Costing the impact of Ebola

The Ebola epidemic in West Africa continues unabated, with a death toll to date exceeding all previous outbreaks combined. The epidemic is not, of course, on the official agenda of the G20 Leaders’ Summit to be held on the 15th and 16th of next month in Brisbane, but no doubt it will be discussed on the sidelines.

As of 25th October 2014, the World Health Organisation (WHO) had reported more than 10,000 cases in eight countries, resulting in almost 5,000 identified fatalities. Where the clinical outcome of disease is known with certainty, a higher mortality of 70% is estimated. Case numbers could exceed 20,000 by early November, well beyond the projected capacity of current response efforts. In a worst case scenario, failure to contain the current outbreak could lead to Ebola becoming established as an endemic human infection causing ongoing disease in West Africa and beyond.

Image credit: WHO Ebola Response Roadmap Situation Report Update, 15/10/14

Image credit: WHO Ebola Response Roadmap Situation Report Update, 15/10/14

G20 finance ministers have identified the importance of a co-ordinated international response to Ebola. Non-government organisations are mobilizing public support to lobby G20 leaders to ramp up the global effort against this disease, emphasizing the need for timely provision of funding for medical supplies and personnel. The G20 Leaders’ Summit provides an opportunity to foster international co-operation to resolve the present crisis, and to identify and commit to resolving gaps in the current system for emergency health response.

The international response to Ebola has been late and fragmented. The World Health Organisation declared a global health emergency in August 2014, some five months after the epidemic was first recognized, with additional delays to development and mobilisation of a humanitarian response. Significant constraints on WHO’s budget have resulted in cuts to the agency’s emergency response capacity in recent years, with heavy reliance on rapid mobilszation of donor funds in the event of a crisis – slow to materialize on this occasion. The UN Security Council, recognizing the potential of this outbreak to reverse peacekeeping and development gains, unanimously called on member states in September for an all-sector response to support the region. A high-level emergency meeting convened by WHO on the 23rd October agreed that financing should not be a limitation to the accelerated development of safe and effective Ebola vaccines – funds will be found.

The World Bank estimates that the economic toll of Ebola in West Africa could exceed $32 billion by the end of 2015. Rebuilding fragile health systems with a decimated workforce will require long-term commitment well beyond any resolution of this outbreak. Public health agencies and the medical community are calling for urgent donor consultation to consider the implications of the Ebola epidemic, and secure financial commitments to strengthen core public health delivery.

Of course, the global economy will be a major topic for discussion at the forthcoming G20 Leaders’ summit, with an emphasis on promoting growth and resilience in the world’s richest economies to improve economic growth and stability. The international public health emergency posed by emergence of Ebola in West Africa is, however, a timely reminder of the consequence of chronic under-investment in the world’s poorest economies, with significant implications for global health security and economic stability.

Over the longer term, stronger leadership and increased global public health capacity are required, not only to resolve this devastating outbreak, but to prevent future similar scenarios and ensure global health security for all.

 

Jodie McVernon is Associate Professor in the University of Melbourne, School of Population and Public Health.

This article was originally published in G20 Watch. It is republished with permission.