Q&A: The UN’s battle against Ebola

Special envoy David Nabarro talks to Al Jazeera about the United Nations’ role in fighting the spread of Ebola.

UN Ebola coordinator David Nabarro says $1.5bn is needed to fight the Ebola outbreak [EPA]
UN Ebola coordinator David Nabarro says $1.5bn is needed to fight the Ebola outbreak [EPA]

United Nations – The UN’s Ebola envoy says reports that the number of Ebola cases in Liberia may be slowing should be treated with caution. Dr David Nabarro says the figures are likely to go up and down in the coming months, adding there may even be under-reporting of the actual figures. 

Al Jazeera recently spoke to Nabarro about the UN’s role in combating Ebola. He says as long as the virus continues to be transmitted, the international community must “intensify” its efforts.

Dr David Nabarro, UN’s senior system coordinator for Ebola

Al Jazeera: There have been reports that in Liberia there is a slowing of Ebola transmission. Are you sure that really is the case?

David Nabarro: Let me be very clear that this is a quite large geographical area and the outbreak curve will look different in different parts of the area, especially as we’ve got some very good programmes of case finding and contact tracing in different parts of Liberia. But let me be clear, as long as there is transmission of this virus, we have a global public health emergency. And, as long as that transmission of the virus exists, we have to intensify our efforts to help people avoid being infected, and to make sure that the outbreak is brought under control as quickly as possible.  

AJ: Do you fear that there is a degree of under reporting; some medical personnel who are so busy that they are not recording the statistics, some people aren’t seeking medical help and are dying without ever seeing a doctor?

DN: In any disease outbreak, you are relying on a system to tell you whether or not people have been ill, or perhaps unfortunately died as a result of that disease. And when people are hard pressed dealing with the problems from day to day, it can be extremely difficult for them to also do the reporting. We do think there is some underestimation for various reasons, and we actually are taking that into account in our assessment of the figures.

AJ: Is the international community doing enough in terms of medical resources they are giving to you, sending to the region and in terms of funding?

DN: This Ebola outbreak that we are experiencing at the moment has touched the world. I think more people are emotionally connected with this issue than I’ve ever seen with any other global health issue. That means they are talking to their politicians and parliamentarians and they are saying, please let’s do something about it this. This is not something that we want to be going on happening in our world. And so there’s been a really amazing generosity of nations responding to requests for help, and some nations have gone back to their ministers of finance two and three times and increased the level of their support. Yes, we are going to need more finance. We’ve had to up our estimates of the total resource needs for the United Nations system since they were last estimated in September. We think that it’s probably going to be  around $1.5bn all in. We find that the amounts of money coming in the United Nations in response to these appeals is slightly over half of what’s being requested, which is amazingly generous.  

AJ: You’ve talked about the global concern. In some cases that turns into hysteria. There have been all sorts of restrictions put on travel by various different national authorities. Remind us of the position of the United Nations.

DN: We are very careful when we describe people’s reactions to a disease. Sometimes we do hear words like that one you just used, which I don’t actually want to repeat. I really would like to encourage everybody to understand that this is a frightening disease. It’s frightening to the people who are exposed to it, it’s frightening to people who just think about it, and so it’s quite natural that there should be reactions to the fear that lead to perhaps attempts to prevent certain people from traveling and coming in to particular countries. 

Let’s be clear.  Our rules are that people should be examined carefully when they are about to travel from an area where Ebola is prevalent. And if they have a history of contact with people with Ebola, or if they have symptoms and signs of infection, then they should be asked not to travel and to be kept under observation, and if necessary, provided with treatment. 

If a country wants to, we understand that it might also do some investigations when people are arriving at airports or seaports.  But we do not recommend any kind of rigorous automatic exclusion or quarantining of people just because they happen to come from a certain part of the world. 

AJ: Ebola was confirmed back in March. Then there were less than 100 cases. Now there are 13,000 cases. Wasn’t the ball dropped early on?

DN: I have worked on a number of outbreaks of disease in my life. What I have found is that when you are in the middle of an outbreak, it can be very difficult to know whether things are getting much worse or not, because you often don’t have up-to-date information.

The early, early signs didn’t enable a very quick judgment as to how serious it was. And so I’m not at this stage ready to say the ball was dropped. Instead I’m saying this virus learned how to exploit the way people lived, and it learned how to get itself into society, and as people moved from rural areas into urban areas, it started to spread very rapidly. And suddenly it did grow exponentially and that was when we turned up our response and made sure that it was concomitant with the scale of the problem.

AJ: As you know there are some in the World Health Organization who do believe that mistakes were made and question the role of political appointees. I know that was before you were in charge. Do you think it would be helpful though to have at some stage a full inquiry into what was done?

DN: That is for others to decide. I am totally focused on the present, on responding with others to the outbreak. I can give my version of history which I just have, but I’m not going to make any judgements. I just want to get on. We’ve got to help make sure this outbreak is ended as quickly as possible then we can go off and do something else. That’s the situation now. 

Source : Al Jazeera

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