases, of whom four died and ten fully recovered. It was a public health victory which showed that Africans could co-operate to end an epidemic on their own terms.

The Trump administration’s dissolution of the United States Agency for International Development (USAID), reducing the organisation to fifteen staff and eliminating over 80 per cent of its programmes – including initiatives for the humanitarian response in Sudan and HIV/Aids medication – has worsened health conditions for some of the most vulnerable populations in the world. In 2014, when a large Ebola outbreak swept through West Africa, the US allocated $8.3 billion for global health, including funds for maternal health, HIV/Aids, malaria and tuberculosis. (To put that sum in context, the US Defense Department’s discretionary budget for 2014 was $615 billion.) But some public health initiatives in African are now managing without American funds.

‘It is necessary to examine the internal factors which make our continent so vulnerable to attack,’ Kwame Nkrumah wrote in 1968, ‘and particularly to look closely at the whole question of African unity. For this lies at the core of our problem.’ In 2016, the Africa Centres for Disease Control and Prevention was set up as ‘a continental autonomous health agency of the African Union established to support public health initiatives’.

Dr Jean Kaseya, the Africa CDC’s director general, holds weekly press briefings online. As Dr Mosoka Fallah, the organisation’s acting director for science and innovation, told Forbes Africa last month, ‘it’s about getting to the community, hearing from them, making them a part of the co-creation of the messages.’

More than anything, perhaps, it seems that African public health experts are trusting science. The US government could learn something from them.