(task) Ebola: an open letter to European governments : The Lancet

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61611-1/fulltext

Ebola: an open letter to European governments

Copyright © 2014 Elsevier Ltd All rights reserved.
After months of inaction and neglect from the international community, the Ebola epidemic in west Africa has now spiralled utterly out of control. Today, the virus is a threat not only to the countries where the outbreak has overwhelmed the capacity of national health systems, but also to the entire world. We urge our governments to mobilise all possible resources to assist west Africa in controlling this horrific epidemic. Based on our expertise in public health and emergency response, we believe the following measures would be particularly effective.

First, with regards to human resources, given the huge need for trained health-care professionals in west Africa, we urge European governments to create mechanisms that allow professionals working in public health-care systems to volunteer for temporary leave (with hazard pay) to contribute to the epidemic control efforts in the region. European countries can and should step up to contribute in line with their capacity and potential.

Second, regarding technical and infrastructure support, there is a huge need for field laboratories, epidemiological and microbiological surveillance resources, diagnostic equipment, and mobile communications software and technology. These needs go hand in hand with basic infrastructure requirements such as electric generators, clean water, and fuel. European countries have the resources and the knowledge to deploy them.

Third, with respect to medical supplies, health-care professionals and communities are in desperate need of personal protective equipment as well as disinfectants, such as soap and chlorine. While health-care centres should have priority, they are completely overwhelmed, and many infected people are receiving care at home. European countries should actively seek to procure and distribute protective clothing to all health-care professionals on the ground as well as to communities in need.

Finally, with regards to transport and logistics, governments should go beyond requesting private companies to resume travel to the affected regions (a measure that is not only epidemiologically unnecessary, but also counterproductive) and create strong incentives for them to do so, while also mobilising military and civil transport by air, sea, and land to ship food, supplies, and personnel to the affected regions.

If we aim for our action to be truly effective, Europe's strategic approach to responding is just as important as its financial and material commitments. We call on our governments to take an active and dedicated role, in partnership with west African countries and the UN, to ensure that the response over the next months is managed transparently and effectively, and in ways that support complementary goals for human and economic development in the region. First, aid should be channelled to organisations already on the ground, particularly those led or primarily staffed by west Africans. This includes national, public health systems as well as non-governmental organisations. Médecins Sans Frontières has been playing an important part, but groups run by west Africans are in the best position to engage local support, act as cultural mediators between international actors and local populations, and build capacity among community stakeholders.

Second, the response should catalyse the link between health and development. The Ebola epidemic has eco-social origins and societal costs that go far beyond the health effects, so all possible efforts should be made to ensure that international donations support—never replace—local economies and social systems.

Third, built-in mechanisms for governance, monitoring, and evaluation should be established. European governments have an obligation, both to their own constituencies and to the communities in need, to deter (and punish) waste and graft so that scant resources are used as effectively as possible. In light of the €97·5 million that the European Commission has announced in budget support measures to Sierra Leone and Liberia, the immediate relevance of solid accountability measures is clear.

Finally, affected populations should benefit from their contributions to research. Those in the affected countries will contribute to the discovery of effective drugs and vaccines and to models of care as researchers, field workers, and, above all, participants in research.

Since Ban Ki-moon entreated the international community to help on Sept 5, 2014, several countries have stepped forward with donations, equipment, and personnel. This global response is long overdue, but we fully expect all our European democracies (predicated on principles of solidarity, equity, and social protections) to make up for lost time with celerity, determination, and commitment. The Ebola epidemic represents a public health imperative; unchecked, it might very well become a geopolitical crisis.

We declare no competing interests.