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Editorial

All Nations Deserve Compassion

August 2014
1044-7946
Wounds 2014;26(8):A9

Dear Readers:

“Don’t worry. It’s Africa. Nobody cares about Africa.”
– General Zateb Kazim
, Sahara, 2005

The above quotation seems to ring as true today as in 2005 when the movie about the indiscriminant release of toxic chemicals into ground water killing many Africans opened in theaters. In the movie, the governmental leader was more concerned about his profits from the toxic waste disposal than the effect the chemicals were having on the people. The recent Ebola outbreak in Western Africa has the same ring to it. It was not until recently, when more than 1,300 people were found to have contracted the disease with more than 700 dying from it, that the viral infection is finally receiving the attention it deserves. Historically called Ebola hemorrhagic fever, Ebola viral infections first appeared in 1976 in 2 outbreaks in Sudan and the Democratic Republic of Congo. The disease gets its name from the Ebola River, which is near the site of the outbreak in Congo. The virus is transmitted from animals to man via contact with the body fluids of the animals. Infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines have been found to be carriers of the disease, with the fruit bat considered the natural host for the virus. Outbreaks occur most frequently in Central and West Africa near tropical rainforests. The World Health Organization (WHO) reports there were 2,387 cases between 1976 and 2012 with a mortality rate as high as 100% but ranging from 70% to 90%.1 The only WHO recommendations for the disease have been to avoid it and use precautions from coming in contact with body fluids of those infected.1

  Why hasn’t more been done to have effective treatments or to eradicate such a devastating disease with vaccines? I assure you that if such a disease was apparent in the United States or Europe, the answer would have been found promptly! It is mentioned that vaccines showing “encouraging results” have been under development by the National Institutes of Health (NIH) and others for “several years.”2 The unfortunate truth was revealed by Dr. Thomas Geisbert, a professor at the University of Texas Medical Branch in Galveston: “Pharmaceutical companies have seen little potential for profit because outbreaks are unpredictable and typically small.”2 This was further emphasized by Dr. Scott Lillibridge, assistant dean at the Texas A&M School of Public Health in College Station, when he said, “Until the current outbreak, many believed there wasn’t a great need for a vaccine because the virus would cause only 10-100 cases a year.”2 I guess the quote at the beginning is true. Unless there is profit to be made, “nobody cares about Africa.”

  How many people have to die before it becomes profitable to treat a disease? This is not a new issue. Dr. Ross Donaldson details how he worked in Sierra Leone treating patients with a hemorrhagic viral disease similar to Ebola in 2003.3 His encounters with dying patients for whom there was no treatment tugs at the heartstrings of anyone with a conscience. Not only are the patients dying, but also those committed to caring for them. Dr. Donaldson’s mentor became infected with the Lassa virus and died.3 Recently, 3 physicians dedicated to helping patients with Ebola have contracted the disease and died—Dr. Samuel Muhumuza Mutoro from Uganda, Dr. Samuel Brisbane from Liberia, and Dr. Sheik Umar Khan from Sierra Leone. The news is replete with the stories of Dr. Kent Brantly and Ms. Nancy Writebol, both of whom have contracted the disease and are undergoing intensive therapy at the time I am writing this.4 How many selfless health care workers have to contract this disease and possibly die before it becomes “profitable” to provide them with the necessary treatment?

  The WHO has pledged $100 million to add workers and resources to help control the disease. How much of it will actually get to the sites to help the patients remains to be seen. There are suggestions that an effective vaccine for the Ebola virus will be “fast-tracked” by the NIH and the US Food and Drug Administration into human clinical trials this fall, with the possibility of a vaccine for health workers available by 2015. Even with the ongoing carnage, these organizations have to “discuss some deals with pharmaceutical companies”2,5 to get something done. How sad is that! It seems to me that companies should be lined up, wanting to help. It is also interesting that these vaccines are suddenly ready for clinical trials.

  The Ebola virus disaster is just one of the many health-related problems facing under-resourced countries. It is nice to have meetings and set goals for solving the issues, but until we as human beings forgo greed and the desire for power, and help our brothers and sisters worldwide, there is little hope these problems will be solved. As one who has been honored to work in under-resourced countries in Africa, I am afraid that, at least today, the General in the movie may be right—“Don’t worry. It’s Africa. Nobody cares about Africa.”

References

1. World Health Organization. Ebola virus disease. Fact sheet no. 103. www.who.int/mediacentre/factsheets/fs103/en/. Updated April 2014. 2. Szabo L. NIH to launch early Ebola vaccine trial in September. USA Today. July 31, 2014. http://www.usatoday.com/story/news/nation/2014/07/31/ebola-vaccine-trial/13404609/. 3. Donaldson RI. The Lassa Ward: One Man’s Fight Against One of the World’s Deadliest Diseases. New York, NY: St. Martin’s Press; 2009. 4. Siegel M. Ebola doctors sacrifice all to bring hope. USA Today. July 31, 2014. http://www.usatoday.com/story/opinion/2014/07/29/ebola-africa-outbreak-aids-virus-column/13313443/. 5. Szabo L, Stanglin D. Ebola Vaccine On Way. Montgomery Advertiser. August 1, 2014; B:3.

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