Ebola Viral Disease in West Africa: A Threat to Global Health, Economy and Political Stability

Omoleke, Semeeh Akinwale; Mohammed, Ibrahim; Saidu, Yauba

Lack of or ill-equipped diagnostic facilities and weak surveillance in SSA can severely hamper containment efforts of major public health threats like EVD. These challenges hinder rapid and early confirmation of the disease during outbreaks. Indeed, in the entire continent, there are only a handful of countries with technologically advanced laboratories, many of which were established or supported by the US-CDC, that are capable of isolating the virus. 46 This reality has resulted in samples being sent to Europe (e.g. Germany or France) for confirmation or exclusion of the disease. The lengthy process involved in establishing the diagnosis often complicates or delays response strategies. In the West African epidemic for instance, it was only until March 2014 that EBV was confirmed by Institute Pasteur in France, even though it has been ravaging rural communities since December 2013 or earlier. 15 Asides laboratories, lack of effective public health surveillance systems in these countries has hampered contact tracing efforts. Related to this, is the failure of quarantine mechanisms in Ebola ravaged nations. For example, it was widely reported that Patrick Sawyer (index case in Nigeria), who had contact with a sister (who died of EVD) while he was in Liberia, actually sneaked out of quarantine. Invariably, this laxity has promoted and is promoting the spread of the disease in the subregion. Obviously, there is need for better funding of quarantine facilities and expansion of such facilities in different locations to enhance accessibility. Furthermore, health information systems seem to be problematic as most often, health ministries fail to deliver timely and reliable health information. To buttress this, there was a long time lag (of close to 4 months) between the time when the outbreak started in the remote community of Guinea and to when the health information was reported to the World Health Organization. 3 A particular weakness in reporting systems in many sub-Sahara African countries is that they are still heavily paperbased, especially, at the peripheral levels. Additionally, field experiences indicate some degrees of under-reporting due to this rudimentary reporting system, documentation and data management systems. Common root causes of under-reporting of health information include political maneuvering, poor health seeking behavior, weak surveillance networks and poor health financing. The overall weakness of the health information management system has contributed immensely to the failure to nip the outbreak in the bud.