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here for an excellent commentary on the Ebola epidemic by Dr. Paul Farmer in the London Review of Books. I was particulary struck by this paragraph:
I’ve been asked more than once what the formula for effective action against Ebola might be. It’s often those reluctant to invest in a comprehensive model of prevention and care for the poor who ask for ready-made solutions. What’s the ‘model’ or the ‘minimum basic package’? What are the ‘metrics’ to evaluate ‘cost-effectiveness’? The desire for simple solutions and for proof of a high ‘return on investment’ will be encountered by anyone aiming to deliver comprehensive services (which will necessarily include both prevention and care, all too often pitted against each other) to the poor. Anyone whose metrics or proof are judged wanting is likely to receive a cool reception, even though the Ebola crisis should serve as an object lesson and rebuke to those who tolerate anaemic state funding of, or even cutbacks in, public health and healthcare delivery. Without staff, stuff, space and systems, nothing can be done.
In other words, this epidemic is driven more by the lack of medical and public health infrastructure than it is by a filovirus.
The same cause might be said for transmission in hospitals - lack of infection control infrastructure. The filovirus must be good at finding the weakest part of the system
ReplyDeleteI appreciate your comments related to the global inequities that are really allowing this outbreak to continue unabated. The president of the World Bank really highlighted this in a recent speech: Thousands of people in these countries are dying because, in the lottery of birth, they were born in the wrong place...This pandemic shows the deadly cost of unequal access to basic services and the consequences of our failure to fix this problem.
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