During early Ebola crisis: “When minutes counted, we lost months”

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“Ebola is not over, the conditions that created it are still there” Committee members told, as members confront consequences of “Sophie’s choice” of funding one disease response at expense of another

A day after the White House responded to Congressional inaction on its request to fund Zika outbreak and impact control with a plan to take the needed money from remaining funds allocated to Ebola control, U.S. Senators heard about ongoing challenges in research, development and health system capacities in West Africa as Ebola transmission continues there.

They are challenges that allowed the Ebola virus to spread swiftly across three countries and make its way to seven more, and that were worsened by the outbreak’s impacts on business, agriculture and education, as well as on health care, speakers representing private and nonprofit sector responses said at a Senate subcommittee hearing today.

panjabiChasms in health care access throughout remote stretches of the three most affected countries allowed Ebola to spread unnoticed from December 2013 to March 2014, said Dr. Raj Panjabi, co-founder of the Liberia-based nonprofit Last Mile Health.

“Lack of care puts all of us at greater risk,” he said.

“We lost time,” he said. “When minutes counted, we lost months.”

What works best in an emergency, he said, “is not an emergency system.”

Among the deaths of more than 11,800 people since the outbreak began, he noted, was a toll that also hobbles recovery, he noted, with the deaths of at least 500 health workers.

“The cost of inaction is greater than the cost of action,” he said. His organization is involved in ongoing work with the Liberian government to build supported networks of community health workers.

“Our response isn’t over,” he said. “We must demand a health worker for everyone, everywhere.”

The hearing of the Senate Foreign Relations Subcommittee on Africa and Global Health Policy was called A Progress Report on the West Africa Ebola Epidemic, but its subtext was what ranking member Sen. Edward Markey (D-Mass) termed a “Sophie’s choice” of funding a response to one global infectious disease threat at the expense of another. Sen. Markey spoke directly to the White House announcement yesterday that it would use funding intended for Ebola responses to confront the spread of Zika virus, after receiving no response from Congress two months after a request for $1.9 billion for research, monitoring and other responses to that outbreak, which has been linked to increased rates of neurological birth defects and disorders.

The administration has urged Congress to supply funding for Zika, and provide authority for the replenishment of the Ebola money.

Speaking of the death of a 30-year-old woman from Ebola in West Africa last week and the illness of her five year old orphaned child, Markey noted that the Ebola outbreak has already sickened more than 28,000 people, and that discoveries of its lingering effects, and potential for renewed transmissions and illnesses are still emerging.

DelaunayThe needs for research and development of tools to respond to Ebola continue, even as transmission continues, Sophie Delaunay of  the international humanitarian organization Médecins Sans Frontières, who also spoke at the hearing, agreed. A diagnostic test to confirm Ebola illness at the points of care in remote areas still does not exist, she said. Treatment options, she said, remain severely limited. And efforts to test vaccine candidates began too late to yield confirmed results, she said. She, too, emphasized the need to prepare before the next outbreak.

“Significant scientific advances are still required against Ebola,” she said.

Subcommittee members also heard from Amanda Glassman of the Center for Global Development who said U.S. responses to infectious disease outbreaks remain “clearly indispensable,” and raise other nations’ awareness of  health crises.

And they heard from Alan Knight, chairman of the Ebola Private Sector Mobilization Group, who concurred funding for epidemic responses would need to continue. “This is,” he said, “an emerging and growing problem.”

Transcripts of the speakers’ full comments at the Senate Foreign Relations Subcommittee on Africa and Global Health Policy hearing of A Progress Report on the West Africa Ebola Epidemic can be downloaded here.

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