Thursday, May 7, 2015

Ebolavirus 2014 Outbreak - #6

Ebolavirus 2014 Outbreak
May 5, 2015 Update #6
Paul Herscu, ND, DHANP, MPH
Herscu Laboratory


Well, it is my birthday today and I decided to treat myself to the birthday gift of writing this update. I am going to keep this short. Back in September, and again in October I wrote that by May 2015 we are going to have Ebola free countries in West Africa, assuming that there are no major cuts in funding. Elsewhere, in webinars on epidemics, I highlighted the different treatment protocols in the different countries, and that all things being equal some countries are going to fare better than other countries. The bottom line though was that by the start of 2015 the disease would become localized and that with all resources effectively brought to bear, Guinea should be clear except for some localized areas and Liberia would be Ebola free sometime in May. Well, if my math is right, by the end of the week, Liberia will be announced as being Ebola free, crossing our fingers still. This leaves two countries with local outbreaks.

And to repeat my points from last October, sadly, it is likely that by now almost no one cares about EBV, that our minds move on to other pressing matters, such as the tragedy is Nepal.
I guess some of the points I made throughout these posts remain valid. The only reason EBV is not in the USA and in Europe has little to do with medical care per se, and all to do with great public health policies, set up late, yes, but set up and funded and staffed, eventually. While I congratulate all in the success of bringing this epidemic to a concluding moment, I still feel saddened by the underlying problems. Health care systems in many areas of Africa are still poorly funded by the world, poorly staffed, with poor public health education. To be clear, mostly they don’t need more ideas or some ‘smart’ people to fix a problem. The solution is not new science per se, but funding. They need money to implement good, known, logical public policies.
In this respect, I would like to say that the EBV epidemic while ending now could have ended a great deal sooner with appropriate funding. In fact, after my last update, funding dropped and bases began to close. Colleagues who were preparing to go abroad had their trips canceled since the whole medical clinic they were visiting was closing. In other words, people wanting to go help were refused because the objective was solely focused on EBV, and not on fixing underlying problems in the infrastructure.
Towards that end, we still have the Cholera problem in Haiti. And to a certain extent the Nepal problem is the EBV problem, as is the plague problem in Madagascar, etc. What we know now, and what we have known for centuries, is good public health measures overall often outweigh the implementation of any one specific medical treatment at a given time. Funding to correct underlying deficits in infrastructure can only help countries become more resilient in any medical emergency.
As I closed the prior EBV update, let’s use this horrible time as a springboard to bring the system into the 21st century. It is for the common good!

In health,
Paul Herscu, ND, DHANP, MPH