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On 30 September 2014 the first case of Ebola outside of West Africa was confirmed in Dallas, Texas. While several other suspected cases of the virus—including one case in Sweden—have proven negative, the Texas case may be the tipping point for properly mobilizing the international community to act. However, it could also be evidence that any such mobilization may come a little too late. The key task for policymakers will be to give the wider issue of global health a permanent place on the international security agenda.
Ebola outbreaks have primarily been sporadic and isolated since the virus was first identified in 1976. What sets the current outbreak apart is the scale of the outbreak, and the fact that it involves multiple countries. The horrific clinical manifestations of the infection, the high mortality rate (around 50 per cent) and the lack of a readily available treatment makes it a very palpable threat to the international community.
It is probable that the current outbreak in West Africa first occurred in 2013 but went unreported or unconfirmed by health authorities. The first officially confirmed case occurred on 22 March 2014 in Guinea and the virus has since ravaged the West African countries of Guinea, Liberia, Nigeria and Sierra Leone, infecting over 6500 people, of whom 3091 have so far died.
Current projections on the further spread of the virus using the Ebola Response modelling tool developed by the Centers for Disease Control and Prevention (CDC) estimate that, without increased prevention measures, the virus could infect up to 1.4 million people in West Africa by January 2015. According to one report, in order to effectively stop the epidemic up to 70 per cent of the patients must enter Ebola Treatment Units or be placed in community settings in which the risk of disease transmission is reduced and safe burials are provided.
In February 2014 the USA, together with 28 other countries, the World Health Organization (WHO), the United Nations Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE), launched the Global Health Security Agenda (GHSA) which aims to increase international collaboration in responses to infectious disease threats, whether natural, accidental or intentional.
On 17 September 2014, US President Barack Obama introduced a new set of measures against the Ebola outbreak, deeming it a threat to both global health and national security. The measures included a commitment to send 3000 medical support troops to West Africa.
The next day, the UN Security Council held an emergency meeting to discuss the developing situation in West Africa, coordinate an international response and start pooling collective resources to prevent further spread of the virus in the region. The Security Council declared Ebola a ‘threat to international peace and security’, while UN Secretary-General Ban Ki-moon declared the creation of the UN Mission for Ebola Emergency Response (UNMEER) which has five main priorities: stopping the outbreak, treating the infected, ensuring essential services, preserving stability and preventing further outbreaks.
The initiative taken by the international community will hopefully anchor the wider issue of global health within the international security agenda. However, while there is little doubt that the outbreak emphasizes the importance of initiatives such as the GHSA, the question remains whether such international coordination will continue after the Ebola outbreak has subsided.
Ebola is currently affecting some of the poorest and most fragile countries in Africa, where health care systems were already overstretched and substandard. It remains possible that an even worse humanitarian disaster will emerge in the wake of the current outbreak, when existing health care systems in these countries have been completely drained of both human and medical resources, which in turn could also lead to a regional destabilization.
Time will tell whether readiness plans currently in place in developed countries are sufficient to stop the further spread of the virus. Deficiencies in planning, poor communication and other weak links persist. For example, one difficulty highlighted in the USA concerns the lack of agreed procedures for proper handling and disposal of clinical wastes from Ebola patients.
On 2 September UN Deputy Secretary-General Jan Eliasson stated that the current Ebola outbreak is ‘going to be a test of multilateralism; a test of international solidarity for people in dire need right now’. The key challenge will be to sustain the momentum of the international community by reminding it that global health and public security are mutually dependent.