West Africa’s Ebola epidemic has morphed into several micro-outbreaks of varying intensity and with the potential to reignite more widespread contagion, a United Nations official said.
The pattern of spread has become more nuanced and complex, occurring over a wider area, David Nabarro, the UN Secretary-General’s special envoy on Ebola, said in a report by the Global Ebola Response Information Centre.
The 36-page publication, dated January 2015, outlines progress to date and changes in the global response needed to end the deadly scourge, which began in December 2013 in a remote area of Guinea, near the border with Liberia and Sierra Leone. Since then, Ebola has sickened more than 21,000 people in eight countries and killed 8,468, according to data compiled by the World Health Organisation on January 16.
“Ending the outbreak will not be easy because the disease is being transmitted in three countries with a collective land area greater than the United Kingdom,” Nabarro said. “Success can only be achieved if communities themselves understand the nature of the outbreak and act in ways that reduce their likelihood of becoming infected.”
The intensity of the epidemic has now reached a plateau and is starting to decline in some places, the report said.
The overall disease reproduction rate, which gauges the propensity for an infection to spread in the community, fell below 1.0 last month, from about 1.4 in September, the report said. At the peak of the epidemic in the third quarter of last year, new Ebola cases were doubling every three weeks in Liberia, Guinea and Sierra Leone, the three worst-affected countries.
“Reaching zero cases and enabling durable social and economic recovery will require sustained commitment from a global coalition of supporters throughout 2015,” UN Secretary-General Ban Ki-moon said in the foreword of the report, titled “Making a Difference – The Global Ebola Response: Outlook 2015.”
By mid-December, there were more than 2,000 beds in Ebola treatment centers, compared with fewer than 350 in mid-August, when patients were being turned away because of lack of capacity, Nabarro said. Available beds now exceed the number of Ebola patients recorded each week, though treatment capacity is unevenly distributed in all three most-affected countries.
“Many deaths are still unreported, and communities in some areas are still reluctant to adopt safe burial practices or seek treatment,” he said. “The virus is lurking close by and in coming months it may make a comeback if we become complacent and let down our guard.”
Local community involvement is crucial, said Sakoba Keita, head of Guinea’s Emergency Operations Centre.
“We have not taken sufficient account of community involvement in the crisis, especially in the aspect of compliance with customs,” Keita said in the report. “At first it was too professional and actions were misinterpreted and led to violence. Now that we have corrected this, we are reducing the reluctance. If we had done that since the beginning, we would have taken much less time to make an impact.”
Ending the outbreak means establishing alert and response capacities in each local government area, ensuring timely and reliable disease surveillance and coordinating all responders, World Bank President Jim Yong Kim said.
Ebola’s economic devastation worsened in West Africa, the Washington-based World Bank said last month, predicting gross domestic product would shrink this year in Sierra Leone and Guinea. If Ebola continues to spread further in Africa, it could cost as much as US$32.6 billion (RM116 billion) by the end of 2015, it estimated in October.
“We simply must find the resources required, no matter the cost, to get to zero cases as soon as possible,” Kim said in the report. “Defeating Ebola now will cost billions, but it will spare the rest of the world from the spread of the virus, save lives in the countries, save money over the long term, and help the countries rebuild their economies.”