At the end of August the World Bank President Jim Yong Kim began a co-authored article published in the Washington Post by writing that “If the Ebola epidemic devastating the countries of Guinea, Liberia and Sierra Leone had instead struck Washington, New York or Boston, there is no doubt that the health systems in place could contain and then eliminate the disease.” No doubt he is spot on.
Guinea, Liberia and Sierra Leone are some of the poorest countries of the world which, according to the World Health Organisation (WHO), have just one to two doctors to treat every 100,000 people and these doctors are heavily concentrated in urban areas. Indeed Liberia, which just like Sierra Leone still bears the scars of war over who controlled vast resources, before this outbreak had just 50 doctors in public hospitals serving a population of 4.3 million. According to BBC the health spending per person in 2012 in Sierra Leone, Liberia and Guinea stood at $96, $66 and $32 respectively. By comparison the UK spends $3,648 and US $8,895 (BBC News, August 20, 2014).
This was confirmed by William Pooley, the British nurse who survived Ebola Virus Disease (EVD) he contracted in Sierra Leone after treatment in London. “I was very lucky in several ways; firstly in the standard of care I received, which is a world apart from what people are receiving in West Africa at the moment”, he said.
Kim also aptly painted a picture of what he called the reality, “The Ebola crisis today is a reflection of long-standing and growing inequalities of access to basic health care. Guinea, Liberia and Sierra Leone do not have the staff, stuff and systems required to halt the outbreak on their own.”
What he however failed to see is that this reality is a reflection of the crisis of capitalism, especially in neo-colonial countries. These countries along with Nigeria, which also has cases of Ebola virus imported into the country by a Liberian-American, are rich in natural resources. But the domination of these economies by imperialists and multinationals, as well as the implementation of the World Bank promoted neo-liberal capitalist model that discourages public spending, has made it impossible for them to build a strong health system against infectious disease like Ebola, let alone safe water and sanitation
For instance in Nigeria, Africa’s biggest economy with a population of 170 million, has just four laboratories that are capable of carrying out test on Ebola virus. But even these laboratories are reportedly only funded with grants from foreign charity organizations. Besides, it is big shame that a year before 2015, the target year of the Millennium Development Goals (MDG), hundreds of Nigerians are still dying annually from preventable diseases such as cholera – a water-borne disease. According to the government statistics, there were 22,347 cases of cholera between January and June this year, out of which 288 people have died in Nigeria. These cholera outbreaks, which have been underreported in the media, reveal much more the monumental failure of the anti-poor, capitalist government than Ebola virus disease which has recorded 8 deaths in Nigeria.
The situation is so bad that in Liberia, which is the worst hit with over 1000 deaths as of September 5, that the hospital where the first two Americans that contracted Ebola in the country were kept, before being flown to the US, does not have facility to do such a basic test as a complete blood count (CBC). CBC is used to determine if somebody has an infection. Another example was that a starving Ebola patient escaped from the isolation centre in Liberia to search for food at a market as the food supply was inadequate at the centre.
Ebola is one of the deadliest diseases in the world, but it is not beyond human capacity to contain or defeat what is becoming a plague in the West Africa. That the EVD has not had cure up to now is because it is utterly unwise, on the basis of capitalism, for big pharmaceutical companies which exist to make super profit to invest in research for its vaccine or treatment. It as a disease that does not only occur sporadically but also used to record in most outbreaks less than one hundred of infections and deaths. Besides, the outbreaks used to be restricted to the rural areas in poor African countries. In other words, there are no huge markets for super profit.
Before now there had been 24 outbreaks of the virus that spanned a period of 36 years from 1976 and 2012 and altogether recorded 1590 deaths out of 2387 cases. Besides, until now the highest number of cases was 425 which occurred in 2000 in Uganda, while the highest number of death was 280 in 1976 in DRC, during the very first outbreak of the virus. As recently as 2012 there were two outbreaks in Ugandan and one in DRC, which recorded altogether 88 cases and 50 deaths, but which did not generate international attention. This also partly explains why the WHO did not act decisively when the epidemic, which started in December 2013 in Guinea, was reported to it in March. An article in the Washington Post however reveals that the WHO’s outbreak and crisis response budget has been cut by more than 50 percent from $469 million in 2012-13 to $228 million for 2014-15.
The current outbreak has greatly surpassed the previous ones in spread and fatality. As of September 5 there were with about 2,100 deaths and close to 4,000 cases dwarfing all the previous outbreaks put together. Indeed, the WHO has estimated that the virus could infect more than 20,000 people before it is brought under control.
Now there are eight experimental drugs and two vaccines for Ebola which have been shortlisted by the WHO as potential medicines for cure and prevention. Their clinical trials have been fast-tracked in order to end the world’s worst-ever outbreak of the killer virus.
The first one whose clinical trial has commenced on September 1 in the United States is the vaccine developed by GlaxoSmithKline. It is instructive however to stress that the pharmaceutical giant only became involved in the Ebola vaccine, according to ABC News, because it bought Swiss vaccine company Okairos AG in 2013. Besides, the trials that will also take place in Britain, Mali and Gambia, and production of the vaccine if results of the trials are good are financed by the British medical charity Wellcome Trust and United Kingdom’s Department for International Development.
Okairos, was one of small biotech firms contracted by the United States National Institutes of Health NIH and Department of Defence’s Defence Threat Reduction Agency to develop Ebola vaccines or treatments. Mapp Biopharmaceutical whose experimental drug, ZMapp was administered on at least six health and aid workers in US, Britain, Spain and Liberia, is also one of the beneficiaries of the funding from the two American agencies.
However, the US did not start the funding of research on Ebola in 2004 with intention of confronting the EVD outbreaks in Africa but as part of George Bush administration “Project Bioshield”’ which is a counter-measure against the use of the killer virus and other agents as biological weapons. The absence of any feasible threat of biological weapons, especially after the hysteria generated by September 11 subsided, meant that there were no urgent efforts to fast tract the development of vaccine or treatment of Ebola.
It is clear that without massive funding from governments and international agencies the multinational pharmaceuticals will not produce the vaccine or treatment for Ebola even if all the trials are successful. What this has called is massive public spending on health care under a democratic control of workers especially in neo-colonial countries. This is more imperative as evidence has shown that a strong health system, along with provision of safe water and sanitation, can reduce significantly the fatality and incidence of Ebola and other infectious diseases. This has also put onto today’s agenda the call for public ownership of big pharmaceutical companies so that research and production of any medicine will be on the basis of the needs of humanity and not profit of a few. But all this will not be possible without a mass movement and struggle for a socialist change.