Globalisation and its Impact on Health: Ebola - Term Paper Example

Globalisation and its Impact on Health: Ebola Name Institution Introduction Ebola hemorrhagic fever (EHF), or Ebola virus disease (EVD), is a fatal viral hemorrhagic fever that affects humans or other primates. It has a high fatality rate of up to 50 percent, or 90 percent in some regions (Cenciarelli et al., 2015). The first Ebola infections were in 1976 in the Democratic Republic of Congo (DRC) at Yambuku near the Ebola River (based on which the name of the disease is derived), and Nzara in Sudan (World Health Organisation, 2014). The outbreaks of Ebola have been known to transpire sporadically in the tropical areas of sub-Saharan Africa. According to the WHO’s data, some 24 outbreaks of the disease that involved around 1,736 cases were witnessed from 1976 to 2013. However, a major outbreak was in the West African epidemic of Dec 2013 to Jan 2016, where some 28,640 cases and nearly 11,320 deaths were witnessed in Liberia, Sierra Leone, and some parts of Nigeria (WHO, 2016a; 2016b). While disease epidemic is yet to be witnessed in other parts of the world, such as Australia and the Asia Pacific region, it is highly considered that because of the ability of humans to travel far and wide due to globalisation, the disease could spread to other parts of the world (Cenciarelli et al., 2015). This paper explores the sources of Ebola and its transmission, the reasons Ebola has no vaccine and lastly, the public health management and prevention Ebola. Source of Ebola and modes of transmission Cenciarelli et al. (2015) indicates that because the virus’ natural reservoir host is yet to be identified, the manner in which the virus initially materialises in humans at the beginning of an outbreak remains unidentified. On the other hand, it is strongly believed that the first patient gets infected when he comes into direct contact with an animal that is infected, including primates like monkey and apes or a fruit bat (of the Pteropodidae family). The Centers for Disease Control and Prevention (CDC) (2015b) describes such mode of transmission as a ‘spillover event.’ Afterwards, person-to-person transmission happens, leading to extensive human infection. In certain documented cases of the virus’ outbreak, several primates become infected with the virus, leading to numerous spillover events, occurring when humans ate or get into contact with the infected primates. Thereafter, transmission of the Ebola virus happens among humans when they come into close or direct physical contact with bodily fluids of the infected persons, such as vomit, faeces, and blood (CDC, 2015b). Some studies have also established that the transmission of the disease indirectly happens when one is exposed to objects or surfaces that are contaminated with the virus. Despite this, the study asserted that the risks of such transmission are significantly low and are highly preventable through proper disinfection and cleaning measures (Hoenen et al., 2012). A study by the CDC (2015a) also established the presence of Ebola virus in the semen of infected men, who have just recovered from the disease. The study suggested that it is likely that the virus may be spread through contact with semen, such as via sex. However, the study failed to establish the length of time the virus may be present in semen. Related studies assumed that it seems the virus amounts diminish with time and leave the semen in due course. A study by European Food Safety Authority (2015) supported the findings by CDC and further suggested that tears and saliva may as well carry risks. Reasons Ebola has no vaccine Ebola currently has no vaccine because of two key reasons. The first is because of the high financial capital resources needed to invest in the research and production of the vaccine, in the face of the small number of affected people. Second, the existing trial vaccines, despite being around for close to 5 years, have not been licensed or approved for clinical use by humans (WHO, 2015). As at March 26, 2016, there are no licensed vaccines to protect humans against the Ebola virus. Despite this, some clinical trials are still ongoing for various candidate vaccines in Sierra Leone, Liberia, and Guinea, which could see an effective vaccine conceived in due time. Still, there have been concerns that lack of vaccine for EVD is because of the fears of pharmaceutical companies of the high financial capital needed for investment in the research, yet small returns, as the most affected countries in the developing parts of Africa are poor to attract large returns. The other reason is the small number of cases of the epidemic, which may not attract large profits for the pharmaceutical companies (WHO, 2015). The market demand arguments are emphasised by Martin (2014), of the Global Research, and Gavi Vaccine Alliance (2016), who contend that despite the progresses made in developing a vaccine, the pharmaceutical companies have blocking progresses in stopping Ebola during the past 15 years, as they could not foresee large profits from a vaccine for Ebola that was only endemic in poor African villagers with inability to pay. These sentiments are backed by another article by Grady (2014), which was published by the New York Times. The article reported that despite the progresses made by U.S. and Canadian scientists in developing a vaccine that is favourably effective in protection of primate (monkeys) from EVD, a product that could have been licensed by 2010, the licensing never happened. The companies feared that only 5,000 had died from Ebola, yet the vaccine needed significant costs of nearly $1.5 billion (Grady 2014). Indeed, compared to measles and influence virus, whose vaccines have been readily licensed and marketed, the Ebola vaccine is yet to be licensed. The market demand argument is that measles and influenza, which are spread by respiratory infections, are more infectious in developed countries with the ability to pay, hence more profits to the pharmaceutical companies (Moss, 2014). The risk of contracting measles in the wealthier countries is high, while the risk of contracting Ebola in the wealthier nations is low. While one person with Ebola will infect an average of two people, one with measles will affect up to 18 people. Again, while Ebola can kill only 5,000 people in a single season, measles can kill an estimated 122,000 people. The same applies for influenza virus, which can kill 50,000 people in the US in one season (Moss, 2014). However, the WHO, in November 21, 2015, insisted that clinical trials are still ongoing in varied phases, and that an effective and safe vaccine is expected to be conceived. For instance, the findings of Phase I clinical trials for the ChAd3-ZEBOV vaccine that GlaxoSmithKline (GSK) in partnership with the US National Institute of Allergy and Infectious Diseases (NIAID), and another vaccine called the VSV-EBOV, which is being worked on by Merck Vaccines USA, and Public Health Agency of Canada, have been found to be safe and effective in human participants (Agnandji et al., 2015). Hence, another reason for lack of the vaccine is the existing trial vaccines, despite being around for close to 5 years, have not been approved for clinical human use. Public health management and prevention The unparalleled scale and geographic scope of the Ebola epidemic in the poor nations in West Africa like Liberia and Sierra Leon in 2014 inundated the local response capacity, and posed tremendous challenge to contain the likely epidemic in wealthier nations, like the United States, France, United States, which had dispatched their healthcare workers to help contain the disease through the Global Outbreak Alert and Response Network (GOARN). For instance, France-based Médecins Sans Frontières (MSF) dispatched a team of 700 healthcare workers. Indeed, a number of health workers who had been affected, had died on returning to their countries, including in the U.S. (European Centre for Disease Prevention and Control, 2014) After the Public Health Event of International Concern (PHEIC) was enacted by WHO on 8 August 2014, the organisation made a recommendation that affected countries, such as in West Africa, perform exit screening of individuals at all their international airports, borders, and seaports for any illness with symptoms of Ebola. Further recommendations to the poorer and wealthier nations included cancelling all international travels of identified Ebola cases, on condition that the travel is for purposes of medical evacuation (ECDC, 2014). In the wealthier nations like the United States, the Centers for Disease Control and Prevention (CDC) recommended that any person with unguarded exposure to contaminated body fluids without personal protective equipment (PPE) be regarded as ‘high risk’ while those with PPR be consider ‘low risk’. Additionally, recommendations included direct active monitoring of healthcare workers who cared for Ebola patients while wearing the recommended PPE, in spite of being in West Africa or the US. This implies directly monitoring any likely symptom for 21 days after contacting the affected area or person, including checking whether their temperature exceeds 38°C each day. Similar recommendations were made by Public Health England (PHE) in October 2014. The individuals categorised as high risk are also restrained from using public transport, or long-distance travel, such as using trains, airplanes, or buses. Mandatory quarantine of health workers in the United States has also been used. Cases of forcing the healthcare workers who arrived in the US to January to quarantine for 21 days were also reported in New Jersey, Florida, Illinois, and New York (ECDC, 2014). In West Africa, the public health management and prevention measures for Ebola included restricted people from travelling abroad, or using public transport, attending public events and self-monitoring. Self-monitoring included individuals monitoring any likely symptom of Ebola and reporting to a health facility is a capacity to isolate patients immediately. Others included preventing direct contact with EVD patient or corpse, or their bodily fluids, and ensuring proper protected contact with EVD patient's bodily fluids (CDC, 2015). Conclusion While Ebola is yet to be witnessed in other parts of the worlds, such as Australia and the Asia Pacific region, it is highly considered that because of the ability or humans to travel far and wide due to globalisation, the disease could spread to other parts of the world. The transmission of the disease happens when one is exposed to bodily fluid of infected person, or objects or surfaces that are contaminated with the virus. Ebola currently has no vaccine because of two key reasons. The first is because of the high financial capital resources needed to invest in the research and production of the vaccine, in the face of the small number of affected people. Second, the existing trial vaccines have not been licensed or approved for clinical use by humans. The public health management and prevention measures for Ebola include restricting international travel to and from infected countries, mandatory quarantine of infected health workers and patients, preventing direct contact with EVD patient or corpse, or their bodily fluids, and ensuring proper protected contact with EVD patient's bodily fluids. References Agnandji, S., Huttner, A., Zinser, M. et al(2015). Phase 1 trials of rVSV Ebola vaccine in Africa and Europe — Preliminary report. The New England Journal of Medicine, 1(1), DOI: 10.1056/NEJMoa1502924 Cenciarelli, O., Pietropaoli, S., Malizia, A. et al. (2015). Ebola Virus Disease 2013-2014 Outbreak in West Africa: An Analysis of the Epidemic Spread and Response. International Journal of Microbiology, Article ID 769121, 1-12 Centers for Disease Control and Prevention (CDC). (2015a). Infection prevention and control recommendations for hospitalized patients under investigation (PUIs) for ebola virus disease (EVD) in U.S. hospitals. Retrieved from CDC website: Centers for Disease Control and Prevention. (2015b). Transmission. Retrieved from CDC website: Retrieved from: < http://www.cdc.gov/vhf/ebola/transmission/> European Centre for Disease Prevention and Control (ECDC). (2014). Infection prevention and control measures for Ebola virus disease Public health management of healthcare workers returning from Ebola-affected areas. ECDE Technical Report November 2014. Retrieved: European Food Safety Authority (2015). An update on the risk of transmission of Ebola virus via the food chain – Part 2: European Food Safety Authority (EFSA). EFSA Journal, 13(3), 2-17 Gavi. (2016). Ebola vaccine purchasing commitment from Gavi to prepare for future outbreaks. Retrieved from Gavi website: Grady, D. (2014). Ebola vaccine, ready for test, sat on the shelf. The New York Times. Retrieved: Hoenen, T., Groseth, A. & Feldmann, H. (2012). Current Ebola vaccines. Expert Opin Biol Ther, 12(7), 859–872. Martin, P. (2014). 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