The world has learned a lot from the previous epidemic
IN MARCH 2014 the brave doctors of Médecins Sans Frontières (MSF) sounded an alarm. They were struggling to contain an outbreak of Ebola in Guinea, a poor and violent west African state. The Ebola virus causes a terrifying disease: a fever sometimes followed by massive internal and external bleeding. It is contagious, via body fluids, and frequently fatal. Yet no one paid much attention to MSF’s warning, and by June the epidemic had spread to 60 places in three countries. It was not until August that year that the World Health Organisation (WHO) declared an international health emergency. The delay allowed Ebola to rage out of control, killing 11,000 people in six countries and leaving 17,000 children without one or both of their parents. Only after the epidemic had peaked did the world pay heed. Some governments panicked, imposing flight bans on all travellers from affected countries. This prompted many to go by road, where they were harder to track.
Global public-health authorities vowed to learn from this catastrophic foul-up. A fresh outbreak of Ebola, this time in the Democratic Republic of Congo, will reveal whether they have done so (see article). So far, the signs are good. The big mistake last time was to dither—containing an epidemic early is easier and cheaper and saves lives. This time medical staff have been rushed to the scene, the 1m-strong city of Mbandaka on the Congo river. Protective gear and medicines have been promptly deployed. Health workers have swiftly started to trace those who have been in contact with Ebola sufferers. Congo’s neighbours are on alert. Isolation zones and treatment centres have been set up. The WHO has released cash from a contingency fund. Canada, Germany, the EU, America and Britain have pledged more. For the next three months the WHO says it needs $26m. That is a bargain: last time it cost $3.6bn to contain the epidemic and it knocked $2.2bn off the GDP of the worst-affected countries.
Technology has improved since 2014. Not only is there a quicker diagnostic test, but there are also ample supplies of an effective vaccine. Thousands of doses are being deployed in a “ring” strategy, to inoculate those who have been in contact with known cases of Ebola, as well as their contacts in turn. Jabs are also being offered to front-line health workers—an essential precaution, given the large number of such workers who died last time. It is not yet clear how well ring vaccination will contain the early stages of an outbreak, when chains of transmission are less certain. The vaccine is also hard to administer, since it must be kept as low as -80°C. However, if this one proves unsuitable, another is available that might work.
Vigilant against the virus
Even with all these advantages, containment will be hard. Congo is atrociously governed; getting anything done there is tricky. The virus could spread along the Congo river, the country’s main artery. Further infections, and deaths, are all but certain. Still, the world is much better placed to fight Ebola than it was four years ago. Public and charitable money ensured that there were vaccine stockpiles. America’s Department of Defence helped to fund vaccine research—which for-profit drug firms are unlikely to do, since such vaccines must be given away, not sold. A new group called the Coalition for Epidemic Preparedness Innovations (CEPI) was set up to raise money and channel it to the most promising projects.
If this epidemic is contained, the world should learn the lesson. Ebola is just one of many horrendous pathogens, including Lassa fever, Marburg fever, SARS and Nipah virus, that could become epidemics. CEPI wants to reduce that risk by developing vaccines now. It is an urgent task.