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Ebola Outbreak in West Africa

What are the economic and sociopolitical conditions that are responsible for the occurrence of Ebola pandemic in West Africa that resulted in reformations in the areas of policy priorities due to their opportunities and challenges?

The West African Ebola virus of 2014 – 2015 was an international health pandemic and was one of the most widespread outbreaks in the history of Ebola virus disease. It caused immense socioeconomic disruption and loss of life in the majority of three countries of Guinea, Sierra Leone and Liberia (Baize et al. 2014: 1422). This essay will aim at answering the research question by carrying out an in-depth analysis of the sociopolitical and economic causes that led to the outbreak of the pandemic in West African countries and discuss the aspect of the policy of the affected states that were altered due to the identified opportunities and challenges. Several researchers have carried out investigations to determine the various underlying aspects of the outbreak, but a gap has been identified as the lack of research in the aspect of policy priority areas. This essay will fill the gap by discussing the policy priority areas of the affected states as it is essential to understand the altered policies for the control and prevention of future outbreaks. The essay will critically review several research articles and government websites to determine the altered policies by using the theoretical framework that is most adequate for the Ebola virus pandemic.

According to a report by World Health Organization, a total of 28,616 cases have been reported till date from the three West African states that collectively resulted in 11,310 death cases. The number of survivors is about 10,000 in the countries of Sierra Leone, Liberia and Guinea and WHO has taken three objectives to completely end the transmission of Ebola virus in these three countries (World Health Organization 2016). Since all these countries were emerging from civil wars, this has decreased the availability of resources of health and dysfunctional systems of healthcare. This was the result of lack of the availability of the healthcare workers who were adequately trained. Since the democracy in these countries was re-embraced, the healthcare workers and providers were over-burdened with increasing needs of the postwar capacities while the redevelopment and economic growth were occurring (Saéz et al. 2015:21). Therefore, these sociopolitical aspects can be explored for examining the opportunities and challenges that will aid in strengthening the health systems of these countries. Although the health status of the population and economy of the affected countries have been improved by the government, the life expectancy continues to be low. Hospital bed and physician capacities are inadequate when compared with global perspectives that fail to meet the basic needs of healthcare for the general population. The economic crisis prevails to be the primary reason for maternal and infant deaths and dissemination of the health messages in not uniform due to high levels of illiteracy (Dudas et al. 2016:72). All these economic and sociopolitical conditions collectively contributed towards the occurrence of Ebola pandemic in West African states.

Causes of the Outbreak and Policy Priority Areas

Under such circumstances of an outbreak of a severe health pandemic, identification of the challenges and opportunities becomes essential to alter and frame new policies to combat the mortality. Several challenges have been identified from multiple researches that focus on community, organizational or structural and individual or personal level challenges. Few of the challenges that require immediate attention in terms of policies are food insecurity and entrenched poverty, limited provision to adequate health facilities, African system of traditional beliefs and poor infrastructure of public health (Gatherer 2014:1622). Mistrust of the modern services of healthcare and government, porous geographic boundaries and borders and emerging from civil conflicts are the other challenges that the West African countries have faced that led to the development of the Ebola pandemic. On the contrary, several opportunities can be identified that can aid to the devising of the theoretical framework for policy development. Viewing the epidemic as an opportunity can help to deal with the global threats of public health and address the existing challenges. Creation of response that is family centered to the outbreaks, the establishment of private-public partnerships for controlling infectious diseases and partnerships for the research and development areas for the discovery of drugs and vaccines are few of the opportunities that can be considered to explore the policy priority areas (Chertow et al. 2014:2055). Both the challenges and opportunities should be critically analyzed based on the theoretical framework for discussing an aspect of the policy of the West African states.

The governments of the West African countries have been receiving funds from international sources to frame policies and control the outbreak of Ebola. $1 billion has been provided by the IFC and IDA of World Bank and $5.4 billion has been provided by the US government (Gire et al. 2014:1370). From these collected funds, the government has framed policies based on the priority areas. The one policy is the regional system for disease surveillance as it is available internationally in various countries of Asia Africa and Europe. This will provide with the theoretical framework for boosting pandemic preparedness in the affected states. Since the infectious diseases are not restricted by the international borders, the regional system for disease surveillance can help to mitigate, respond, prevent and detect quickly the outbreaks through a co-operative network of the national systems of surveillance. This system is of much importance in West Africa as it will serve to provide earlier response and warning that can control and prevent the outbreak of the disease (Fowler et al. 2014:735). The theoretical framework of the regional system for disease surveillance is the most adequate as it helps in strengthening of the co-ordination of the multi-sector response in a local area, helps to maintain the essential services after and during the outbreak, supporting treatment protocols and Ebola care and restricting the Ebola spread (Oleribe 2015:55). This policy will help the regional areas to implement the national and international plans and guidelines that are recommended. Apart from the framework, it is also essential that the regional centers should follow the laid down framework of the policy and adhere to their best possible abilities to the guidelines set forward by the national and international health and response organizations. The framework has been aligned with the recent protocols and guidance for controlling the Ebola outbreak in the affected West African states.

Challenges and Opportunities

Since Ebola is an infectious disease of animal origin, it can spread across borders to several countries. The situation becomes increasingly complex and challenging with the increased movement of people, services and goods across the world facilitating the quick spread of the disease. From this aspect, regional disease surveillance system is the best policy to make the country ready for early detection, rapid identification and effective response to the future outbreaks of Ebola. Tapping into the vast repository of global knowledge for building resilient health systems can be of great benefits for globalization that cannot be simply wasted or overlooked. Co-operative arrangements among the three states of West Africa can aid to control the disease outbreaks cross-border at the source for improving health outcomes (Tambo, Ugwu and Ngogang 2014:1). The theoretical framework associated with this policy of regional disease surveillance system helps in complementing local and global disease surveillance systems by addressing the limited capacity of surveillance in these countries. Regional disease surveillance system can add value to the control system of Ebola by complementing the country and global surveillance systems by addressing the limited or lack of surveillance capacities. Since the West African countries are economically backward, this policy will be effective in further deteriorating the health system of the country due to pandemic threats (Spengler et al. 2016:956). Limited diagnostic capabilities and reporting disincentives due to the panic of the economic consequences can act as set back parameters for this policy. Therefore, the framework has to be so designed that can channel the flow of the collected funds appropriately to the needy regions for setting up diagnostic facilities and educating the people about the benefits of early reporting that can aid in controlling the spread of the disease effectively. Harnessing of the network power by upgrading the systems of national surveillance helps in supporting the standardization of reporting, detection and definitions by prioritization of the trust-based relationships facilitating sharing of sensitive information and informal reporting (Towers, Patterson-Lomba and Castillo-Chavez 2014). This will eventually help in strengthening of the technical capacity of the country and cross-border collaboration to control Ebola outbreaks. Regional disease surveillance system helps the national institutions to adapt to the changing needs and conditions that are associated with the spread of Ebola as it requires multi-disciplinary, multi-sectoral and multinational solutions. It also helps in establishing networks for fostering the local action and leaderships and aids in building collaboration among the national institutions of public health with the training and research centers.

Government Policies and Funding

The countries of West Africa Sierra Leone, Liberia and Guinea along with the international community are in the process of strengthening the response to Ebola for achieving their target of zero cases of Ebola. For doing this, it is crucial to establish entire West Africa nationwide regional disease surveillance systems for connecting the affected countries along with its neighboring countries as Ebola is an infectious disease that cannot be restricted by international borders (Dixon and Schafer 2014:551). For making the policy sustainable and successful, it is essential that the factors of funding support, engagement and active leadership of the international agencies and national governments should be coupled with the participation continuity of the institutions and individuals for gradually establishing a basis of experience, trusted communication and shared knowledge (Chan 2014:1184). Moreover, the ability to build upon and leverage existing governance initiatives and structures is required for the success of the policy by connecting national institutions of public health and the research and training centers of the region. Therefore, it can be stated that the crisis of Ebola pandemic offers challenge as well as opportunity to evolve by learning through the theoretical framework implemented in the form of policies. It is estimated that the basic expenses for hospital and primary care might range between $36-55 for each patient annually (Chua et al. 2015:3734). This is well beyond the capacity of the West African citizens and the public spending levels and therefore, regional disease surveillance systems can help to reduce the burden of the disease and therefore, can reduce the public expenses of the county. UNMEER (UN Mission for Ebola Emergency Response) was an emergency health mission undertaken by United Nations to support the governments of the West African countries Sierra Leone, Liberia and Guinea to achieve their target of zero Ebola cases (Global Ebola Response 2016). In the process of achieving the goal, UN provided the governments with strategic guidance for regional disease surveillance systems for meeting the immediate needs that are related to the spread of the disease and fight against it. Human resources, logistical and financial support was provided by UN to support the achieving of the target of zero Ebola case.

In accordance with the research question, the economic and sociopolitical conditions have been well discussed that are responsible for the occurrence of Ebola pandemic in West African countries. The sociopolitical aspects during the post-war condition have been explored for examining the challenges and opportunities for strengthening the health systems of the West African countries that led to the development of policies for controlling the outbreak of Ebola. This was in tune with the goal of the research question that laid the pathway for reaching the goal of understanding an aspect of the policy using the theoretical framework. The essay was structured to examine the various parameters separately to gather information regarding the effectiveness of the effectiveness of the adopted policy and summarized the policies of the international communities like WHO and UN towards the affected states. This structure eventually helped to answer the research question of examining the areas of policy priorities with respect to the opportunities and challenges. It can be concluded that the severity of the Ebola outbreak could have been controlled if the applied policy of regional disease surveillance system would have been implemented earlier. This could have made the government aware of the rising pandemic beforehand that could have prevented the pandemic. However, its implementation can prevent future outbreaks but further research is required to connect other policies undertaken by the government to ensure zero Ebola cases and no future outbreaks.

Regional Disease Surveillance System

References

Baize, S., Pannetier, D., Oestereich, L., Rieger, T., Koivogui, L., Magassouba, N.F., Soropogui, B., Sow, M.S., Keïta, S., De Clerck, H. and Tiffany, A., 2014. Emergence of Zaire Ebola virus disease in Guinea. New England Journal of Medicine, 371(15), pp.1418-1425.

Chan, M., 2014. Ebola virus disease in West Africa—no early end to the outbreak. New England Journal of Medicine, 371(13), pp.1183-1185.

Chertow, D.S., Kleine, C., Edwards, J.K., Scaini, R., Giuliani, R. and Sprecher, A., 2014. Ebola virus disease in West Africa—clinical manifestations and management. New England Journal of Medicine, 371(22), pp.2054-2057.

Chua, A.C., Cunningham, J., Moussy, F., Perkins, M.D. and Formenty, P., 2015. The case for improved diagnostic tools to control Ebola virus disease in West Africa and how to get there. PLoS Negl Trop Dis, 9(6), p.3734.

Dixon, M.G. and Schafer, I.J., 2014. Ebola viral disease outbreak—West Africa, 2014. MMWR Morb Mortal Wkly Rep, 63(25), pp.548-551.

Dudas, G., Carvalho, L.M., Bedford, T., Tatem, A.J., Baele, G., Faria, N., Park, D., Ladner, J., Arias, A., Asogun, D. and Bielejec, F., 2016. Virus genomes reveal the factors that spread and sustained the West African Ebola epidemic. bioRxiv, pp.71-79.

Fowler, R.A., Fletcher, T., Fischer, W.A., Lamontagne, F., Jacob, S., Brett-Major, D., Lawler, J.V., Jacquerioz, F.A., Houlihan, C., O’Dempsey, T. and Ferri, M., 2014. Caring for critically ill patients with Ebola virus disease. Perspectives from West Africa. American journal of respiratory and critical care medicine, 190(7), pp.733-737.

Gatherer, D., 2014. The 2014 Ebola virus disease outbreak in West Africa. Journal of general virology, 95(8), pp.1619-1624.

Gire, S.K., Goba, A., Andersen, K.G., Sealfon, R.S., Park, D.J., Kanneh, L., Jalloh, S., Momoh, M., Fullah, M., Dudas, G. and Wohl, S., 2014. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. science, 345(6202), pp.1369-1372.

Global Ebola Response. (2016). UN Mission for Ebola Emergency Response (UNMEER). [online] Available at: https://ebolaresponse.un.org/un-mission-ebola-emergency-response-unmeer [Accessed 4 Nov. 2016].

Oleribe, O.O., Salako, B.L., Ka, M.M., Akpalu, A., McConnochie, M., Foster, M. and Taylor-Robinson, S.D., 2015. Ebola virus disease epidemic in West Africa: lessons learned and issues arising from West African countries. Clinical Medicine, 15(1), pp.54-57.

Saéz, A.M., Weiss, S., Nowak, K., Lapeyre, V., Zimmermann, F., Düx, A., Kühl, H.S., Kaba, M., Regnaut, S., Merkel, K. and Sachse, A., 2015. Investigating the zoonotic origin of the West African Ebola epidemic. EMBO molecular medicine, 7(1), pp.17-23.

Spengler, J.R., Ervin, E.D., Towner, J.S., Rollin, P.E. and Nichol, S.T., 2016. Perspectives on West Africa Ebola Virus Disease Outbreak, 2013–2016. Emerging infectious diseases, 22(6), p.956.

Tambo, E., Ugwu, E.C. and Ngogang, J.Y., 2014. Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries. Infectious diseases of poverty, 3(1), p.1.

Towers, S., Patterson-Lomba, O. and Castillo-Chavez, C., 2014. Temporal variations in the effective reproduction number of the 2014 West Africa Ebola outbreak. PLOS Currents Outbreaks.

World Health Organization. (2016). Ebola virus disease outbreak. [online] Available at: https://www.who.int/csr/disease/ebola/en/ [Accessed 4 Nov. 2016].

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