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Ebola Infections Are Predicted to Skyrocket Over the Next Month

VICE News caught up with World Bank President Jim Yong Kim to discuss the institution's role in the Ebola response efforts.

by Kayla Ruble
Sep 23 2014, 6:50pm

Photo by Tim Freccia

More than 20,000 people will have contracted Ebola in West Africa by early November if the control measures do not change quickly, according to figures released by the World Health Organization today. The updated infection rates come six months to the day since the United Nations health agency formally announced that an outbreak of the hemorrhagic fever had taken hold in Guinea.

In those six months the countries of Sierra Leone, Guinea, and Liberia have felt the brunt of the outbreak. Infections have also been confirmed in Nigeria and Senegal, initially imported into the country via air travel from the outbreak's epicenter.

New figures from the US Center for Disease Control (CDC) estimate that 1.4 million people could be infected by January, if current trends continue. However, the CDC explained in a report out Tuesday that if 70 percent of patients were to be contained, we could see an end to the outbreak by January — which would be a little more than a year since the virus first cropped up on December 26, 2013 in the village of Gueckedou, Guinea by way of a two-year-old boy.

While numbers of infections and deaths continue to rise, the international community has boosted its commitment to the outbreak in recent weeks. Western countries including the US, Cuba, and China have committed money and personnel to help with response efforts. While these supplies and people have already begun landing in West Africa, the situation remains dire. Doctors Without Borders (MSF) has continued its efforts on the front lines, while the WHO has taken an increased role in the crisis. And after a historic UN Security Council meeting on Friday, UN Secretary-General Ban Ki Moon established the UN Mission for Ebola Response — the first such mission for a public health crisis.

But despite these advances, WHO Director-General Dr. Margaret Chan said the situation was likely "the greatest peacetime challenge that the United Nations and its agencies have ever faced."

Sierra Leone was on lock down for three days over the weekend under a government mandated, nationwide quarantine. In Guinea, eight Ebola workers were killed while visiting a local villager to increase awareness about the virus, their bodies were found on Thursday. Liberia continues to see an uptick in cases, while hospitals are overflowing and patients are dying in front of the centers looking for care. Airlines have canceled as many as a third of the flights going into the region, despite international warnings that this practice was ineffective.

Beyond the immediate effects on the population and society in West Africa, a recent World Bank Group report warns of the potential financial effects the largest Ebola outbreak since ever could bring on countries in the region. The combined impact on economic output for the three countries in the short term is estimated at $359 million, with a potential worst case scenario of $809 million in 2015, according to the report. In order to tackle the immediate response efforts, as well as these feared economic effects, the international financial institution has put up $117 million — with promises to send more if needed.

VICE News caught up with World Bank President Jim Yong Kim — a former director of WHO's HIV/AIDS department — at the sidelines of the Social Good Summit to discuss the institution's role in the Ebola response efforts.

VICE News: Can quickly explain how the World Bank has been involved in and why you have a stake in the [Ebola] response?
Jim Yong Kim: The World Bank funds a huge variety of programs in developing countries, and one of the things we fund is health care. And so in looking at what happened in Liberia, in Sierra Leone, in Guinea, fundamentally it's because we didn't develop the healthcare systems enough so that they'd be able to respond to this disease. Any hospital in the United States could deal with Ebola very easily, because it's really straightforward interventions, universal precautions and then supportive care, meaning IV, IV fluids, electrolyte repletion, it's pretty straight forward stuff. And we can keep just about everybody alive in a rich country. So the World Bank is involved now because there is no other source of emergency funding that can move quickly to the countries and help them mount the emergency response. So, for example, in Haiti we responded very quickly. We were involved in Haiti in everything from building back school to removing rubble. We jump in and sort of do whatever is needed.

First and foremost, we are a very good source of income and have good relationships with these governments, but the other piece of it is if we didn't respond and if we didn't put the money on the table as quickly as we did, the chance that this would have a huge and much larger economic impact goes up everyday. And it's still going up. And so you know, we've moved as quickly as we can, but we're late, there's no question that we're late. So we're just trying to, not only have we made the money available, we're now in the countries trying to help them disperse it, trying to help them get people hired, and the extent to which we can do that, the speed at which we can do that, will have a determining impact on how bad this gets and how big of an economic impact it has.

Photo by Fred Shaia

You have pledged money to the immediate response, you've also just released this report about the economic impact the outbreak is going to have, how do you tackle both at the same time?
The good news is, the same intervention will treat both the contagion of the virus and the contagion of the fear factor. So what we found, is that 80 to 90 percent of the economic impact after SARS, 80 to 90 percent of the economic of the H1N1 epidemic was not related to the virus itself but was related to the response. We call it aversion behavior, you know airports get shut down, roads get shut down, people don't go to work, things just stop moving in the economy. So the only way to stop the aversion behavior is to stop the virus. So for right now we're really focusing on getting treatment and prevention out there, so we can stop the spread and we can keep people alive. If we can do that, then we'll also treat the contagion of aversion behavior, and we'll be able to finally sort of get them back on the right path. But you know this is awful already for Liberia, Guinea, and Sierra Leone, you know they all three of these countries are coming out of conflict and were just beginning to make moves out of fragility and now this hits. So we're going to have to go back in and find a lot more resources to help them build back.

Going off of that, these are countries coming out of conflict, and we also have conflict in Syria, what happened this summer in Gaza, so looking towards the future and how can the World Bank and other organizations can respond to these crisis when it comes to public health?
We're in all those places, and as much as we can we try to continue our work even during the conflict. We're not in Syria right now, but we continue to be in Gaza. So for a while we had to pull some of our people out of Gaza because of the ongoing fighting, but we're now back there and we're going to do everything we can to help them rebuild. You know the refugees were in Jordan and Lebanon and we're doing everything we can to help Jordan and Lebanon, especially, respond to the crisis that was caused by this influx of refugees. But one of the lessons that come out of this, is that we have to just admit that we did not build the public health systems that should have been in place and you know, this is Ebola and it's a slow moving virus, but what if it were not? What if it were spread by the respiratory route? This would have started in Liberia, Guinea, and Sierra Leone and boom, spread to the rest of the world. Now if they had systems in place where they could get those outbreaks under control in those countries, then it wouldn't spread to the rest of the world. So we now have to really tackle that project of building functioning public health systems in every country in the world.

Going forward, specifically with the role of the economy, are you guys already looking at steps you're going to take when this outbreak starts to wind down? Hopefully it's six to nine months we're looking at. Where do you go from there?
I think one of our big responsibilities will be to build these public health systems, and so we're really going to focus on that. I think we also need to look at innovative ways of making financing available to fight pandemics earlier. Right, so this has taken time and we've had to wait for donations, we've had to wait for all these processes, whether in the United States or the UK or anywhere else. So we're also looking at ways of putting together financial instruments, that's what we do after all, that for example would disperse immediately if there were an outbreak. So that we wouldn't have to wait for countries to make pledges. And we're in the middle of discussions now with finance ministers and others to see if we can do something creative that will help us to have an immediate response that will really blunt the impact of future pandemics. So build those systems and think creatively about what can we do financially that will help us respond in the future.

It does sort of seem [in recent weeks] like there is a response that we're getting, we're actually finally seeing those reactions that MSF and WHO were asking for months ago, do you feel that way and do you have a sense of optimism of where this is going?
You know I'm cautiously optimistic, because I think now we have all the right players here. This is a very special kind of response that we need a response that on the one hand is very broad, but on the other hand is pretty complicated. So we need to bring everyone to the table who has experience doing complicated things in health in poor countries. And now that they're involved and now that the US is stepping up, and now that they're seems to be more money, I'm much more optimistic than before.

Left to Die: Liberia's Ebola Victims Have Nowhere to Turn as Treatment Centers Overflow. Read more here.

Follow Kayla Ruble on Twitter: @RubleKB

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