by Whitner Chase, Humanitas Global
It’s been a year since the Ebola epidemic ravaged West Africa and triggered a mania across the world. In hindsight, the anticipated spread of the disease in West Africa was overestimated. Ebola never proliferated outside of West African countries, and thankfully, the CDC’s prediction of 1 million cases by January was way off-target. Many media outlets are issuing reports on the state of the disease since last July, rightly acknowledging that it is still a danger to many in Guinea, Liberia, Sierra Leone, and other neighboring countries. However, these reports have yet to address an issue far more important than quelling Ebola: the disease was, and still is, a signifier of more systemic and dire health gaps in the affected region. What do we need to address these gaps? More healthcare professionals, better healthcare infrastructure and increased healthcare spending, and better support overall for human capacity, such as improved literacy are all critical for creating more robust and resilient health systems.
Countries with the worst Ebola outbreaks rank among the worst for other health issues as well.
West Africa needs more healthcare providers. Take doctors for example. In China, there are almost 1.5 doctors for every 1,000 people in the country. In the U.S., that number rises to almost 2.5. The disparity between these two countries and that of countries in many West African nations is enormous. Liberia has 1.4 doctors for every 100,000 people. On average, fewer than two doctors are available to serve the same population size that 250 doctors in the U.S. and 150 doctors in China serve. When comparing these statistics, it becomes clear why so many lives were lost during the Ebola outbreak: there just aren’t enough physicians to treat everybody and stop an outbreak before it starts.
# of doctors/1000 people over 4 recent years in Liberia ©|Quandl
In addition to a lack of available trained medical staff, general healthcare funding issues in West Africa are widespread. Guinea spends approximately $19.00 on health per person, well below nearby African country Ghana’s national allotment of ~$60/person. Meanwhile, most European countries are able to spend thousands per person, or at least hundreds. The funding deficit feeds into the lack of available medical professionals – if budgets were higher, it is likely there would be more room to hire additional healthcare workers. Developing countries, however, face a number of competing funding priorities. Where this happens, international and regional mechanisms are needed to help fill in the gaps. However, a contributing factor to the spread and slow response to the ebola crisis was a decline in funding for the WHO. According to an article from The Economist, by 2014, the WHO’s budget for outbreaks and declined by 35% since 2010. Disease spreads for lack of funding in the health care system.
As is often repeated in development, no single focus area exists within a vacuum – better health indicates better incomes and better quality of life. The reverse is also true – a population’s health status is not the result of deficient health systems alone. Possibly one of the largest contributors to the spread of Ebola is the lack of education in the region. Governments can advertise to raise awareness levels and prevention efforts, but with an adult literacy rate of only 60% in Liberia, many health care messages won’t be able to reach a large portion of the population. In other West African countries, literacy rates and primary school enrollment rates are even lower. An education in health is important not only in the prevention of common diseases, but to be prepared for a new, uncommon outbreak like that of Ebola this past year.
A primary school classroom in Guinea ©|National Geographic
Looking back on the Ebola scare, it is too easy to think that the worst is over. However, problems persist in West Africa despite containment of the disease, and affected countries are no less susceptible to other diseases than they were before. Furthermore, disease prevention is just one of a whole host of challenges facing West African countries, for which the support of education and health care funding are only two solutions. Supporting a holistic approach to global aid seems to be the most sustainable method of development. This way, it is not the symptoms we are treating, but the source.