The future of global health after the Ebola outbreak

INTRODUCTION

The Ebola outbreak has changed the context of global health in the world. Global health was known as a part of the public health. It was not taught in some universities in Africa. The concept of public health was more commonly used in the academic fields. Before the Ebola outbreak, one could say that such wide involvement of the international community in the fight against one disease was never seen as it was during the Ebola outbreak. Before the Ebola outbreak in West Africa, it seemed that the international community was more involved in the war than the global health response to epidemic diseases.

The Ebola outbreak started in March 2014 in the forest region (the south region) of the Republic of Guinea in West Africa. Before that period; the Ebola infection first outbreak was noticed in the Democratic Republic of Congo (Zaire) in 1976. The international community was less mobilized to prevent the epidemic from causing another human catastrophe as it was lately observed in Guinea; Sierra-Leone; and Liberia. The real involvement of the international community became effective when the United States recorded the first case of Ebola on its soil. Here was the highlight of the Ebola outbreak; and here marked the start of the true concept of global health as it defined in the scholars’ books.

METHODS

This article is both retrospective and prospective. It is analytic. It is based on factual considerations rather than clinical trials. It is a viewpoint article. The aim of the article is to determine the future of global health by inspiring on its past and its present. The article will then use the data provided by the World Health Organization; the Center of Disease Control and other scholars’ data about the previous and the recent Ebola outbreak.

RESULTS

The Republic of Guinea recorded its first patients in March 2014. The authorities; at that beginning, remained slow in their response. That negligence resulted in hundreds of deaths in the community. “23 March 2014-The Ministry of Health (MoH) of Guinea has notified WHO of a rapidly evolving outbreak of Ebola virus disease (EVD) in the forested areas of south-eastern Guinea. As of Mars 2014, a total of 49 cases, including 29 deaths (case fatality ratio: 59%) had been reported” (WHO, 2014).¹

After reporting to the World Health Organization, the Guinean authorities waited about four months before taking the epidemic into real considerations. That was the first errors in the concept of global health. The Center of Disease Control and Prevention (CDC, 2015); reported on September 18, 2015 the outbreaks chronology of the Ebola virus worldwide as follows: “Zaire: 1976: Case: 318, Deaths: 280; DRC: 1995: 315, Deaths: 250; Uganda: 2000-2001: 425, Deaths: 224; DRC: 2007: 264, Deaths: 187”.² According to the Guinean government (Republic of Guinea, 2014; “From January to Mars 24, 2014, the overall suspected cases was 86 with 59 deaths, including 34 deaths in the communities of some countries of the forest region of Guinea; the lethality rate was 69%”.³ Since that period, the Ebola virus has caused thousands of deaths worldwide. The virus killed thousands of people; mainly in Guinea, Sierra Leone and Liberia. Some of the countries that were previously affected by the virus are now declared free of Ebola, while Guinea continues to record some sporadic cases.

DISCUSSION

In analyzing the aforementioned data, it appears that the concept of global health was not working in the proper sense from 1976 to 2014. The concept started to work after noticing the rapid deaths of thousands of people in Guinea, Sierra-Leone, and Liberia. Also, the involvement of the United States of America has accelerated the process of the global response to the Ebola outbreak. Rapidly, a vaccine was developed with 100% effectiveness. The development of that vaccine did not follow the traditional cycle of the development of pharmaceutical products. It was so rapid that can spark many scientific questions. The clinical trial of such a vaccine should be conducted in the laboratory on the animals. Since, the massive involvement of the international community in the global response to the Ebola outbreak from 2014 to 2015 has revolutionized the concept of Global Health in the world especially in Africa.

The 19^th-century shift in population that accompanied industrialization and migration from the countryside to cities led to overcrowding in poor housing served by inadequate or nonexistent public water supplies and waste-disposal systems. The conditions resulted in repeated outbreaks of cholera, dysentery, TB, typhoid fever, influenza, yellow fever, and malaria. Global urbanization accelerated dramatically during the last four decades of the 20^th century, putting more and more people at risk for large-scale disease outbreak.⁴

By analyzing that statement, it is easy to deduct that global health was not taking into consideration every aspect of the global health problems until 2014. None of the medical books described the Ebola outbreak as a part of the global health problem. Global health books did not mention any details about the Ebola infection as they did about the HIV, TB, Cholera, Malaria etc. The Ebola outbreak in 2014 has determined the future of Global Health by:

• ✓ Involving the entire international community for a global response against Ebola.
• ✓ Mobilizing the world population around a single goal.
• ✓ Mobilizing the necessary funds without any delays.
• ✓ Enabling the infrastructures and deliverable without delays.
• ✓ Rapidly enabling a vaccine with 100% effective.
• ✓ Educating people to the concept of Global Health and Public Health.
• ✓ Educating the healthcare professionals to support the patients.
• ✓ Implementing a strong follow up system in the concerned countries.

CONCLUSION

Before the Ebola outbreak, the concept of Global Health was barely used in some countries, the Center of Disease Control and Prevention was not significantly present in Guinea, Sierra-Leone, Liberia. The World Health Organization and UNICEF were focused on the traditional public health context. I believe that the financial helps from those organizations were directed to other diseases. The Ebola infection was not taken into account in the scholars’ researches as it should be.

Nowadays, Organizations are more focused on the global response to the communicable disease than they have ever been before. The CDC, the WHO, the World Bank and many other organizations are involved in the research, the prevention, and the treatment of the Ebola infection. They are funding local governments and local organizations in the fight against Ebola. The future of modern medicine will pass by the knowledge of the concept of Global Health which is an inclusive part of the Public Health. Global Health is now taught in developed countries. After the Ebola outbreak, universities in Africa and around the world must include the teaching of Global Health in their curriculum.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

REFERENCES

1. 1. WHO: World Health Organization: Emergencies preparedness, response: Ebola virus disease in Guinea. 2014. Available at: http://www.who.int/csr/don/2014_03_23_ebola/en/. Accessed 10 October 2015.
2. 2. CDC: Center of Disease Control and Prevention: Outbreaks Chronology: Ebola Virus Disease, 2015. Available at http://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html. Accessed 10 October 2015.
3. 3. Republic of Guinea: Information about the Hemorrhagic Fever at Ebola Virus in Guinea Conakry, 2014. Available at: https://www.humanitarianresponse.info/system/files/documents/files/INFO%20FIEVRE%20EBOLA%20GUINEE%2024%20MARS%202014.pdf. Accessed 10 October 2015.
4. 4. Markle WH, Fisher MA, Smego Jr. RA. Understanding Global Health: Second Edition: Global Health: Past, Present, and Future. By McGraw Hill Education. USA. 2014:4.