Many of us have felt helpless watching the devastation caused by Ebola in West Africa, which has killed nearly 11,000, and sickened thousands more. After a disgracefully sluggish start to the international aid response, Liberia has celebrated a milestone with no new cases for five consecutive weeks, and there have been no new health worker infections for the last two weeks. However, Sierra Leone and Guinea are still fighting to eradicate the disease.
Faced with the daunting realities of the Ebola epidemic, health care professionals across the U.S. raised their collective voice to advocate for equity as a key weapon against Ebola, signing the Health Professionals’ Petition Regarding Emergency Measures for Ebola Control.
An International Response To Ebola
Ebola’s toll reaches beyond those infected and will linger long into the future. It has shattered already fragile health care systems in the hardest hit countries, destroying the infrastructure essential to ensure safe childbirth, the delivery of immunizations, the treatment of malaria, and other lifesaving care. West Africa is losing much of the public health progress it has made towards the health-related Millennium Development Goals.
The current shock can be traced to the global inequality that underlies poverty and the dysfunctional health systems that allow Ebola to thrive. It comes as no surprise that the mortality rates in West Africa far exceed countries with more health care resources. In failing to provide equal opportunity for health, we produce inequality of health outcomes. The benefits of West Africa’s abundant natural resources—diamonds, rubber, iron ore, and fertile soil—have accrued to multinational corporations, but have not been shared with the impoverished majority. Ironically, the shortage of rubber gloves killed vital medical personnel in Liberia, home to the world’s largest rubber plantation.
Racism is a prime suspect for the initially slow international response. We are struck by the parallels with the discourse over systemic racism that is currently riling American cities and medical schools under the rubric “#blacklivesmatter.”
The Health Professionals’ Petition
Hence, health care professionals signed the petition that demanded a commitment of $8.4 billion annually from the federal government (the equivalent of one day’s U.S. health care spending) to Ebola control and health system infrastructure development in Africa. It asked health care professionals, health institutions, and health-related businesses to similarly commit one day of income each year toward this cause.
The petition also calls for the immediate removal of barriers to health care for those in the U.S. who may be affected by Ebola, because delays in seeking care can increase mortality and community transmission. Paid sick leave, universal health coverage, and protection from legal reprisals for immigrants who seek care are all essential to facilitate timely access.
Recognizing that drug companies failed to pursue an urgently needed Ebola vaccine because it offered little prospect of financial gain, the petition recommends the establishment of a public pharmaceutical firm to develop drugs and vaccines in the public interest. The final provision asks for the renunciation of punitive measures such as travel bans and blanket quarantines, as well as vigorous measures to combat the stigmatization of immigrant and black communities.
Resources must not stop flowing once the Ebola crisis is contained. Strong health systems are essential both to end the current Ebola outbreak and to guard against future shocks. In the spirit of Universal Health Coverage Day on December 12, 2014, we applaud the recent efforts of the World Health Organization (WHO) to start a dialogue on “building resilient systems for health in Ebola-affected countries.”
The reality is that Ebola will not be a disaster in the United States because we already have the essential resources for control — as Paul Farmer has put it, “the stuff, staff, space and systems.” However, Ebola reminds us of the importance of global health equality. As we continue to support urgent efforts to control Ebola, we should also support African nations in building lasting health systems.
“Liberia is not faultless. She lacks training, experience and thrift.
But her chief crime is to be black and poor in a rich, white world;
and in precisely that portion of the world where color is ruthlessly
exploited as a foundation for American and European wealth.”
— W.E.B. DuBois (1933)