Controlling Ebola in West Africa will cost “at least $600 million” and possibly “a lot more,” and the response needs to be scaled up by three to four times what is currently in place, according to Dr. David Nabarro, senior United Nations system coordinator for Ebola disease.
Dr. Keiji Fukuda, assistant director-general for health security at the World Health Organization, cited estimates that it takes more than 200 people, including health workers and support staff, to treat 80 Ebola patients. The number of confirmed and probable cases as of the beginning of September was 3,500.
“The real challenge is to get existing staff in the countries in a position where they can go back to work,” Nabarro told reporters Sept. 3.
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That means deploying enough cash to create “inducements” to work — like hazard pay — and acquiring enough trucks and other equipment to supply and staff treatment centers in the three countries most affected: Liberia, Sierra Leone and Guinea.
Some participants in the Sept. 3 briefing expressed frustration with what they perceived as a disconnect between the scale of the problem and the response it has generated so far.
“If this is such an urgent response, if the window of opportunity … is closing … why are we having committee meetings?” asked Laurie Garrett, senior fellow for global health at the Council on Foreign Relations.
“Why weren’t we in a command and control structure with dedicated military-assured transport routes … and with a massive mobilization such as would be happening for a major humanitarian response?” Garrett added.
U.N. and WHO leaders stressed that the international community’s first priority is to support the efforts of West African governments. WHO Secretary-General Margaret Chan noted that the coordinating bodies have struggled to convince foreign medical teams to join the Ebola fight.
“That is a reality. Without the support of foreign medical teams, it is very difficult to mount a response to the scale that is [required],” she said.
A new coordination plan
“I have sought, so far, not to use language or style which encourages people to perceive that this is something that we cannot deal with,” Nabarro said.
“It is doable with the institutions and resources we have,” he added. “But the scale-up that is needed to actually achieve it in the time that is available … is in the order of three to four times what is currently in place.”
Nabarro, Fukuda and Chan are currently in Washington to meet with U.S. government and World Bank leaders to “ensure they commit to working to end the problem,” Nabarro said.
The United Nations is in the process of refocusing its response coordination effort around a new 12-part plan. Nabarro said it will go into effect over the “next few days.”
Among the 12 priorities are communications and messaging, health services for non-Ebola conditions, care for those infected, medical services for those who are responding and maintaining access to food and nutrition.
“You might say: Why is it so many pieces? The answer is: because this is complicated,” Nabarro told reporters.
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