The U.S.-Africa Leaders Summit that officially opened today in Washington is as notable for what isn't on the agenda as for what is. The meeting between President Barack Obama and more than 40 African heads of state has been billed as forum for talks on security issues, foreign investment and economic development on the continent. But so far, at least, the recent outbreak of deadly Ebola virus in three African nations has remained absent from the official agenda. Mr. Obama needs to take this opportunity to strengthen cooperation between the U.S. and its African partners in efforts to bring the epidemic under control and provide the resources needed to prevent its spread.
The reappearance of Ebola after several years of relative dormancy was first observed in March in the West African nation of Guinea. From there it spread to the neighboring countries of Sierra Leone and Liberia, most likely carried by air travelers crossing their borders; there was also one reported death in Nigeria involving a man returning to his country after having cared for a sister who died of the disease in Liberia. In all, some 1,300 people have been infected with the Ebola virus, of whom more than 700 have died, making the current epidemic the deadliest outbreak of the disease since the virus was first discovered in 1976.
But unlike earlier outbreaks, which were confined to a handful of remote, isolated rural communities in East Africa, the current Ebola epidemic is spread over a vastly larger geographical area in West Africa inhabited by a highly mobile population. There simply aren't enough doctors, trained health workers, hospitals or medical resources to screen people for possible infection or isolate those who show symptoms of the illness in order to prevent the virus' spread.
Last week the head of the World Health Organization, Dr. Margaret Chan, warned that "this outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socioeconomic disruption and a high risk of spread to other countries." Dr. Chan called the epidemic "by far the largest ever in the nearly four-decade history of this disease," adding that the types of illnesses health workers were contending with were caused by the most lethal strain in the Ebola family of viruses.
Complicating the deadliness of the virus, which kills up to 90 percent of those it infects, and for which there is no known cure, is the widespread misunderstanding among people most at risk for contracting the illness about how the virus is transmitted. Ebola is passed directly from person to person through contact with bodily fluids such as saliva, blood and urine. The only way to contain it is to isolate patients who show symptoms of the disease in facilities where health workers can treat their symptoms, then seek to identify anyone who has had recent contact with the victims and monitor them to see if they too develop symptoms. If so, the new victims must also be isolated while health workers in turn trace everyone with whom they have come into contact as well.
The ability of such "contact tracing" to stem the incidence of new infections is limited not only by the shortage of trained health workers and treatment facilities but also by local customs. For example, many families follow burial practices that require them to come into prolonged and close contact with the bodies of victims, increasing the risk they too will contract the virus. In other cases, misunderstanding about how the virus is spread led some communities to believe that visiting foreign health workers are themselves causing the illness and have barred access to their villages. There also have been cases in which residents have hidden sick relatives from health workers and then secretly buried them in ways that allow unsuspecting others to come into contact with their infected bodily fluids.
That is why what is needed is not only more health workers to treat and trace victims of the outbreak but also teachers, social workers and volunteers to conduct a massive government public health campaign aimed at educating people about how to avoid the risk of infection. The United States and other developed nations can offer help, but it won't be sufficient unless Africans take the lead in breaking down barriers to effective containment and treatment. With dozens of African officials gathered in Washington this week, U.S. officials need to help make sure that happens, and President Obama ought to be one of the clearest voices sounding the alert.
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