Sep 2, 2014
As the Ebola epidemic continued to spread in West Africa, with more
than 3,000 cases and 1,500 deaths, I invited CGD senior
fellow Mead Over, a
health economist and one of the world’s top experts on the
economics of HIV/AIDS, to discuss newly released maps from the
World Health Organization (WHO) and measures for limiting
the economic fallout from the epidemic.
“Ebola is much more like Avian Flu and SARS than AIDS,”Mead
tells me. “Its
gestation period is very rapid, and that stirs a panic that creates
an economic impact.”
In the case of the SARS epidemic, he notes, there were only about
800 deaths but the economic impact of reduced trade, tourism and
investment was estimated at about $40 billion—the equivalent of $50
million per death.
In the case of the Ebola epidemic, where cases will far exceed
those of SARS, the economic impact could be far greater, he
He emphasizes however that the Ebola epidemic so far is tiny
compared to the toll of malaria, tuberculosis, and HIV, “all of
which are many multiples more deadly on a continuing
Our conversation then turns to two
maps that the WHO released late last week, one showing the
location and spread of the Ebola virus (Figure 1), the other
showing the location of laboratories and treatment centers (Figure
Figure 1: Location of cases throughout the countries with
most intense transmission
Figure 2: Response Monitoring
“These maps are very helpful to those of us who are trying
to grasp what’s happening in real time in West Africa. What they
show is that we have a long way to go,” Mead
He adds that it is “shocking” how few laboratories able to confirm
the diagnosis are shown in the map. While there may be some
additional laboratories that are not shown, the WHO maps are
presumably the best information available, so either the data or
the labs themselves are alarmingly lacking.
“Labs are necessary to confirm a diagnosis of Ebola. The inability
to confirm a diagnosis makes it much harder for the physicians and
nurses to protect themselves. It means there's a need to quarantine
people who would not otherwise need to be quarantined. And
quarantining is extremely difficult,” he explains.
Released along with the two maps last week was WHO’s “Ebola
Response Roadmap” which outlined steps for affected
countries and the international community to contain the
WHO projects that if all
recommended measures are taken the epidemic may be contained within
6-9 months with perhaps more than 20,000 cases.
Noting that most of the cases shown on the WHO map are recent, Mead
says that the toll may be much higher.
“That’s an indication that this epidemic is growing very rapidly in
the countries of Liberia, Sierra Leone, and Guinea. The reported
cases do not seem to be close to the border of Senegal or
Guinea-Bissau, but there are cases close to the borders of Mali and
Cote d’Ivoire,” he says.
So while this epidemic has been confined primarily to three
countries, the governments of Cote d’Ivoire, Mali, and
Guinea-Bissau are all on the alert.
“There’s a need for all those countries to strengthen their health
infrastructure at the borders,” Mead says.
Mead concludes by discussing the international community’s response
to minimize the economic fallout, an issue he addresses in greater