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Thursday, 08/28/2014 8:55:30 PM

Thursday, August 28, 2014 8:55:30 PM

Post# of 146189
Cost to control Ebola shoots up

World Health Organization projects 20,000 cases and requests $490 million to control epidemic.

Sara Reardon
28 August 2014

Twenty thousand people may die before the Ebola outbreak in West Africa ends.

Controlling the Ebola outbreak in West Africa will require an infusion of cash from international donors — up to US$490 million over the next six to nine months, the World Health Organization (WHO) said on 28 August.

That figure, described in a new report, is significantly higher than the WHO's 5 August request of $71 million to fight Ebola. It is based on the agency's estimate that 20,000 people may be infected with the disease before the current epidemic is contained. The $490 million would pay only for the immediate response to Ebola, not the long-term rebuilding of ravaged healthcare systems in West Africa that experts say will be necessary once the disease is contained.

“This is putting out the fire, not building the firehouse,” WHO assistant director-general Bruce Aylward says.

The WHO estimates that 750 foreign healthcare workers and 12,000 workers from the affected countries will be necessary to meet the goal of stemming the Ebola outbreak within six months. The agency could not offer figures on how many health workers are already involved in Ebola response.

WHO member states are expected to foot the bill for the fight, along with sources such as the World Bank and the African Development Bank, which have already pledged $100 million and $210 million, respectively. By comparison, the WHO’s budget for outbreak and crisis response is only $228 million; it was slashed in half last year due to budget restructuring and the economic downturn.

The agency has a three-part plan for fighting the Ebola epidemic, which has now killed more than 1,500 people. First, governments and first responders must ensure that all affected geographic areas have adequate surveillance and healthcare within three months so that standard strategies for containment and tracking the spread of the disease will work. Secondly, countries need to contain any outbreaks in new regions within eight weeks, and finally, countries need to strengthen their capacity to detect and respond to cases.

Knock-on effects
The $490 million estimate assumes that the outbreak is two to four times larger than the WHO has been able to detect, as many cases of infection are likely going unreported. It also assumes that within two weeks, health workers will be able to convince airlines to resume flying to regions where Ebola is rampant. The companies' decisions to suspend flights to these areas have significantly hampered the ability of the WHO and other groups to deliver personnel and protective equipment. If the travel restrictions continue, transportation costs could rise significantly.

Jeremy Youde, a political scientist at the University of Minnesota in Duluth, says the WHO's transparency is admirable and demonstrates why its plan to fight Ebola is a worthy investment. But he wonders whether $490 million will be enough to end the current epidemic, and suggests that funding could become more difficult to obtain as the outbreak continues.

Youde says that the WHO is likely thinking about its immediate Ebola response in relation to its long-term budget. Member states, which supply 77% of the WHO budget , “could say ‘We gave $100 million for Ebola, so we can't pony up for flu,’” Youde says.

But Barry Bloom, a public health scientist at Harvard University in Boston, Massachusetts, says that the WHO could benefit if its Ebola response is effective, by strengthening the agency's case for funding in future years, especially for improving health systems generally in developing countries.

“The hope is that in the course of putting on the band-aids, there will be some training,” he says.

Nature doi:10.1038/nature.2014.15790

http://www.nature.com/news/cost-to-control-ebola-shoots-up-1.15790

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