Infectious disease deaths tell of crumbling systems

What you need to know:

  • Heart of the problem: The poor state of health systems in most of Africa, ostensibly a result of poverty, is responsible for the spread of most epidemics.
  • Unless we abandon our elaborate conspiracy theories and face up to our responsibilities, our people will continue dying of preventable causes.

Close to 3,000 people have succumbed to the Ebola disease that is ravaging West Africa.

Thousands more have been affected, and there is a huge risk of a wider spread, and more infections and deaths unless emergent and increasingly drastic measures are taken to stop its spread.

In the past, this disease was thought to be self-limiting because those infected either fought it off or died so quickly that they could not spread it outside a very limited locality.

We have gradually come to grips with the reality of a globalised world, in which such an infection can spread from one end of the world to the other within hours.

An epidemic of a dangerous infectious disease in any part of the world therefore constitutes a global public health emergency.

The United Nations arrived at this same conclusion recently, declaring the Ebola outbreak a threat to global peace and security and deploying a mission to begin combating the disease to prevent further outbreaks.

The only other scourge previously declared a global health emergency was HIV/Aids, and the distribution of this pandemic largely in poor countries spawned a genre of conspiracy theories themed around world domination by “western” powers.

The same is the case with Ebola, and some are questioning why the outbreak is restricted to (west) African countries and not the whole world.

In fact, there have been reported cases of health workers being attacked and killed in west Africa when they visited a village to help deal with Ebola patients.

CONSPIRACY THEORIES

As scientists, we are supposed to maintain an attitude of healthy scepticism, and this we do.

We investigate all plausible (and many implausible) claims in order to arrive at an approximation of the true situation.

If one were to investigate the conspiracy theories as far as healthcare in Africa is concerned, an interesting picture emerges.

The fact is that HIV/Aids, and even Ebola, can infect anyone who is exposed to the viruses, and this may happen anywhere in the world. Once a person is infected, though, the rest of the events depend on other factors.

On the surface, the magnitude of spread depends largely on geographic location.

An Ebola patient in Freetown, Sierra Leone will infect dozens of others before anyone figures out that they are sick, while in, say, Maastricht, in the Netherlands this may not be the case.

Digging deeper, it appears that it is not just the larger geographic location that matters, because even in Sierra Leone, certain neighbourhoods are more affected than others.

The key differentiating factor is the state of poverty among other key social development indicators.

The reason Africans appear to be more susceptible to such epidemics boils down to the relative poverty on the continent.

Former South African president Thabo Mbeki caught a glimpse of the link between poverty and HIV, but did not do enough to justify his claims that Aids is caused by poverty.

WE ARE ALL TO BLAME

The poor state of health systems in most of Africa, ostensibly a result of poverty and underinvestment in health, is therefore responsible for the spread of most epidemics across the continent. The blame therefore lies squarely with us!

Unless we abandon our elaborate conspiracy theories (also linked in a big way to poverty) and face up to our responsibilities, our people will continue dying of preventable causes.

Dr Lukoye Atwoli is Consultant Psychiatrist and Dean, Moi University School of Medicine; [email protected]