#dnaEdit: Make amends now

With the World Health Organization declaring the Ebola outbreak in West Africa as an “international public health emergency”, world nations have their task cut out. For nearly four months since March 31, when Doctors Without Borders termed the outbreak “unprecedented” and warned that the “geographical spread is worrisome”, the international response was rather tepid to say the least. Official figures have pegged the number of reported cases at 1,825 and fatalities at 961 in four African nations since the first reported incident in December 2013 in a Guinea village bordering Sierra Leone and Liberia. However, doubts abound that institutional care has reached only a small number of infected persons. Now that the virus has infected the residents of three capital cities, Conakry (Guinea), Freetown (Sierra Leone) and Monrovia (Liberia), the challenges of isolating patients, curbing the free movement of citizens, and mobilising a massive corps of properly-trained health workers is staring the world in the face. 

In its emergency meeting on August 6 and 7, the WHO has called for a “coordinated international response” to reverse the spread of Ebola. Such a strategy has become inevitable considering the weak public health systems in the currently affected countries, the virulence of the Ebola virus and the transmission patterns that are taking a heavy toll on medical professionals and volunteers. Four nations, including Nigeria to where the outbreak has recently travelled, have imposed a state of national emergency and even begun troop deployments to ensure that quarantine measures are not violated. In contrast, the 2003 SARS epidemic and the 2009 H1N1 swine fever epidemic — when the WHO had previously declared public health emergencies — originated and were endemic in countries with comparatively better health systems. But the WHO has expressed confidence that the outbreak can be contained because of the nature of the Ebola virus. Unlike SARS and H1N1 which are air-borne, Ebola is known to spread only through bodily contact with fluids, blood, tissue or excreta of infected persons. 

But the scale of the latest infection raises fears of more recurrent outbreaks; that the outbreak could quickly spread to countries with no history of Ebola like Sierra Leone and Liberia, points to the improved nature of travel facilities and increased human contact. The failure of the US to expedite the development of a number of vaccines for Ebola, which are reportedly in various stages of clinical trials for several years now, points to the role of commercial, rather than public interest, in prioritising vaccine development. With the virus endemic only in the poor African nations, it is hardly surprising that these vaccines are yet to clear all statutory laboratory and animal trials before it can be tested on humans. The situation has prompted the WHO to convene a meeting on Monday to deliberate the ethical aspects of using “unregistered interventions with unknown adverse effects” on humans.

The encouraging news that an experimental serum appears to be working on two infected US aid workers gives hope for the long-term. But its stocks are reportedly too limited for the short-term fight. Countries like India, which has nearly 45,000 nationals living in the Ebola-affected countries, must review its capabilities to detect, investigate and manage Ebola cases, besides ensuring screening facilities at airports for passengers arriving from the affected countries. More importantly, at this stage, the four affected countries need international aid in terms of thousands of trained manpower and huge quantities of personal protective equipment.