Getting rid of the Ebola virus in West Africa is not just about saving lives. It’s also about stopping an attack on society that could lead to food shortages and mass migration, turning a medical emergency into a large humanitarian crisis.
This week, the World Health Organization said that the situation in Liberia is much worse than was thought before. On Tuesday, a panel at the Harvard Kennedy School (HKS) warned about the possible side effects of the epidemic.
Director of the Harvard Humanitarian Initiative Michael VanRooyen said, “We need to control the epidemic quickly before there is a lack of food and people start to move.”
Liberian President Ellen Johnson Sirleaf, who spoke at the School’s John F. Kennedy Jr. Forum via video conference, said that the epidemic has already had a wide range of effects on society. The predictions for economic growth have been cut in half, mining has stopped, and trade across borders has been stopped. Some people who could have left the country have already done so, and Sirleaf said that many Liberians who live abroad and could have gone back have chosen not to. Sirleaf, who graduated from HKS in 1971, said that building roads, power grids, and health care facilities has slowed down.
Sirleaf said, “The consequences are huge.”
VanRooyen, who is a professor of global health and population at the Harvard School of Public Health (HSPH) and vice chairman of the emergency department at Brigham and Women’s Hospital, and Dyann Wirth, who is the Richard Pearson Strong Professor of Infectious Disease, chair of the HSPH’s Department of Immunology and Infectious Disease, and director of the Harvard Malaria Initiative, spoke at the event, which was put on by the Institute of Politics. Sheila Burke, an adjunct lecturer in public policy at HKS and a research fellow at the Malcolm Wiener Center for Social Policy, was in charge of the meeting.
Wirth said that two vaccines are being tested to make sure they are safe, and it is likely that they will be used without the full set of clinical trials that vaccines usually go through. In tests on animals other than humans, these vaccines showed promise, but there’s no guarantee they will work on people.
The people on the panel all agreed that the epidemic is a big problem that needs a lot more medical help and protective gear. But it’s just as important to spread information about the disease to the public as soon as possible. There is a need to get people who are thought to have the virus into treatment centres, to quarantine and track down all of their contacts, and to change burial practises that can spread the virus.
Sirleaf said that some progress is being made. People are slowly getting over their doubts and scepticism about the disease. People are leaving treatment centres after getting better, and cremation, which was not done in Liberia before, is becoming a common way to get rid of the dead, she said.
“It took a long time because people couldn’t believe it,” Sirleaf said. “The situation is still very bad.”
Sirleaf said that she thinks the disease outbreak in Liberia will get worse for a few more weeks, then reach a plateau and start to get better. Wirth, on the other hand, said that it’s not clear where the epidemic is in the stages that have been found in previous outbreaks. Epidemics tend to start slowly, spread quickly, and then level off. Wirth said that the rise in reported cases in Liberia could mean that the disease is still spreading quickly, but it could also mean that the disease has stopped spreading and more cases are being reported.
Wirth and VanRooyen said it’s likely that untreated Ebola cases will reach the United States and other developed countries, and they could even spread to a small number of people. But the health systems and monitoring in those countries are so good that it’s very unlikely the epidemic would spread much further.
Even though Ebola was discovered in 1976, the current outbreak has shown that there are still things we don’t know about it, Wirth said. She said that work on a vaccine is still going on, but that it will be hard to decide where to put limited public health resources. Even though the epidemic has drawn attention from all over the world and is much bigger than previous Ebola outbreaks, the number of deaths is still low compared to other diseases.
Wirth said that malaria has killed between 300,000 and 400,000 children under the age of 5 in the months since the Ebola outbreak began. She said that people in charge of global health will continue to have to figure out how to balance the needs of people right now with the needs of new diseases like Ebola and SARS that will keep coming up.
Wirth said, “It’s a question we have every day.” “This is something we’ll keep seeing,” he said.