Jim Kim: World Bank may divert more long-term funds to fight Ebola

Just a day after mobilizing a $105 million grant for immediate response to the ongoing Ebola outbreak in West Africa, the World Bank insisted in mid-September that it would do everything in its power to prevent the disease from causing “potentially catastrophic” short- and medium-term damage to the economies of Guinea, Liberia and Sierra Leone. The world’s top multilateral donor had initially pledged $200 million in August for the Ebola response, over $100 million of which was for the medium- and long-term health systems strengthening in the three affected countries, “but if there is not enough money coming online to build the immediate response … we will have to … divert it and focus on the immediate response,” World Bank President Jim Yong Kim said Wednesday. If that is the case, Kim explained during a conference call with reporters attended by Devex, the bank’s executive board will have to go back and review its concessional loan window managed by the International Development Association — the institution’s fund for low-income countries — to review how to make sure there is still funding to build back the health systems in the affected countries. The World Bank chief underscored how investing in dealing with the crisis now could prevent a regional economic catastrophe that could top $800 million if the response was not scaled up immediately. “We have a choice right now; we have a choice today,” Kim said. “And that choice is if we invest everything that is needed right now, the costs going forward will be much, much less, not only in human lives — which is of course the most important to us — but in overall economic impact.” The latest figure everyone was talking about in September was the World Health Organization’s most recent estimate of $1 billion — and that may just be enough, if we acted now. “We just need more people, more money, more attention, more commitment,” Kim said, adding that even if the bank’s executive board was unanimous in its decision to release the funds — a “rare occurrence” around a particular issue within the institution’s top management — others also must step up to the plate. If donor countries, other international financial institutions and even the private sector don’t provide the resources West Africa needs at this time, the head of the World Bank revealed: “I am prepared to go back to the board and ask for more [money].” Swift response needed As West Africa continues to grapple with the worst Ebola epidemic in history, the World Bank published its most recent economic assessment of the crisis Sept. 17. If the virus continued to surge in three already fragile countries, the assessment projected, the economic impact of the outbreak in a worst-case scenario could grow eightfold to a staggering $809 million by 2015. For instance, this means that Liberia would see its gross domestic product slashed by 11.7 percentage points — from a 6.8 percent growth to -4.9 percent. Families that were very vulnerable to food price shocks even before the outbreak are now suffering the effects of inflation like food shortages, panic buying and speculation, as well as volatile exchange rates fueled by uncertainty and capital flight. On top of that, World Bank specialists believe the worst economic effects will not be because of direct costs like mortality or lost productivity, but rather indirect costs associated with fear of contagion. The analysis bases that contention on lessons learned from SARS in the early 2000s and the swine flu epidemic in 2009, where human behavior accounted for up to 90 percent of the economic impact of those outbreaks. “It won't be just the health care sector that we have to look at. We are going to have to make inputs in agriculture [and] in many aspects of the economy,” Kim said during the media briefing. “So we are really in the process of rethinking our overall envelope for these three countries and any affected countries.” Moving forward, the World Bank analysis recommended four priority sectors for international assistance at this time: ● Humanitarian support for health workers and facilities. ● Budget support to address the fiscal gap in affected countries, estimated at $290 million for 2014 alone. ● Deployment of screening facilities at ports of entry to enable the flow of both aid and trade. ● Strengthening the capacity of African health systems for surveillance, detection and treatment to prevent future outbreaks. On the last priority sector, Kim said he believed it was time to change the conversation and start talking more seriously about universal health coverage and how it will “help us respond much more effectively in the future to these kinds of epidemics.” How to overcome fear Ever since Ebola was first detected in May, gross misunderstanding of the virus and how to deal with it has seriously hampered efforts by health workers to contain the outbreak in West Africa. Devex has reported how the huge media attention to the steadily rising death toll has created the public perception that contagion — or even just showing symptoms without getting tested — is already a death sentence that has left clinics empty of both patients and staff, farms abandoned, and supposed and real victims roaming around just waiting to expire. So what can we do to address this “fear factor”? Francisco Ferreira, the World Bank’s chief economist for Africa, suggested to fast-track efforts to bring the epidemic under control by reducing the number of cases and mortality rate as well as providing more treatment centers, and at the same time carry out an “active, urgent and comprehensive” communication campaign for the population to understand the disease. One of the main problems, he told Devex, is that affected communities are convinced that the mortality rate is 90 percent, when in fact current statistics show it’s just 53 percent. In at least one hospital managed by Médecins Sans Frontières, the mortality rate has gone down to only 20 percent after implementing the appropriate treatment protocols. “It’s a serious disease, let’s not kid ourselves, but the chances of survival are higher than we anticipated,” Ferreira said. That message really needs to reach the people, and so far neither health workers on the ground nor the governments of Guinea, Liberia and Sierra Leone have been able to get it across. Would this have changed if more outside help had arrived from the beginning? Probably yes, but it’s not too late. “We all recognize that the international community didn’t respond as quickly in the early phases as it should have, but now we are catching up,” Ferreira said. “We are helping to provide these people the services they need to reduce this fear, and therefore reduce the economic impact [of Ebola].” Read more development aid news online, and subscribe to The Development Newswire to receive top international development headlines from the world’s leading donors, news sources and opinion leaders — emailed to you FREE every business day.