Ebola virus: Public health a big challenge

ebola-patientThe death toll from the recent outbreak of Ebola virus in West Africa, which began in March 2014, is now over 900. Initially the disease spread was slow; however during the end of July, within a span of two-three days, more than 50 to 60 deaths have occurred indicating the gravity of the situation and an urgency to respond quickly. The World Bank has announced allocation of USD 200m as emergency assistance for West African countries to contain the Ebola outbreak. Initially the spread of the virus was restricted to states like Guinea, Liberia and Sierra Leone. The disease has now engulfed more states with infections rising sharply. The World Health Organization (WHO) is constantly monitoring the situation and has called for concentrated efforts by all. Currently, the Red Cross, United State’s Center for Disease Control (CDC) and few European Union and African agencies are providing both technical as well as financial support to tackle this threat.

This virus was first identified in the 1970s and its initial symptoms are similar to flu or the common cold but over a period of time advances to vomiting, upset stomach, organ failure and bleeding. During the last four decades there have been dozens of Ebola outbreaks, mainly in Central and East Africa. The rate of fatality has been around 55 per cent of the infected cases. Ebola is not spread through casual contact but is highly contagious; the deadliest strain of this disease can kill up to 90 per cent. Unfortunately, no medicine has yet been found for curing this disease nor any vaccine is available to stop its spread. While a good number of health workers are assisting authorities in Africa to handle this threat but more than 50 doctors have died in the process of controlling this outbreak.

Compared to the cases in the past this time the disease spread has been quick and has rapidly covered a wide geographical span. There could be many reasons for this. One, this time the disease is found to be prevalent more in cities suggesting clearly that a vast number of people undertake intra and interstate travel. Two, it may be true that owing to the nature of the disease, the exact identification took time, which unknowingly allowed the spread of the disease. Three, the present virus is the most deadly strain in the Ebola virus family and the disease appears to be contagious. Four, in certain parts of Africa panic among local communities lead to attacks on health workers and the process of ‘isolation’ stands hampered. In the absence of any known treatment, the medical aid administered is only in the form of a supportive therapy to control the deterioration of health.

Various countries have already started putting systems in place to guard against any likely impact of this disease. Obviously the immediate threat is expected from the airline travelers from the African region. Some airlines have already stopped their flight operations to a few places in Africa. Also, a few states have started undertaking “passive screening” at various international airports for passengers returning from the affected African countries.

As per reports, there are around 45,000 Indians staying in the region infected by the Ebola virus. India has largely taken a mature approach while dealing with the problems of Indian population working abroad. The 1991 Gulf War is a good example. During recent times, India has successfully evacuated its workers in places like Libya and the nurses kidnapped by the ISIS in Iraq. However, if the severity of the Ebola spread increases then it likely to pose a real challenge for the government. The real ‘test’ will be whether to allow infected Indians back into the country. On the one hand it would be inhuman to allow Indians to be left stranded and suffer but at the same time to allow the patients entry to India would risk spreading the disease in the country.

Broadly, the Indian community in Africa could be divided into three groups: Indians’ working in Africa, people of Indian origin with strong family links in India and Indian troops who are part of various United Nations peacekeeping missions. Currently, India has its own troops (military+police) deployed in Ebola infected places like Liberia, Ivory Coast, etc. India’s diplomatic and economic engagement with Africa is growing and one of the reasons for this is India’s dependence on Africa for the supply of strategic minerals (from cobalt, fluorite to iron ore, etc). For example, in case of Liberia the overall bilateral trade has seen substantial rise during last few years with a current value of USD 280.31. Also, there are about 150 Indian companies (small and medium) operating in Liberia, ranging from small trading firms to medium manufacturing enterprises. Companies like ArcelorMittal and Vedanta have strong presence. Since, the present spread of disease over the African region has not yet acquired a humongous scale, it could be premature to discuss the possible impact of the outbreak of Ebola virus on the economy. However, it needs to be appreciated that forecasting the nature of health emergencies arising from infectious diseases is a difficult task and hence states should factor in various possibilities and ‘worst case scenarios’ in their planning. Normally, it is expected that the tourism sector could become the immediate victim of such disasters.

As per the reports, India’s health ministry has a plan in place to deal with such possible emergencies. It is important to keep such plans ‘dynamic’. It is equally essential for the government agencies to use the social, electronic and print media constructively and ensure that no unnecessary situations of panic and rumour mongering are ‘constructed’. The government should immediately engage the biotechnology sector and various associated governmental agencies to undertake research on Ebola vaccine development. Any possible breakthrough could be of great help to humanity. In the past India has handled heath challenges like SARS and Bird Flu successfully. There is a need to establish a central agency which could effectively coordinate all concerned organisations and remain ready for any possible contingencies.

The views expressed in this article are solely those of the author. 
(Courtesy: IDSA)

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