Ebola could kill 100,000 and needs $1 billion to defeat, but Nigeria shows the world how it's done

For over a week there has not been a single new case of Ebola in Nigeria

AS the “war” against Ebola intensifies in West Africa, the World Health Organisation gives a harrowing warning that the number of Ebola cases could start doubling every three weeks and to prevent the outbreak from becoming a “human catastrophe” it will cost nearly $1 billion to contain.

Already the numbers are staggering. There have been at least 2,400 deaths, with nearly half of the 5,000 cases occurring in the past three weeks. Countries across the globe are now rallying to help contain the spread, Obama declared that the US will send 3,000 troops, China has dispatched 59 medics, and Cuba 165.

In a report released last week by the World Health Organisation, the group describes how it will take between six to nine months to control the outbreak and that the “climate of intense fear” is having negative repercussions on the ground.  This is evident in Guinea where the government has said seven people, who were part of a team sent to educate villagers in the southeast about Ebola, were found dead. 

Sierra Leone imposed a three-day lockdown to fight the disease.

Other experts have also warned that a worst-case scenario would see an additional 77,181 to 277,124 Ebola cases by the end of 2014.

The case count in West Africa’s unprecedented Ebola outbreak could grow by tens or even hundreds of thousands of cases before the end of this year, a new study suggests.

The work, published Thursday in the online journal Eurosurveillance, said that if growth continues at its current pace, a worst-case scenario would see an additional 77,181 to 277,124 cases by the end of 2014.

However, authors suggested it is unlikely the worst-case scenario would come to pass because containment efforts are being scaled up in response to the crisis. Nonetheless, using that figure, and based on the average fatality rate of the West African Ebola outbreak of just over 50%, some experts are projecting that the disease could have killed up to 100,000 people by year’s end.

Buying blood

The WHO has also warned that desperate patients are turning to the black market to buy blood from survivors of the virus. The report states that while “studies suggest blood transfusions from [Ebola] survivors might prevent or treat Ebola virus infection in others…the results of the studies are still difficult to interpret…More research is needed” – buying blood off the black market is dangerous and could lead to the spread of other infections, including HIV and other ailments.

The “three main affected countries, Guinea, Liberia and Sierra Leone, are struggling to control the infection against a backdrop of severely compromised health systems [and] significant deficits in capacity.” Fortunately, there is one country that, amid all the bad news, has come out as a role model for the rest of the world – Nigeria. 

Pay attention to Nigeria

On September 17th, the Nigerian Ministry of Health made a statement saying that for one week there had not been a single new case of Ebola in Nigeria. In fact, the international confidence in Nigeria’s ability to cope with the outbreak is apparent - it is the only country of the five in the region affected by the mass outbreak that has been given permission to send its pilgrims to Mecca for the world’s largest gathering of Muslims. This will however entail a three-tier health screening check before Muslims are even allowed to board the plane.

Despite the outbreak occurring in July, the Nigerian authorities have so far been able to successfully track and contain it. The total number of confirmed Ebola cases remain at 19, with seven fatalities. It was first detected when Patrick Sawyer, a man coming from Liberia, died in Lagos and then spread to a small number of cases linked to him in Lagos in Port Harcourt. 

Lagos is one of the world’s largest and most densely populated cities, with a population of over 20 million and is a travel hub in Africa - this was one of the worst case scenarios for an Ebola outbreak. But what could have quickly escalated into a national disaster didn’t.

National movement 

With Africa’s largest population of nearly 180 million, and federal and state governments that are noted for ineptitude, and authorities struggling to defeat a Boko Haram insurgency that is mostly confined to the northeast of the country,  how come it been quite competent in dealing with Ebola?

To begin with, Nigerian authorities  were quick to act in what can only be described as a national movement. Epidemiologists — health professionals who investigate patterns and causes of disease - quickly tried to track down anyone who may have come into contact with Sawyer after he walked off the plane in Lagos. Nigerian President Goodluck Jonathan approved more than $11 million toward containing the virus, within days declared the outbreak “a national emergency”, and was quick to urge the public not to spread “false information about Ebola” - which the government sought to tackle by establishing an “Ebola hotline” and used social and traditional media to get the word out. Major disease awareness campaigns and protocols to improve sanitation were implemented in transportation systems, schools, hotels and offices throughout the country.

In all the major hotels, there are sanitisers at every corner. Among Nigeria’s wealthy class, Ebola checks were imposed even for private parties at homes…you had a high temperature or wore unsually sweaty, you wouldn’t be allowed in whoever you were.

One month after Sawyer landed in Lagos Nigeria hit a stable period. Country Director of the U.S. Centre for Disease Control in Nigeria, Catherine Avery, commended the Federal Government for involving major stakeholders in the control of outbreak of Ebola virus disease which contributed to its containment. This includes every state government in the country that has now instituted emergency screening and response mechanisms, even if they have no reported cases. 

Border checks

There are also strict measures up to prevent Ebola from coming into the country undetected.  Travellers are being screened at all points of entry into the country and suspected cases are immediately sent to a new, clinical ward in Lagos. It has 40 beds  though the government has plans to expand it even further just in case they are needed.

Dozens of people are being watched by Nigerian authorities for symptoms, and the government is using volunteers to gather information on those who may also have been exposed to the virus. The state is also providing the public with plenty of information, showing the systematic procedures in dealing with the outbreak whilst preventing the dangerous spread of misinformation. 

Currently, the government states that the contacts under surveillance are; four in Lagos State and 344 in Rivers State. 347 contacts have been discharged from surveillance in Lagos State while 182 contacts have been discharged from surveillance in Rivers State. To help further contain the virus in the Rivers state, President Jonathan recently approved the release of approximately $1.2 million to the Rivers State Government as direct financial support. 

Nigeria’s decisive and effective action will further be bolstered by a grant from the African Development Bank (AfDB) which gave Federal Government $1 million in the fight against Ebola. 

Geography also favoured Nigeria, it must be admitted. With all its border checks, it still has over 2,000 unmanned unofficial crossings—-so it was lucky that neither Guinea nor Liberia are its immediate neighbours. 

Finally, while Nigeria’s states have effective in fighting Ebola, the best case the decisive action by Lagos State, they have one thing that most local and state authorities in Africa, outside South Africa, don’t have - real power and budgets. so they can act effectively if they choose to.


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