President Barack Obama announced on 16 September that the US would send 3,000 troops to West Africa to assist in efforts against ebola, including a major deployment to Liberia where the epidemic is spreading fastest. The news is the latest in a series of recent announcements from world powers and international organisations promising more funding and manpower to tackle the disease. Although the deployments are vital to countering the spread of the virus, it will take time to mobilise these resources and the World Health Organisation (WHO) estimates it will still be at least six to nine months before the disease is fully contained.
The US response to the crisis is by far the largest deployment of foreign resources to curb the ebola outbreak since it was first reported in February. In addition to supplying 3,000 troops, the US plans to build 17 treatment centres with 100 beds each, train 500 local healthcare workers a week, and establish a military control centre for coordination in the Liberian capital Monrovia. Obama has requested an additional USD 88 mn from Congress to combat the disease, including USD 58 mn to speed up production of the experimental antiviral drug ZMapp and two possible vaccines. China and Cuba have also pledged to send medical staff to Sierra Leone, while France has donated USD 11.6 mn in aid to Guinea to help it tackle the outbreak. On 10 September the Bill and Melinda Gates Foundation announced USD 500 mn in funding to UN agencies to assist in the purchase of supplies and to scale-up operations, marking the foundation’s largest ever donation towards a humanitarian cause.
Although late in coming, the developments of the past few weeks represent an increased recognition of the severity of the epidemic and its continued spread in the West African region. According to the WHO’s latest tally on 5 September, the disease has killed 2,400 people out of 4,787 cases across Liberia, Sierra Leone and Guinea, with smaller outbreaks also reported in Nigeria and Senegal. On 8 September, the WHO warned it could take another six to nine months to contain the disease, which may eventually infect up to 20,000 people. The UN has called the health crisis “unparalleled in modern times,” saying it would need USD 1 bn to fight the outbreak.
The spread of the virus has been particularly severe in Liberia, where ebola has been reported in 14 of 15 counties and has caused 1,296 confirmed ebola deaths. Decades of underfunding meant Liberia was already facing a public health crisis before the disease struck, and the outbreak has underscored the inadequacy of medical infrastructure in the country. Medecins Sans Frontieres (MSF) has said it has had to take almost sole responsibility for providing medical facilities, and in many cases it has been forced to turn infectious patients away due to limited resources, increasing the risk of further contagion. The Liberian government’s role in tackling the disease has been almost entirely limited to liaising with the various NGOs. Reflecting these failings, Liberian President Ellen Sirleaf Johnson announced on 14 September she had dismissed 10 senior government officials for failing to return to the country to help combat the disease.
Despite the additional resources now available, the challenge facing public health workers remains vast. It will take some time for the US to train up the 10,000 local health workers the WHO estimates are required to contain the outbreak. The WHO has warned these figures will increase if the number of cases rises, as is widely expected. No timeframe has been given for how long it will take to establish the treatment centres, while shortages in the ZMapp drug means further testing will not take place until the end of the year.
Given the late stage at which the international response to counter the disease has been mobilised, the epidemic will almost certainly continue into 2015, though there are now improved prospects that there will not be significant outbreaks beyond Liberia, Sierra Leone and Guinea. In those countries, the disease has already had a clear impact on their respective economies, forcing many companies to suspend operations. The mining sector has suffered acutely, with several companies having to declare force majeure amid public health restrictions on the movement of people and goods. Sierra Leone announced on 10 September that its economic growth for 2014 would be cut to seven percent, down from a projected 11.3 percent, as a result of the virus. The absence of senior government officials and the added strain on public administration has paralysed government operations in Liberia, increasing the risk of delays to the issuance of permits and public contracts across business sectors. Such disruption to business operations will likely continue for at least the remainder of the year while the outbreak continues, stalling any prospect of an economic recovery for the three worst affected countries over the next six months.