Without Ramped-Up Ebola Response Efforts, Afflicted Nations Could Collapse

September 24, 2014
Davy James, Associate Editor

Potential for widespread chaos and eventual collapse of hardest-hit nations without ramped-up international response.

The Ebola outbreak in West Africa could reach unprecedented proportions by early next year, leading to the eventual collapse of the hardest-hit nations unless intervention efforts increase substantially.

On Tuesday, the US Centers for Disease Control and Prevention (CDC) issued a dire predictive model projecting Ebola could potentially infect up to 1.4 million people in Sierra Leone and Liberia by January 2015 without ramped-up containment efforts or changes in community behavior.

“If conditions continue without scale-up of interventions, cases will continue to double approximately every 20 days, and the number of cases in West Africa will rapidly reach extraordinary levels,” the CDC said in a study posted on its website.

The World Health Organization (WHO) has estimated that, as of September 23, 2014, the current Ebola outbreak has killed more than 2800 people, with more than 5800 confirmed and suspected cases.

Without increased interventions, Sierra Leone and Liberia will have an estimated 8000 Ebola cases by September 30, 2014. Factoring in the evidence that Ebola cases have been drastically underreported thus far, the model estimates that approximately 21,000 total cases are possible in Liberia and Sierra Leone by the end of the month.

Reported cases in Liberia are doubling every 15 to 20 days, while cases in Sierra Leone are doubling every 30 to 40 days.

However, the CDC estimates do not account for intervention plans by various nations. In addition to the 3000 military personnel whom the United States committed to send to the afflicted region, the United Nations General Assembly and Security Council recently announced the creation of the Mission for Ebola Emergency Response to contain the outbreak.

Under a hypothetical scenario by the CDC, every 30-day delay in increasing the percentage of patients in treatment units to 70% would cause the number of daily cases to nearly triple. As innovative isolation methods are scaled up for patients who are unable to gain access to treatment units, however, the higher projections become less likely.

The significance of additional aid from the United States and other nations was underscored on Tuesday by the International Crisis Group (ICG), which warned that the epidemic could destabilize the region as the hardest-hit countries face widespread chaos and eventual collapse.

“Citizens are understandably terrified and increasingly desperate. In Liberia, protesters have blocked highways, looted clinics, and attacked security forces,” the ICG said in a statement on its website. “Eleven years after its civil war, Liberia faces the risk of a popular revolt against a fragile state that has been very slow to build key institutions, especially beyond the capital city of Monrovia.”

While additional personnel and resources from other nations are positive signs, the group cautioned that the current response is not nearly adequate. A lack of action, the ICG warned, could eventually cause the outbreak and subsequent collapse of countries to become a threat to international peace and security.

“Adding social breakdown to the epidemic would create disaster perhaps impossible to manage,” the ICG said. “To avoid such a scenario, the international community must provide more personnel, resources, and engagement not only to the immediate medical response, but also to the longer-term problems of strengthening governance and rebuilding health care systems.”