Ebola outbreak: UN says $1bn needed to contain epidemic

As of 2014, an epidemic of Ebola virus disease (EVD) is ongoing in West Africa. The outbreak began in Guinea in December 2013 after which it spread to Liberia, Sierra Leone, Nigeria and Senegal. The outbreak is caused by Ebola virus (EBOV). It is the most severeoutbreak of Ebola in terms of the number of human cases and deaths since the discovery of the virus in 1976,[5] with the number of cases from the current outbreak now outnumbering the combined cases from all known previous outbreaks.[6] Another outbreak in theDemocratic Republic of the Congo, which has 66 possible and confirmed cases and 37 deaths as of 12 September 2014, is believed to be unrelated to the West African outbreak.[7]

As of 10 September 2014, the World Health Organization (WHO), the United States Centers for Disease Control and Prevention (CDC) and respective governments reported a total of 5,232 suspected cases and 2,538 deaths (3,032 cases being and 1,509 deathslaboratory confirmed).[2][3][8] Many experts believe that the official numbers substantially understate the size of the outbreak because of families' widespread reluctance to report cases.[9] On 28 August, the WHO reported an overall case fatality rate (CFR) estimate of 52%, considerably lower than an average of the rates reported from previous outbreaks. However, difficulties in collecting information and the methodology used in compiling it may be resulting in an artificially low number.[10] A more accurate method that observed patient outcomes in Sierra Leone found a CFR of 77%.[11]

Affected countries have encountered many difficulties in their attempt to control the spread of this Ebola epidemic, the first that West African nations have experienced. In some areas, people have become suspicious of both the government and hospitals; some hospitals have been attacked by angry protestors who believe that the disease is a hoax or that the hospitals are responsible for the disease. Many of the areas that have been infected are areas of extreme poverty without even running water or soap to help control the spread of disease.[12] Other factors include belief in traditional folk remedies, and cultural practices that predispose to physical contact with the deceased, especially death customs such as washing the body of the deceased.[13][14][15] Some hospitals lack basic supplies and are understaffed, which has increased the likelihood of staff catching the virus themselves. In August, the WHO reported that ten percent of the dead have been health care workers.[16]

By the end of August, the WHO reported that the loss of so many health workers was making it difficult for them to provide sufficient numbers of foreign medical staff.[17] By September 2014, Médecins Sans Frontières, the largest NGO working in the affected regions, had grown increasingly critical of the international response. Speaking on 3 September, the international president spoke out concerning the lack of assistance from the United Nations member countries saying, "Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it".[18] A United Nations spokesperson has stated "they could stop the Ebola outbreak in west Africa in 6 to 9 months, but only if a 'massive' global response is implemented."[19] The Director-General of the WHO, Margaret Chan, called the outbreak "the largest, most complex and most severe we've ever seen" and said that it "is racing ahead of control efforts".[19] On 12 September Chan stated, "In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new cases is moving far faster than the capacity to manage them in the Ebola-specific treatment centers. Today, there is not one single bed available for the treatment of an Ebola patient in the entire country of Liberia."[20]