Ebola spending: will lack of a positive legacy turn dollars to dolour?

Millions were invested in west Africa to tackle the Ebola crisis, but some experts doubt there will be any lasting benefits for public health systems


LONDON -- While it is still too early to call time on the Ebola outbreak, a sense that the worst may have passed is tentatively taking root in west Africa, alongside an acute realisation of the need to ensure a positive long-term legacy for battered healthcare systems.

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Why Didn't Ebola Kill Me?

An ambulance transports the author to the Nebraska Medical Center in October. (Sait Serkan Gurbuz/Reuters)

THE ATLANTIC by Ashoka Mukpo                                                                          Feb. 12, 2015

Like the majority of patients taken to Western hospitals, I recovered from the disease—but health authorities are still struggling to figure out how to bring up the much-lower survival rate in West Africa.

...the 80-percent survival rate among patients who were evacuated to Western hospitals shattered the idea that an Ebola diagnosis spelled near-certain death. I know this all too well, as I’m one of those patients myself. In October, I contracted Ebola while covering the outbreak as a freelance journalist in Liberia. I was airlifted to a hospital in Nebraska, where aggressive treatment likely saved my life....
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Ebola-hit Guinea asks for funds for creaking health sector: TRFN

A health worker injects a woman with an Ebola vaccine during a trial in Monrovia, February 2, 2015. REUTERS/James Giahyue

REUTERS   by Misha Hussain                                                                                   Feb. 12, 2015

CONAKRY (Thomson Reuters Foundation) - International donors wishing to help Guinea fight Ebola should use their money to strengthen the West African country's health system and help it tackle future epidemics instead of building more Ebola treatment centres, a government official said....

"We already have over 400 beds (in Ebola treatment centres), but the attendance is among the lowest of the epidemic, so let's leave it at that," government spokesman Fode Tass Sylla told the Thomson Reuters Foundation in an interview in Conakry.

"Help us strengthen the health system, because after Ebola, all these treatment centres will disappear and Guinea will still be too weak to deal with the next epidemic," Sylla said, adding that the government was in talks with all funding partners....

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Lack of Effect of Lamivudine on Ebola Virus Replication

CDC EID JOURNAL by  Lisa E. Hensley, Julie Dyall, Gene G. Olinger, and Peter B. Jahrlin (NIH)                     Feb. 12, 2015

The unprecedented number of Ebola virus disease (EVD) cases in western Africa has compelled the world to consider experimental and off-label therapeutics to mitigate the current outbreak. For clinicians, approved drugs are an attractive solution because of known safety profiles and availability.

Oral lamivudine (GlaxoSmithKline, Brentford, UK), a US Food and Drug Administration–approved anti-HIV drug, has been suggested as a possible antiviral agent against Ebola virus (EBOV). In September 2014, a Liberian physician, Dr. Gorbee Logan, reported positive results while treating EVD with lamivudine (1). Thirteen of 15 patients treated with lamivudine survived presumed EVD and were declared virus free. Clinical confirmation of EVD in these cases remains to be verified....

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Postmortem Stability of Ebola Virus

CDC  EID JOURNAL                                              Feb. 12, 2015                                   
Study by Joseph Prescott, Trenton Bushmaker, Robert Fischer, Kerri Miazgowicz, Seth Judson, and Vincent J. Munster

The ongoing Ebola virus outbreak in West Africa has highlighted questions regarding stability of the virus and detection of RNA from corpses. We used Ebola virus–infected macaques to model humans who died of Ebola virus disease.

Assessing the stability of corpse-associated virus and determining the most efficient sampling methods for diagnostics will clarify the safest practices for handling bodies and the best methods for determining whether a person has died of EVD and presents a risk for transmission. To facilitate diagnostic efforts, we studied nonhuman primates who died of EVD to examine stability of the virus within tissues and on body surfaces to determine the potential for transmission, and the presence of viral RNA associated with corpses.


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Red Cross teams in Guinea attacked 10 times in a month

REUTERS                                                        Feb. 12, 2015

CONAKRY- Red Cross teams in Ebola-hit Guinea have been attacked on average 10 times a month over the past year, the charity said on Thursday, warning that the violence was hampering efforts to contain the disease.
In the most recent incident last Sunday in the town of Forecariah about 60 kilometres (40 miles) southeast of Conakry, two Red Cross volunteers were beaten while trying to conduct a safe burial, the charity said.

Ending traditional burials is seen as crucial to stopping the spread of the latest outbreak... because rituals often involve extensive contact with highly contagious corpses.

"As long as people have misconceptions about how Ebola is spread, and continue to prevent volunteers from doing their work, we will not stop the disease," said Youssouf Traore, president of the Red Cross Society of Guinea.

Health workers stand at the entrance to a quarantine zone in a Red Cross facility in the town of Koidu

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UN: 10,000 US-supported civilians needed to fight Ebola

ASSOCIATED PRESS by Edith M. Leder                                                                          Feb. 11, 2015
UNITED NATIONS (AP) — The U.N. Ebola chief says U.S. troops being withdrawn from Liberia have done their job of building desperately needed treatment centers but that more than 10,000 civilians working in West Africa and supported by the United States are still essential to combating the deadly disease.

Dr. David Nabarro warned in an interview Wednesday with The Associated Press that the battle against Ebola is far from over, pointing to a disappointing rise in new cases last week in hardest-hit Liberia, Sierra Leone and Guinea.

He said civilians from the U.S., Britain, France and elsewhere are still needed to help with tracing Ebola victims' contacts, re-establishing health services and changing behavior in communities.

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For Immediate Release February 11, 2015 FACT SHEET: Progress in Our Ebola Response at Home and Abroad

THE WHITE  HOUSE  PRESS OFFICE                                          FEB. 11, 2015

Fact sheet on the Ebola situation

"...Together with our international partners – and the people of the three nations themselves – we have bent the curve of the epidemic and placed it on a much improved trajectory. We have gone from over 1,000 new suspected, probable, and confirmed Ebola cases a week in October, to roughly 150 new confirmed weekly cases in the most recent reports.  Liberia has reported only a handful of new cases per week, a drop of well over 90 percent.  Significant declines also have been reported in Sierra Leone from the epidemic’s peak. Among the accomplishments in this response:..."

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Also see:

Most U.S. Troops will be withdrawn, posted yesterday, Feb. 11, 2015

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Ebola cases on the rise for second week: WHO

AFP                                                                                                        Feb. 11, 2015

Geneva -- The number of new Ebola cases in west Africa rose for the second week running after a previous fall, including a "sharp increase" in Guinea, the World Health Organization said Wednesday.

Health workers wearing protective suits carry a patient suspected of having Ebola on their way to an Ebola treatment centre in Macenta, Guinea, on November 21, 2014 (AFP Photo/Kenzo Tribouillard)

Nearly 9,000 people have died from the epidemic, the WHO said while admitting that it was impossible to give a precise number as the outcomes of some cases remained unknown.

All but 15 of the fatalities have happened in the worst-affected west African countries of Sierra Leone, Liberia and Guinea.

In the week up to February 8 a total of 144 new cases were registered, compared to 124 the previous week.

"Guinea reported a sharp increase in incidence, with 65 new confirmed cases compared with 39 the week before," the WHO said in its report.

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UK should resume flights to Ebola-hit nations: parliamentary watchdog

REUTERS   by  Katie Nguyen                                                                                       Feb. 11, 2015

LONDON - Britain's decision to stop direct flights to Ebola-hit countries had "no scientific justification", probably increased the cost of dealing with the outbreak and should be reversed, a parliamentary watchdog said on Wednesday.

Several airlines including British Airways and Emirates stopped flights last year to countries in West Africa affected by the worst outbreak of Ebola since the deadly virus was identified in 1976.

In September, independent health advisers to the World Health Organization (WHO) concluded that there should be no general ban on travel or trade with Ebola-affected areas....

The committee also criticized the Department for International Development (DFID) for failing to respond to the crisis with enough urgency. It said DFID should focus on strengthening healthcare systems in the region so they could cope better with future public health emergencies.
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Sarepta drug protects lab monkeys from Ebola

REUTERS   by Sharon Begley                                                                                      Feb. 10, 2015

NEW YORK --An experimental Ebola drug from Sarepta Therapeutics Inc protected six of eight lab monkeys injected with the virus, scientists from the company and the U.S. Army reported on Tuesday.

The drug, called AVI-7537, joins ZMapp from Mapp Biopharmaceutical and a compound from Tekmira Pharmaceuticals Corp as the agents shown to cure non-human primates given otherwise-lethal injections of Ebola virus.

The ZMapp and Tekmira drugs protected 100 percent of lab monkeys in studies, giving them a possible edge. But, unlike those, Sarepta's drug has been formally tested in healthy human volunteers at high doses and caused no serious side effects.

Sarepta's $300 million contract with the U.S. Department of Defense to develop drugs against Ebola and the related Marburg virus ended in 2012 due to government funding cuts. The study was completed just before then but not published until the current Ebola outbreak increased interest in the drug....

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How trials will work for Ebola vaccines

The search for an Ebola cure is gearing up — but there may be too few patients.  (Scroll down for Graphics.)

WASHINGTON POST     by  Amy Brittain                                                                      Feb. 10, 2015                        

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Ebola-hit Sierra Leone announces disease control agency

AFP   by Rod Mac Johnson                                        Feb. 10, 2015
Freetown -- Sierra Leone announced Tuesday the launch of an infectious diseases prevention agency, saying it would convert its Ebola clinics into treatment and research units for some of the world's deadliest viruses.

The organisation will follow the model of the United States Centers for Disease Control and Prevention, the leading American public health institute which has been at the forefront of the response the west African Ebola outbreak....

Although some Ebola units are temporary, Sierra Leone and its neighbours Guinea and Liberia have been looking for ways to continue using others launched at great expense at the height of the epidemic.

"We are now on the verge of constructing a permanent Centres for Disease Control in Sierra Leone, and also the introduction of an ambulance service in the country," government spokesman Abdulai Bayraytay told an online news conference.

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Sierra Leone to prosecute fraudulent Ebola "ghostworkers"

REUTERS  by Emma Farge                                                                                          Feb. 10, 2015

DAKAR --Sierra Leone said on Tuesday it had cleaned up a list thought to contain thousands of "ghostworkers" on its Ebola staff and would prosecute those who sought to swindle money from the government, tackling a problem that has dogged its fight against the epidemic.

More than 10,000 Ebola cases have been reported in Sierra Leone since last May, making it the hardest hit country in the world's worst outbreak of the hemorrhagic fever. The epidemic has been concentrated in West Africa and killed nearly 9,000 people out of 22,495 known cases since December 2013.

In Sierra Leone, payments to Ebola staff have repeatedly been frozen because of the difficulty distinguishing between genuine workers -- such as ambulance drivers and grave diggers -- and those forging their identities to claim hazard bonuses or registering twice to claim double pay.

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Most U.S. troops will return from Ebola fight by end of April

UPDATE: Obama says US has ‘risen to the challenge’ of fighting Ebola

ASSOCIATED PRESS  BY Edith Lederer in New York and Josh Lederman in Washington               Feb. 11, 2015

WASHINGTON — President Barack Obama heralded a “new phase in the fight” against Ebola on Wednesday and said progress against the outbreak in West Africa will allow the U.S. to withdraw nearly all American troops sent to Liberia last fall.

He cautioned the mission was not over, and he set an ambitious goal of eliminating the disease. “We have risen to the challenge,” he said at the White House. “Our focus now is getting to zero.”

Obama said only 100 of the 2,800 troops sent to Liberia will remain there after April 30. About 1,500 have returned home.

...Earlier in the day, he met with philanthropists and foundation leaders who had supported the fight against the outbreak, which had threatened to spiral out of control and fostered fears in the U.S. and elsewhere beyond West Africa.

At the height of the outbreak, Liberia was experiencing 119 confirmed Ebola cases per week. This week there were only three. But Guinea reported a sharp increase with 65 new confirmed cases compared with 39 the week before. Sierra Leone reported 76 new confirmed cases.

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