Despite their call to action, both governments and those in private sector were slow to act in the early months of the outbreak, a mistake that has cost lives and increased the estimated cost to stop the disease to nearly $1 billion, according to a recent assessment conducted by the United Nations.
Part of the slow response comes from past experience with the disease. Historically, Ebola has produced a few hundred cases before eventually running its course. Health experts believe many may have assumed the current outbreak would follow the same pattern.
“The outbreak has been an unprecedented situation that's moved much harder, faster and in a more serious way than anyone could have predicted,” said Dr. Jeffrey Duchin, a professor of allergy and infectious diseases at the University of Washington and Public Health Committee Chair for the Infectious Diseases Society of America. “It required more than a traditional outbreak response. What was needed was more of a large-scale disaster response and traditional public health agencies were not prepared.”
The U.S. now will commit more than $500 million and 3,000 military troops in an effort to rebuild the health infrastructures of Guinea, Liberia and Sierra Leone, all of which have been overwhelmed beyond their capacities to effectively treat the thousands who have been infected.
Non-governmental organizations hailed the U.S. plan as a good first step, but said more would be needed from the international community if there is to be any hope of containing the spread of the virus, which has killed more than 2,400 people and infected nearly 5,000 as of Sept. 13, according to the World Health Organization.
A similar trend can be seen until recently relative to philanthropic efforts.
“I think people have just been holding their breath saying 'Well it will die out again this time,'” said Dr. Lee Norman, chief medical officer at the University of Kansas Hospital, Kansas City. “The dynamics of this outbreak are so dramatically different that all the cases in the history of Africa don't total up to what the numbers are right now—it's clearly a different beast and it needs a different approach.”
According to the United Nations Office for the Coordination of Humanitarian Affairs Financial Tracking Service, $337 million in pledges and funding have come in as of Wednesday.
Norman said the U.S. military presence in the region will help stabilize the health infrastructure of the affected countries. The U.S. plan includes the construction of treatment centers that will add up to 1,700 new beds. Such resources should help sway more health workers to go to the region.
“I think if people have something to go to and have ways to make sure that they can render effective care, it will enhance people's incentives to go there,” said Dr. Amesh Adalja, an associate at UPMC's Center for Biosecurity. “The construction of these temporary hospitals will have a trickle effect that will have a lot of impact on how this outbreak will eventually be controlled.”
According to Rebecca Milner, vice president for Institutional Advancement for the humanitarian health aid organization, International Medical Corps., the creeping, silent nature of the Ebola disease also may have played a role in the slow financial response during the first few months of the outbreak, a reaction she hopes will reverse itself with increased media focus.
“When it's a slower kind of an emergency that takes a little while to evolve and there's less loss of life initially, it is more common for philanthropy to kind of take off at a slower pace than the situations around a natural disaster,” Milner said.
With a staff of about 175 currently in the region, Milner said her organization recently partially opened a 70-bed Ebola treatment facility in Liberia, which she expects will require a staff of up to 200 to become fully operational. It's been difficult to recruit volunteers to help in the relief effort because of the nature of the outbreak, which has infected as many as 240 of the region's healthcare workers, and resulted in death for half of those cases, she said.
There are indications that other countries are beginning to join the U.S. in providing aid. Tuesday, the WHO announced that China plans to send a 59-person mobile laboratory team to Sierra Leone to improve testing capacity. Last week, Cuba announced plans to send a medical team of 165 health professionals to Sierra Leone for a six-month stay to help with the treatment of Ebola patients beginning in October.
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