Ébola (Continuación)

Celebrations erupted Saturday in Monrovia after Liberia was declared Ebola-free. Credit Ahmed Jallanzo/European Pressphoto Agency

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On Saturday, the World Health Organization declared Liberia to be Ebola-free, recognizing that there had been no new cases since the end of March. While its neighbors Sierra Leone and Guinea still wrestle with this virologic demon, this is a moment for reflection and cautious optimism in Liberia. The world must ensure that what happened in Liberia never happens again — there, or anywhere.

Only eight months ago, the most tragic scenes were still unfolding in Liberia, one of the three countries hardest hit by the outbreak. Newly built treatment centers sat empty while bodies of the dead, and nearly dead, lay in the streets.…  Seguir leyendo »

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Strange deaths in a community from a disease that people had never heard of; this is immediately followed by a period of uncertainty and anxiety; and then a myriad of strange health workers appear, driving around in white jeeps with long antennas. They wear half jackets and brown boots and nervously wash their hands with incessant routine.

They all seem eager to help but bring bad news about a new disease called "Ebola." The outbreak control efforts include a mixture of persuasion and days of community "lock-downs," enforced by the military. The community is scared; they don't know who to trust.…  Seguir leyendo »

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El brote de ébola que comenzó el año pasado en Guinea, Sierra Leona y Liberia, tres de los cuatro países de la Unión del Río Mano, es el más grave registrado desde que en 1976 se diagnosticó esa enfermedad por primera vez en el África central. Las consecuencias de la epidemia han sido devastadoras y han puesto en entredicho los importantes avances socioeconómicos de nuestros tres países después de decenios de conflictos e inestabilidad.

Hasta ahora, esa región ha registrado un total de 25.791 casos y 10.689 muertes, casi diez veces el número de muertes de todas las epidemias de ébola combinadas.…  Seguir leyendo »

Yes, We Were Warned About Ebola

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The conventional wisdom among public health authorities is that the Ebola virus, which killed at least 10,000 people in Liberia, Sierra Leone and Guinea, was a new phenomenon, not seen in West Africa before 2013. (The one exception was an anomalous case in Ivory Coast in 1994, when a Swiss primatologist was infected after performing an autopsy on a chimpanzee.)

The conventional wisdom is wrong. We were stunned recently when we stumbled across an article by European researchers in Annals of Virology: “The results seem to indicate that Liberia has to be included in the Ebola virus endemic zone.” In the future, the authors asserted, “medical personnel in Liberian health centers should be aware of the possibility that they may come across active cases and thus be prepared to avoid nosocomial epidemics,” referring to hospital-acquired infection.…  Seguir leyendo »

Gráfico 2 : Fondos de origen español para la lucha contra el Ébola en Africa

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Recientemente experimentamos en España el revuelo y la alarma de la aparición de un caso de Ébola por el contagio de un sanitario en nuestro territorio. La curación de la persona afectada  y que no se produjera el contagio de otras trajo la calma y el olvido, aunque el problema y la amenaza persisten.

El caso del Ébola incorpora varias características de los bienes públicos globales. Por supuesto las que determinan su incorporación a esta tipología: trascender fronteras, elevados efectos externos, interrelación con otros bienes (en nuestro caso sanidad y seguridad), ausencia de una organización -equivalente a un gobierno- que suministre el bien, tecnología de producción de eslabón débil (depende el resultado final del que menos gasta en este bien).…  Seguir leyendo »

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"Every day, we cried" -- these were the words spoken over and over to me by a colleagues as we sat down after another long day for a rare drink in Monrovia, Liberia's bustling capital.

She was reminiscing about the period in September and October when the Ebola outbreak was at its peak. "Of all the pain that we faced, the cremation was the hardest", she explained. I knew exactly what she meant -- cremation was as far away from the norm for burials in West Africa as one can imagine.

As the Ebola outbreak wanes in Liberia, it is easy to imagine the heroes as the myriad of foreign doctors, nurses, epidemiologists and logisticians that have come to support the country in their days of need, and yes, these expatriates have definitely brought to bear much knowledge, expertise and resources on controlling the outbreak.…  Seguir leyendo »

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Last week, President Obama announced that the vast majority of United States troops deployed to fight Ebola in West Africa would be home within 60 days, and he announced the next phase of the Ebola response: the move from containment to eradication. It was also my last week as the government’s first Ebola response coordinator, a position that gave me the chance to reflect on what has been done, and what remains to be done.

Thanks to Mr. Obama’s leadership, tremendous progress against Ebola has been made in recent months: Caseloads in West Africa are down 85 percent, and we have put in place measures to protect the United States without needless quarantines or travel bans.…  Seguir leyendo »

How Bad Data Fed the Ebola Epidemic

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The West African Ebola outbreak first hit Sierra Leone in May 2014, followed by an explosion of cases in the capital Freetown in the autumn. The epidemic now counts more than 10,500 cases across Sierra Leone, with signs that the spread is slowing.

The early days of the crisis were characterized by a sense of immense fear, anxiety and alarm, regionally and globally. In Sierra Leone, a three-day, countrywide, military-led lockdown in September fed the fear in West Africa and beyond. Many flights originating in unaffected African countries were restricted. African students were prevented from attending some American schools, and there were countless reports of discrimination against Africans across the globe.…  Seguir leyendo »

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Port Loko is not far from Freetown, the capital of Sierra Leone and a global hub of maritime commerce. City and town, linked by paved roads, remain epicenters of Ebola transmission and deaths. Getting to zero new infections is the overarching goal of what is now the world’s largest public-health endeavor. But it’s still far from an ambitious clinical endeavor. The numbers say it all. Not a single American has died of Ebola; the majority of Europeans infected have survived; a Cuban survivor is already back here at work. Across West Africa, 70 percent of those afflicted die. And that figure applies only to the sick who receive care at treatment centers: Over 90 percent of those who stay home perish.…  Seguir leyendo »

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Las operaciones de construcción de paz posbélica (misiones orientadas a reconstruir un país que ha padecido un conflicto armado) se han convertido desde finales de la década de los ochenta en la principal actividad de Naciones Unidas. El nuevo contexto de internacionalismo favorecido por el fin de la guerra fría supuso que dichas operaciones fueran adquiriendo mandatos muchos más amplios, escenificando una notable ruptura con los objetivos de las tradicionales misiones de mantenimiento de la paz. Asimismo, esta agenda de construcción de paz posbélica ha ido configurando un modelo cada vez más estandarizado y homogéneo, conformado por múltiples reformas que persiguen la transformación de diferentes aspectos políticos, sociales o económicos del contexto posbélico en cuestión y por múltiples actores (internacionales, regionales y locales) encargados de implementarlas.…  Seguir leyendo »

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Considerando la cobertura de los medios en Estados Unidos y Europa al brote de ébola en África Occidental, podríamos pensar que la situación en los países afectados está mejorando gradualmente. Pero, aunque la epidemia ya no ocupa las primeras páginas, el virus dista de haber sido contenido. Por el contrario, continúa siendo una grave amenaza para la salud mundial.

Recientemente viajé a Conakry, la capital de Guinea, junto con el presidente francés François Hollande, luego visité Macenta, un distrito rural en la región boscosa del país, cerca del punto donde se originó el brote. En ambos lugares presencié directamente el devastador impacto del virus: sufrimiento, miedo, desesperación y, en última instancia, muerte.…  Seguir leyendo »

This undated handout file photo issued by Save the Children UK on Wednesday, Nov. 5, 2014, shows prospective health care workers in the Kerry Town Ebola Treatment Centre being tested on their personal protection equipment procedure in Sierra Leone. (Louis Leeson/AP)

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No evacuation plane to the United States or Europe awaited Dr. Thomas Rogers in early December when he fell ill with the Ebola virus in Sierra Leone.

Instead, the highly trained physicianstruggled to be admitted to one of the few Ebola treatment centers in the West African country. After finally securing a bed, Rogers died on Dec. 5 , sharing the tragic course of the Ebola epidemic with his countrymen.

With the death of Rogers, nearly 10 percent of Sierra Leone’s doctors have perished from Ebola since the epidemic started in March. Among them are Olivet Buck, one of the country’s few female physicians, and Sheik Humarr Khan, who led the initial response to Ebola.…  Seguir leyendo »

Del ébola y otras miserias

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Remitida la ansiedad que desbordó a las sociedades occidentales –particularmente la española– ante la irrupción del ébola en sus vidas, es momento de reflexionar sobre algunas realidades a menudo soslayadas por percepciones marcadas por prejuicios y análisis apresurados. Quizá se consiga, así, conjurar futuros peligros que se ciernen en el horizonte. La primera verificación es que África no está tan lejos; la indiferencia ante sus miserias es fuente de contingencias más engorrosas que la ola de calor sahariano que a menudo sofoca la Península Ibérica.

Conocí la existencia del ébola a principios de 1995, siendo delegado de la Agencia EFE en África central.…  Seguir leyendo »

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La epidemia de ébola en el África occidental está destruyendo vidas, diezmando comunidades y dejando huérfanos a niños a un ritmo que no se había visto desde las brutales guerras civiles de esa región que se acabaron hace más de un decenio. En Liberia, el 60 por ciento de los mercados están cerrados ahora; en Sierra Leona, sólo una quinta parte de los 10.000 pacientes de VIH que están en tratamientos antivirales siguen recibiéndolos y el Gobierno de Guinea está comunicando un desfase financiero de 220 millones de dólares debido a la crisis. Si no se contiene pronto el brote, la mayoría de los beneficios económicos y sociales logrados desde que se restableció la paz en Liberia y Sierra Leona y desde que se inició la transición democrática de Guinea podrían perderse.…  Seguir leyendo »

Members of District 13 ambulance service disinfect a room in a village north of Monrovia, Liberia. Credit Jerome Delay/Associated Press

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In my career as a medical doctor and global health policy maker, I have been in the middle of monumental struggles, including fights to make treatment accessible in the developing world for those living with H.I.V./AIDS as well as multi-drug resistant tuberculosis. But the Ebola epidemic is the worst I’ve ever seen.

More than 11 months into the crisis, thousands of people are dead and more than 17,000 have been infected. The virus kills quickly, spreads fear even faster, alters human relationships, devastates economies and threatens to cruelly extinguish hope in three fragile countries that were on the rebound after years of misery.…  Seguir leyendo »

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No solo vidas se perdieron en la presente crisis del ébola. En el debate público reciente sobre cómo combatir el virus, el rigor metódico de la ciencia y la medicina dio paso a la política de la exageración y a la histeria de la gente. Para enfrentar el brote actual se necesitan políticas públicas serias y fundamentadas, de eso no hay duda. Pero también es importante aprovechar las lecciones de la epidemia y asegurar que otras enfermedades nos encuentren preparados.

Hay dos grandes lecciones que podemos extraer de este brote de ébola. La primera es que nunca hay que dejar de fortalecer todo el sistema sanitario de un país por concentrarse en combatir una sola enfermedad.…  Seguir leyendo »

A lioness gives a lift to one of her cubs at Masai Mara National Reserve. (Jamie Swain / DK Grand Safaris)

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Unlike the United States, not one of the following countries has had a single case of Ebola this year: South Africa, Kenya, Tanzania, Botswana and Namibia. If that's surprising news, it shouldn't be. None of these countries is near the heart of the outbreak in West Africa. In fact, Sierra Leone's capital of Freeport, one of the cities hardest hit by the disease, is closer to Paris than it is to Johannesburg.

So why are so many people canceling travel plans to Africa's safari belt?

Ebola is a frightening and dangerous disease, which is what prompted the U.S. Centers for Disease Control and Prevention to issue warnings advising Americans to avoid inessential travel to several West African countries.…  Seguir leyendo »

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Estados Unidos y Europa han reaccionado de manera exagerada y burda ante unos pocos casos aislados del virus del Ébola al interior de sus fronteras. Estas respuestas aterrorizadas no sólo son inútiles. Al violar principios científicos básicos, desafían el criterio ético fundamental para una acción obligatoria en materia de salud pública. Y cuando se trata de proteger a los ciudadanos del Ébola -para no mencionar impedir que crisis sanitarias globales similares ocurran en el futuro-, estas respuestas bien pueden ser contraproducentes.

Los ejemplos más indignantes de reacción exagerada se produjeron en Estados Unidos, donde la respuesta inicial implicó una revisación más profunda de los viajeros provenientes de Guinea, Liberia y Sierra Leona.…  Seguir leyendo »

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I’m writing this somewhere over Morocco and my stomach is tied in little knots of excitement and just a hint of trepidation. I’m en route to join the King's Sierra Leone Partnership which is currently running the Ebola Isolation Unit in Connaught Hospital, Freetown. After a year of happily living in PhD-land, which has mostly involved wrestling with pipettes, I’m hurling myself into the biggest outbreak ever of a virus the very name of which makes people blanch. Bonkers. Clearly.

And yet there really isn’t anywhere else in the world I should be. I’ve always hero worshipped those who volunteered for Medecins Sans Frontieres and similar crisis response NGOs, and wondered if I‘d have the guts to go myself.…  Seguir leyendo »

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It may, in the end, turn out to be fortunate that a handful of people in developed countries — four in the United States and one in Spain — have contracted Ebola. Tragic as this was for Thomas Duncan, the only one of these patients who has died, if all of the more than 13,000 cases and nearly 5,000 deaths had occurred in Africa, Ebola would never have aroused nearly as much attention in rich countries.

In this respect, Ebola is — or, rather, was — an example of what is sometimes referred to as the 90/10 rule: 90 percent of medical research is directed toward illnesses that comprise only 10 percent of the global burden of disease.…  Seguir leyendo »