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

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

Although, the impact of other factors in the spread of EBV cannot be under-estimated, we strongly opine that rapid improvement in transportation systems, porous border networks and poor port health services in West Africa are some of the important factors driving the spread of the current epidemic. This opinion is supported by views of Médecins Sans Frontières (MSF) experts, who after citing a case of a young man who travelled through five villages in one week before reporting to their center for treatment, acknowledged that …people in West Africa travel far more than those… they have previously treated in Central African Countries. 18 But what explains this high level of population mobility in this sub-region? The subregion, like many other nations in SSA has witnessed remarkable economic growth, which is far above global average. 52 This has spurred rapid development in almost all areas of society, including improved transportation systems. Air traffic has significantly increased both within and beyond the sub-region. Indeed, prior to the suspension of flights by major airlines, there was an average of 13 regular inter-continental flights per week from each of the capital cities of the three most heavily hit countries-that is, 15 from Freetown, 13 from Conakry and 11 from Monrovia. 21 In addition to air traffic, highways linking major cities in the sub-region have been established. Similarly, in rural villages, the availability of cheap Chinese motorcycles, which are heavily under-regulated, is enabling villagers to easily ply the roads of remote vil-lages and cross border hubs. 53 These improvements, alongside economic cooperation fostered by ECOWAS have enhanced free movement of humans (population mobility) and goods and services among villages, cities and across the sub-region. These developments have made it possible for journeys to be completed within an average of 48 hours, a duration that is far less than the incubation period for most pathogens (2-21 days) . This relatively short time of humans and cargo traffic can enhance the spread of pathogens around the world. 54 The current West African EBV outbreak clearly demonstrates how improvements in transport systems can enhance the spread of deadly diseases beyond national frontiers. For example, in August 2014, an infected Liberian-American travelling from Liberia landed at an international airport in Lagos and initiated the outbreak in Nigeria. Similarly, the confirmed cases in Senegal, Mali and United States were imported from Guinea and Liberia respectively. 3 However, border or port health services that are entrusted with maintenance of international health regulations are hugely compromised due to corruption and poor condition of service. But despite this potential for exportation, various experts believe that the risks of EBV spreading beyond the confines of West Africa are extremely low. 55 This low risk, however, should not be underestimated, as there are still potential for expatriates or other travelers to introduce the disease into other settings. For instance, in 2000 a South African health professional contracted the disease while treating patients in Gabon, 56 and upon his return, he infected a nurse who was attending to him. 57 Similarly, nurses have been infected in Madrid, Texas after attending to Ebola patients from West Africa. These scenarios highlight the need for countries, including at-risk countries in SSA, to develop and implement contingency plans to pr