Ebola. Black death of the 21st century

Analyse of the Ebola epidemic 2014

Seminar Paper, 2014

7 Pages


Ebola is a viral disease caused by several viruses
and the disease is known as Ebola hemorrhagic
fever. Humans are not the natural host for it
and can not be carriers. Infection is contracted
by contact with carrier animals in different
ways. Humans become infectious during the
sickness period especially in crowded places and
where culture embraces close body contact
with family and friends as the disease spreads
by body fluids. Generally Ebola is not a disease
that might lead to an epidemic due to several
reasons, the fact that there are no human
carriers, the replication time of the Ebola virus
makes its transmission rate limited to 1.8% and
normally it kills the host before it spreads. What
led to this epidemic becoming the largest of
Ebola is the question to answer (PHMS, 2014).
Sierra Leone is a small country located in West
Africa. Inhabitants are estimated to be around 6
million by the united nations in 2012. In terms
of human development, Sierra Leone is ranked
in the Human Development report (HDI)
among 187 countries included, in other words,
one the worst countries ranked (UNDP, 2013).
Health system within Sierra Leone is not well-
structured and with high out-of-pocket
expenditure, life expectancy on the other hand
is one of the lowest worldwide with 45.3 years
at birth (World Bank database, 2013).
in Sierra Leone pushed people to work
in the agricultural investments, as
they have huge rainforest and
Savannah which allowed more contact
with the host animals -mostly fruit
bats- and led to the spread of disease
within that slice of community at the
beginning (PHMS, 2014).
We live in a time in which issues needed to be
dealt with are not limited to one area, have
growing intensity and extensity in relation to
crossing geographical borders, yet the collective
approaches to solve them are weak and
incomplete, with the difficulties encountered
are mainly due to the anemic problem-solving
capacities at global and regional levels, mostly
due to structural complexity that hinders urgent
responses and policy-setting in reaction to
global emergencies (Held, D., 2008). The lack of
ownership of problems at global level, for

example now after the Ebola outbreak the WHO
stated that "it is technical body, and the
responsibility lies first on the countries to
protect their citizens", yet they are not the ones
to blame. All of this is mainly due to lack of clear
global governance structure, "a ship with more
than a leader sinks" (Gostin, L. O., & Friedman,
E. A., (2014). On the contrary, countries in
which the epidemic has started are poor, and
the life expectancy at birth is considered to be
of the lowest worldwide, this indeed reflects
the poor health status in general and the health
care system within, which means that the
governments aren't taking their "assumed role"
as mentioned by the WHO, and if we are to
improve the social determinants of health,
governments of those countries must assume
their role and take action in population
protection and human rights provision including
health (Gostin, L. O., & Friedman, E. A. 2014).
The world has witnessed many Ebola outbreaks
in the past, all of which originated in Africa, in
Uganda, Sudan, Zaire and other countries, but
why has there been no movement in regard to
prevention of further outbreaks, why has there
been no advance in research for vaccination or
treatment for Ebola?
The development of international organizations
and global health actors was introduced as a
means of solving the problems faced by traders
and merchants due to health-related issues
faced when national policies were the way to
face infectious diseases which cross borders, in
other words, health improvement has always
been a by-product of economic benefits and not
the priority, some scholars even argue that
WHO was the fruit of the merchants pushing on
their governments (Fidler, D. P., 2001). so is the
reaction late because of the lack of incentives
and undermining of its effect on the global
In this epidemic the first cases were recorded in
Guinea in December 2013 and then it started
spreading to Liberia and Sierra Leone (Periods,
K. T. 2014), while the first roadmap set by global
actors was published in August 2014, eight
months after the cases recorded in Guinea,
which shows a clear belated response to the
emergency. The fact that the efforts on global
level are belated hinders the successful
international cooperation, a factor -amog
others- that led to the relatively huge spread of
such a disease (Fidler, D. P., 2001).
Ebola is currently a living example indicating
Global governance malfunction, which signifies
the need to face the problems of the framework
upon which global health governance can be
built, and the need to define leadership and
authority. Of course economic barriers and
resources are the major issues to be solved -for
what the director general of WHO mentioned
about cutting its budget, which had an effect on
emergency response department in the
organization- and by definition, how can states
work together in a cohesive way to achieve the
results aimed at (Dodgson R. Lee, K. and Drager,
N., 2002).

Ebola can be fought by the immune system of
humans' body, yet the effective response is
delayed ­Hypersensitivity reaction type 4- and
takes a few weeks to develop. A functioning
immune system needs good general health in
order to respond, and this is related to other
determinants of health like nutrition and
general fitness. Poverty rate in Sierra Leone is
52.9% (WBD, 2014). On top of that comes
illiteracy and cultural behaviors which together
create a good environment for Ebola to spread
and make management of patients more
difficult(Farmer, P., 2008).
When conditions above are combined with
anemic healthcare system in Sierra Leone, such
a disease ­although not highly contagious- cant
be controlled or managed properly. Ebola, until
today, has no cure and its management is only
supportive, which means patients are treated
symptomatically until their body is capable of
fighting the disease, in Sierra Leone there are 2
nurses per 10,000, of course less physicians -
due to brain drain-, and distant health facilities
makes this supportive management not
expected to be delivered, or at least not in a
proper way (World bank database, 2014). This
shows the gap in global governance and the
poor prediction of and prevention of such
disasters. Ebola is a lesson for the future ­
because due to globalization and
interconnectedness of the world, diseases don't
know borders anymore ­, healthcare systems
must be strengthened globally to be able to
cope up with such disasters and prevent
outbreaks (Fryatt, R., Mills, A., & Nordstrom, A.,
2010). A clear example of the capability of
proper healthcare systems to contain outbreaks
is the US system, one case was diagnosed, two
locally infected but no further spread, on the
contrary, more than 9,000 have been affected
in Africa with a mortality rate of approximately
50 % (CDC, 2014).
Realistically, this cant be done by each state
alone, or public sectors alone, as huge amounts
of money should be shifted to meet the needs
of strengthening healthcare systems, so it must
be a collaborative work on different levels,
national and global, public and private, all must
contribute to this goal (Fryatt, R., Mills, A., &
Nordstrom, A., 2010). At Alma-Ata it was agreed
globally on the principle of health as a human
right and the concept of Primary Health Care
which basically aimed at improving healthcare
systems in states, funds were raised for that
purpose and the world had one vision (Chan,
M., 2008), yet with the emergence of the World
Bank as a global power, and some of the
international health actors, WHO started to
have diminished role in terms of leading the
world health. Recommendations from the world
Bank ­which was clearly against Alma-Ata
outcomes (Lister and Labonte, 2009) ­to
privatize health service provision was adopted
by most of the countries, and the shift from
strengthening the health systems to vertical
programs, which led to stasis of health systems
with no or slight improvement. The world ­
Excerpt out of 7 pages


Ebola. Black death of the 21st century
Analyse of the Ebola epidemic 2014
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Abdalla Ibrahim (Author), 2014, Ebola. Black death of the 21st century, Munich, GRIN Verlag, https://www.grin.com/document/283800


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