Part of the reason that this ebola outbreak is so hard to contain is that it is so geographically spread out. There are multiple foci spread across four countries. To stop the spread in anyone of these hot spots requires a team of health workers, epidemiologists, medical anthropologists, plus lab equipment, protective gear, and facilities to isolate patients and hygienically bury the dead. This is a pretty massive undertaking and the sheer number of hot spots has stretched the capacity of the international responders and national systems beyond their breaking points.
There is simply not enough personnel, equipment or cash on hand to contain the outbreak. There are troubling reports of a hospital in Monrovia, Liberia running out of beds in its isolation unit; of hospitals demanding payments from symptomatic patients; of a “dearth of personal protective equipment” for health workers on the frontline (which is why so many doctors are getting infected). Beyond that, public awareness and public information efforts are faltering-in many places local populations are hostile to health workers, which undermines surveillance and containment efforts.
What’s needed above all else is money to correct these problems: to fund the deployment of more health workers; to purchase and deploy equipment; and to boost community awareness about the disease.
The WHO launched its response plan on July 31 with a $100 million emergency appeal. So far it has received a little under $30 million, leaving a $71 million gap. Without these resources, there will be no stopping the spread of Ebola in West Africa and around the world.
UPDATE: Good news. the World Bank announced a big pledge to fight the ebola epidemic in west Africa. The World Bank will disperse up to $200 million to both emergency efforts and long term projects to shore up the health systems of affected countries. The precise amount that will go toward the WHO’s emergency $100 million appeal is still being worked out, but World Bank spokesperson Phil Hay told me this will be a “consequential sum,” that is “definitely in the tens of millions of dollars.”
Update II: USAID announced today that it’s contributing an additional 5 million to the WHO’s response plan and also deploying an emergency Disaster Assistance Response Team to the field.
Bonus Content: A WHO perspective on why this outbreak has been so hard to contain