Ebola threatens West Africa

2014-10-21 05:00


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Cape Town - Mali, the Ivory Coast and Nigeria are as "similarly ill-equipped" as Sierra Leone for an outbreak of Ebola, a London-based think tank has warned.

The Legatum Institute said its annual report, an Index which ranks countries in terms of wealth and well-being, "paints an alarming picture" of the west African countries which run the risk of contagion.

The news comes as the World Health Organisation (WHO) dispatches teams of experts to test levels of preparation in Mali and the Ivory Coast - top priorities on its list of 15 African countries at risk.

Nigeria is still under observation by health experts despite being declared free of Ebola by the WHO on Monday.

'Dire' health care

The 2014 Legatum Prosperity Index ranked Sierra Leone, the source of the Ebola outbreak, at the bottom of the 142 countries in terms of health.

The Institute found that Sierra Leone spends $205 per person on health care and has just 0.4 hospital bed per person.  It said that as a result health care is "dire", with the second highest rate of tuberculosis in the world and the highest incidence of infant deaths.

The Index, which will be published in full next month, measures infant deaths, life expectancy and health care spending alongside other governance indicators.

On all these factors, the Index found public health statistics in Sierra Leone to be "dismal".


Guinea and Liberia, the two neighbouring countries which are most affected by Ebola, are also ranked near the bottom of the index, at 134th and 129th respectively.

Revealing that its Index has ranked Nigeria 132nd, the Ivory Coast 128th and Mali 123rd, the Institute questioned whether these countries would be "any better" at responding to an epidemic.

It warned that the three nations are "similarly ill-equipped".

Though the details of South Africa's ranking on the 2014 Index will not be released until next month, last year it ranked among the best-equipped in sub-saharan Africa.

However, South Africa has slipped five places since 2009 and last year ranked 77th out of the 142 countries, behind Botswana in 72nd place.

Though higher spending on health care sees lower levels of infant deaths and higher life expectancy, the Institute said it is not simply spending that drives up standards.

It pointed out that the United States spends far more on health care than any other country in the world - almost $9 000 per person. Yet the average American lives to 78.7 years - 4.7 years less than the average person in Hong Kong - which has the highest life expectancy and a health care spending of $2 144 per person.

Threat spreads

Though no cases of Ebola have been reported in the Ivory Coast or Mali, Nigeria has suffered from 20 cases, including 11 deaths.

On Thursday, the WHO said 10 experts were due to be dispatched to Mali on Sunday and another team was to head to the Ivory Coast this week as the threat spread to areas nearing the countries' borders.

At a conference in Geneva, WHO's health security response chief Isabelle Nuttall said: "As the number of cases is increasing, it wouldn't be a surprise to have a case in a neighbouring country. And it's for this very reason that we are working with them so that they are able to detect and take immediate action".

On Monday, the WHO declared Nigeria Ebola-free after six weeks with no new cases. Speaking from the capital Abuja, the WHO country representative Rui Gama Vaz said: "This is a spectacular success story that shows to the world that Ebola can be contained". 

In a piece of "world-class epidemiological detective work", the WHO said it had linked all confirmed cases of Ebola in Nigeria back to a Liberian air traveller who introduced the virus to the country on 20 July.

It said it has traced all the people known to have had contact with that passenger.

'Remains out of control'

Despite this, the WHO and the medical charity Doctors Without Borders continue to actively monitor the country, with the WHO pointing out that the outbreak "remains out of control" in Guinea, Liberia and Sierra Leone.

The WHO said that the "unusual characteristic" of Ebola was that it has a cycle of dips in cases followed by sudden flare-ups.

James Barty, senior adviser to the Legatum Institute said: "Ebola is a warning that low levels of health provision create the conditions for outbreaks such as this to spread.

"The countries that do not have the health and governance infrastructure in place to deal with the outbreak - such as Sierra Leone, Guinea and Liberia - are suffering the most. We must not only help to contain the outbreak but ensure that the health care systems are upgraded in such a way that it cannot happen again."

Read more on:    who  |  sierra leone  |  nigeria  |  mali  |  ivory coast  |  west africa  |  health  |  ebola

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