The real things we should be afraid of in the ongoing Ebola outbreak are that it will cause the fragile healthcare systems in West Africa to collapse under its weight and that it will spread to Nigeria:
Last week, my brilliant Council on Foreign Relations colleague John Campbell, former U.S. ambassador to Nigeria, warned that spread of the virus inside Lagos — which has a population of 22 million — would instantly transform this situation into a worldwide crisis, thanks to the chaos, size, density, and mobility of not only that city but dozens of others in the enormous, oil-rich nation. Add to the Nigerian scenario civil war, national elections, Boko Haram terrorists, and a countrywide doctors’ strike — all of which are real and current — and you have a scenario so overwrought and frightening that I could not have concocted it even when I advised screenwriter Scott Burns on his Contagion script.
Inside the United States, politicians, gadflies, and much of the media are focused on wildly experimental drugs and vaccines, and equally wild notions of “keeping the virus out” by barring travelers and “screening at airports.”
Let’s be clear: Absolutely no drug or vaccine has been proven effective against the Ebola virus in human beings. To date, only one person — Dr. Kent Brantly — has apparently recovered after receiving one of the three prominent putative drugs, and there is no proof that the drug was key to his improvement. None of the potential vaccines has even undergone Phase One safety trials in humans, though at least two are scheduled to enter that stage before December of this year. And Phase One is the swiftest, easiest part of new vaccine trials — the two stages of clinical trials aimed at proving that vaccines actually work will be difficult, if not impossible, to ethically and safely execute. If one of the vaccines is ready to be used in Africa sometime in 2015, the measure will be executed without prior evidence that it can work, which in turn will require massive public education to ensure that people who receive the vaccination do not change their behaviors in ways that might put them in contact with Ebola — because they mistakenly believe they are immune to the virus.
The former concern is already dangerously close to happening:
At the same congressional hearing, Dr. Frank Glover, a medical missionary who partners with SIM, a Christian missions organization, and the president of SHIELD, a U.S.-based NGO in Africa, warned that Liberia had fewer than 200 doctors struggling to meet the health needs of 4 million people before the epidemic. “After the outbreak that number went down to about 50 doctors involved in clinical care,” said Glover.
I myself have received emails from physicians in these countries, describing the complete collapse of all non-Ebola care, from unassisted deliveries to untended auto accident injuries. People aren’t just dying of the virus, but from every imaginable medical issue a system of care usually faces.
Liberia, population 3.5 million, for example has a single medical school with another in the planning stages. Each doctor or nurse there that dies of Ebola is not just a tragedy but a disaster. We are complicit in the desperate condition of African healthcare by tempting African physicians away from their home countries to the fleshpots of western medicine and Western volunteer organizations are completely inadequate to make up the difference.