The messages emerging from people dealing with the Ebola outbreak on the ground in west Africa are becoming more hair-raising by the day. Here’s the World Health Organisation’s assistant DG:
[It] is a scale that I think has not ever been anticipated in terms of an Ebola outbreak.
And here’s MSF’s emergency coordinator on the ground:
The number of patients we are treating is unlike anything we’ve seen in previous outbreaks. This is not an Ebola outbreak, it is a humanitarian emergency and it needs a full-scale humanitarian response.
For a good overview of the situation, this Foreign Policy article pulls no punches, stating bluntly that “you are not nearly scared enough about Ebola”, and also making the key point that the humanitarian impact of the outbreak extends far beyond those actually exposed to the disease:
I myself have received emails from physicians in these countries, describing the complete collapse of all non-Ebola care, from unassisted deliveries to unattended auto accident injuries. People aren’t just dying of the virus, but from every imaginable medical issue a system of care usually faces.
So what of the “full scale humanitarian response” that MSF says is necessary? Well, the World Health Organisation has just published an Ebola road map (pdf) that sets out detailed cost estimates for what’s needed to strengthen the response and contain the outbreak.
Their headline cost estimate is that just under half a billion dollars is needed, of which nearly $400 million would be for countries currently experiencing “widespread and intense transmission”, with the rest for response measures in countries with initial cases or localised transmission and preparedness in neighbouring countries.
Compare that with what countries have actually pledged and you start to see why MSF are sounding so pissed off. The United States’ last funding announcement was for $5 million, bringing their total contribution since March to just under $20 million – less than 4% of what WHO say is needed. Britain, meanwhile, has contributed £5 million over the entire crisis. And as of last month, the UN’s Central Emergency Response Fund had given UNICEF and WHO the princely sum of… $235,000. (Compare this with the World Bank, which has pledged $200 million. But then, the bank is run by a medical doctor who has experience of infectious disease. Go figure.)
And what of NGOs other than MSF? No appeal has been issued by the Disasters Emergency Committee; at the same time, individual agencies are also keeping strangely quiet about the outbreak. Which is odd, because this isn’t just about humanitarian assistance – it’s also, as Kel Currah observed to me in conversation, a powerful opportunity for them to make the argument about why massive investment is needed to scale up entire health systems.
To return to a theme I’ve often blogged about before (most recently here on Eden 2.0), Ebola is a classic case of a shock that has the potential to open up a lot of political space to make the argument for doing more to help developing countries – but it all depends on the right influencers being ready to move swiftly to make those arguments.