Ebola! Prevention and Responsibility

Ebola! Ebola! Ebola! The word is everywhere—the name of the deadly virus from West Africa with a seventy percent fatality rate. A sense of dread and dismay is beginning to spread through our country. Asking vital questions will shed light on how to stop the spread of the current outbreak as well as prevent future outbreaks. Policies impacting both infectious diseases and those institutions that focus on treating, curing and stemming outbreaks need to be reworked to offer stronger support for nations with almost no public health facilities.

Since Ebola was first detected in the Congo by the Ebola River in 1976, it has sporadically struck remote villages in West Africa. Why haven’t Western countries responded with their advanced medical science and testing laboratories? For the same reason they were late in responding to malaria, resurgent tuberculosis and HIV/AIDS, which together continue to take millions of lives a year. These diseases prevail in developing nations and were initially uncommon in developed countries. Until, as with HIV/AIDS, they make their way to Western nations.

Why didn’t the National Institutes of Health (NIH) properly anticipate Ebola? It did, according to NIH director Dr. Francis Collins. “NIH has been working on Ebola vaccines since 2001,” he asserted, pointing to stagnant congressional funding for developing a vaccine and therapeutics. Dr. Collins said that with funding, “we probably would have had a vaccine in time…”

What was Congress funding? It was pouring trillions of dollars into the blast everywhere, quagmire “War on Terror,” which has spread al-Qaeda-type groups and violent instability into a dozen countries in a classic “blowback” against the U.S.

Along with the estimable Doctors Without Borders, I have been urging Presidents Clinton, Bush and Obama to make the fight against the invisible but heavyweight viral and bacterial “terrorists” into a major priority. With organized pressure from HIV/AIDS victims and their families, the U.S. government was forced to address this disease domestically and in Africa. However, there is no such victims’ lobby for the international fight against malaria and TB. Modest increases in public funding for the prevention and treatment of malaria and TB are due significantly to the efforts of Senator Patrick Leahy (D-Vermont), some foundations and some citizen groups like Princeton Project 55.

Collectively, the American people should take Congress to task for such neglect in the face of global experts in these and other infectious diseases saying “it is not a matter of if, just a matter of when.” Huge budgets are passed by members of both parties for weapons of mass destruction reminiscent of the Soviet Union age of hostilities. If the status quo persists, the pittances provided by Congress will do little to thwart infectious diseases that have taken and will continue to take millions of lives.

What of the immensely profitable drug companies—coddled with huge tax credits and billions of dollars in taxpayer-funded drug development given away free to selected pharmaceutical corporations like Pfizer and Bristol-Myers-Squibb? They have long avoided doing work on vaccines because, unlike life-style drugs such as Viagra or those for chronic ailments like high-blood pressure, vaccines are not taken daily or often. Vaccines do not have the same return on investment for pharmaceutical companies as those medications taken daily for a variety of conditions and treatments.

During the avoidable Vietnam War, the second leading cause, after wartime injuries, for hospitalization of American soldiers was malaria. The Pentagon got so fed up with the U.S. drug companies refusing to do any research for anti-malarial drugs, that it set up its own very successful research division at Walter Reed Army Hospital. It was a there that dedicated physicians and other scientists developed most of that era’s breakthroughs for anti-malarial medicines at a fraction of what the price-gouging drug companies would have charged patients for access to the same medication.

Such drug industry indifference is not new. The public should demand that Big Pharma disgorge some of their profits, stop charging Americans the highest prices in the world, and create a fund to pay for research on drugs that can curb the spread of infectious diseases.

Another question is why there are so few doctors and health workers in these African countries. Dr. E. Fuller Torrey wrote in the Wall Street Journal recently that for years the U.S. has been part of the brain-drain of African physicians (and other health care professionals) because of an entirely preventable doctor shortage in our own country. He wrote, “The loss of these men and women is now reflected in reports about severe medical-manpower shortages in these countries, an absence of local medical leadership so critical for responding to the crisis, and a collapse or near-collapse of their health-care systems.”

He estimated that Liberia, a country of four million people, has only 120 Liberian physicians, while there were 56 Liberian-trained physicians practicing in the U.S in 2010.

Through H-1B visa preferences, we lure doctors and nurses from the developing countries that need them desperately. In contrast, Cuba, a much smaller and less wealthy country, has dispatched thousands of doctors over decades to assist needy countries in Latin America and Africa. Just this month, Cuba announced it had sent 165 healthcare workers to Sierra Leone with another 296 doctors and nurses on their way to Liberia to help counter the spread of Ebola.

Going deeper, we might ask how the “structural adjustment” policies of the World Bank and the International Monetary Fund stripped developing countries of funds that could have been spent on health facilities and public works. At the same time, the World Bank and IMF pushed these countries to cut consumer food subsidies and change land that had produced grains and vegetables for the local populations into land for growing cash crops for export that drains these earnings to pay for their ever increasing debts to these financial institutions.

As long as Western nations keep politicizing the World Health Organization and keep it on a short budgetary leash (its annual budget is less than any of the revenues of the largest hospitals in Boston, Cleveland, New York or Houston), these nations are playing with the fate of millions of people, including those in Europe and North America.

Let’s face it, when it comes to putting preventative programs in place and reordering our public priorities, only we the people can get it done. Citizens are a democracy’s first responders. The first move is easy; call 202-224-3121 and ask for your Senators and Representatives. If you don’t get elected representatives on the phone, tell their assistants your questions and demands and ask for a detailed letter describing what your lawmakers intend to do about infectious disease epidemics.

No one can stop you from taking this first step.

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