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Fenner 1 The Effect of Disease on the Economic Status of Qasim Maria Fenner ENGL 2089 17 April 2015 Abstract Disease can have devastating consequences on a developing country. Various obstacles can prevent a country such as Liberia from gaining the necessary resources to stop disease and improve the quality of life of citizens. It is important that such boundaries be resolved to better healthcare and improve the way of life of people in the developing world. Medical research proves that the amount of pain an illness can cause on all levels of life for the citizens of a developing country is horrific. Many people of developed countries do not realize the economic impact that an infectious disease such as Ebola can have on a population. Increasing funding for research, education and prevention could save many lives and protect the economy from the destruction that disease creates. For instance, Ebola in Liberia has not only effected health and the healthcare system, but the entire economic system. Through the loss of life, Liberia lost the productivity of many and the economic growth that comes from a strong work force. The destruction of disease will only create a ripple effect of economic pain that lasts for decades. Introduction In 2014, the medical world witnessed a modern major Ebola outbreak. The Journal of Natural Sciences Research stated, “[t]he 2014 Ebola outbreak is one of the most devastating outbreaks in history and the first ever witnessed in West Africa.” As of August 2014, 3,685 cases and 1,841 deaths were reported (Jalloh 1). New Guinea, Liberia, and Sierra Leone suffered major losses in life, leading to fewer able-bodied workers, and a destroyed economy in already impoverished countries. Seeing as many researchers and consumers believed Ebola to be a problem of the past, the world was caught off-guard at its sudden onset. The widespread lack Fenner 2 of awareness, research and preparation of the 2014 Ebola outbreak proves just how easily an epidemic can sweep across a region, and threaten an entire way of life. Background on Ebola The Ebola virus is an extremely contagious hemorrhagic fever passed from human to human through contact with bodily fluids such as blood and sweat. According to the World Health Organization, Ebola is typically characterized by a sudden fever, weakness, muscle pain, headache, nausea and a sore throat. Eventually, symptoms become much more severe and can include vomiting, problems in kidney and liver function, and both internal and external bleeding (Ebola Virus Disease: Background and Summary). While most common in West Africa as of late, this disease is not limited to one area. In a time in which travel is extremely common, illness could spread to all corners of the Earth in a matter of days. If Ebola were to spread it could destroy lives, communities, economies, and entire populations. There are several species of Ebola and many outbreaks in recent history. Titilola Obilade of Virginia Polytechnic Institute and State University reports that the specific strain responsible for the most recent outbreak is a variant of the Zaire species of Ebola virus and thought to have been initially spread by bats (4). Such strain suggests that the virus from the outbreaks of the 1970s are still circulating, despite the common misconception that humans are now immune. Infectious diseases like Ebola are not demolished so easily. It will take foreign aid, awareness and research to combat Ebola at its source and prevent the rapid spread and skyrocketing fatality rates that this illness guarantees. Fenner 3 A deadly and highly contagious disease can reach epidemic proportions more quickly than it can be combatted if proper steps are not taken. Derek Gatherer of the Journal of General Virology warns, “[t]he case fatality rate in [Ebola virus disease] is so high, approaching 90% in some outbreaks… that members of the family Filoviridae have been classified as Category A potential bioterrorism agents” (1). Without preventative actions and quick containment of deadly diseases like Ebola, we stand no chance in fighting them. Left unchecked, disease will wreak havoc on the stability of a developing nation. Major setbacks in economic growth can stem from a small population of ill citizens. The fatality rate in Guinea and Liberia as of April 2014 was 61%, only 27% less than the all-time high 88% in both Congo in 2003 and the Democratic Republic of Congo in 1976-1977 (Jalloh 3). Even today with so much technology and research invested in the cure of major diseases, we still see high fatality rates in cases like the West African Ebola outbreak. If, with our rapidly growing list of advanced resources, we still cannot successfully fight small outbreaks, we are welcoming major epidemic all over the world. If not properly combatted, diseases like Ebola can spread rapidly from region to region. The Centers for Disease Control and Prevention’s “Morbidity and Mortality Weekly Report” for the week of September 26, 2014 estimated that cases in Liberia are doubling every 15-20 days and that, if trends continue, Liberia will soon account for 6,000 cases. In Sierra Leone, cases are doubling every 30-40 days and the two countries could have 21,000 cases when correcting for underreporting (Estimating the Future Number of Cases in the Ebola Epidemic - Liberia and Sierra Leone 5). The more quickly we contain the disease, the faster we can prevent the spread Fenner 4 and the mass death it can cause. When an epidemic like Ebola is left unchecked, it will only continue to grow at rapidly increasing rates. Healthcare, Development and Economy In countries that have limited income, not all health services can be funded. The United Nations Development Programme states, “[t]he epidemic is also reducing welfare. Health status is seriously endangered by cuts in expenditures on non-Ebola related health services… As a result, more people will die from childbirth, malaria and AIDS” (Assessing the Socio-economic Impacts of Ebola Virus Disease in Guinea, Liberia and Sierra Leone: The Road to Recovery 10). With one epidemic consuming so much of the public’s attention and funding, other diseases can easily be overlooked. Epidemics can strike quickly and steal public attention, funding and lives more quickly than it can be combatted. Disease impacts every aspect of everyday life. When a major epidemic like Ebola hits a developing country, what is already a delicate system can be torn apart in a matter of months. According to the United Nations Development Programme, an epidemic like the Ebola outbreak of 2014 can erase five to ten years of socioeconomic growth in countries with high poverty rates, such as Liberia, New Guinea and Sierra Leone, (Assessing the Socio-economic Impacts of Ebola Virus Disease in Guinea, Liberia and Sierra Leone: The Road to Recovery 8). For a modern emerging country, it can take years to achieve even the slightest amount of growth. Unfortunately, this growth could be as easily erased by an epidemic as it could be by a war. The destruction that infectious diseases cause go far beyond the number of workers available. Fenner 5 Death only begins a major ripple effect of pain felt in all areas of everyday life for the citizens of expanding nations. The Economic Commission for Africa illustrates the deep connections of disease and economy, listing the economic impacts of Ebola felt by Liberia, New Guinea and Sierra Leone as including but not limited to: public finance, public revenue, public spending, fiscal deficits, investments, savings, private consumption, labor supply and productivity, inflation, money, and exchange rates (Socio-Economic Impacts of Ebola on Africa: Revised Edition 13). So often it is forgotten how far illness can reach beyond health. Health is the corner stone for a strong country. Without a healthy population, a country has few workers, few consumers, few tourists, and shrinking revenue. Diminishing numbers of workers leads to floundering national earnings. As stated by the Journal of Natural Sciences Research, the World Bank revised its projections for 2014 economic growth in Liberia and Guinea “from 5.9% and 4.5% to 2.5% and 2.4% respectively. In all the three hardest hit countries, whilst fiscal revenues are declining, government spending has significantly increased in trying to contain the spread of the disease” (Mohamed 2). As less is produced and more of a country’s resources are spent trying to stop the spread of disease, the ripple effect of economic destruction only becomes more severe. Without rebuilding a strong population of workers, a country cannot recover. The healthier the workers, the stronger the country. Developing nations need a strong foundation built on the ability of its laborers. Nations like the United States and United Kingdom are easily protected by their strong foundations. If a citizen is ill, he or she can easily Fenner 6 get the care they need to go back to work quickly. In unindustrialized nations however, resources are hard to come by, and recovery from a major disease is far less likely. Dr. Dan Yamin and colleagues of “Annals of Internal Medicine” declared that the number of Ebola cases in Liberia exceeded the capacity of all treatment units in August 2014 and showed no sign of improvements as Ebola continued to spread only months after the outbreak began (1). Without sufficient preventative measures, the epidemic continued to spread and the risks of a much larger-scale spread increased exponentially. When smaller countries are not given the resources they need to combat epidemics, there is no chance in stopping the destruction of disease. Preventing Disease Proper training for both citizens and clinicians is key in containing any illness, not just Ebola. The World Health Organization’s Dr. Cota Vallenas emphasizes the importance of educating health-care workers, explaining that of those who were trained in proper treatment, “only 1 doctor out of the entire brigade of 400 health-care professionals became infected.” With proper protective measures, more healthcare workers and more inhabitants can be protected from contracting the illness. Prevention is the first step in our marathon of fighting disease. The World Health Organization declares, “[r]aising awareness of the risk factors for infection and the protective measures that should be taken is the only way to reduce human infection and subsequent deaths” (Ebola Virus Disease: Background and Summary). The biggest step that can be taken to Fenner 7 combat disease is to prevent it from happening. Increasing awareness of disease and how it spreads can only decrease the number of cases we see. Inadequate government preparation for illness can only increase economic damage. In the editorial “Outbreak of Ebola Virus Disease in Guinea: ‘Where Ecology Meets Economy,’” Bausch and Schwarz state that in cases of such severe outbreaks, “inefficient and poorly resourced governments struggle to respond, as we are seeing all too clearly with this outbreak of Ebola virus disease in West Africa, which is now by far the largest on record” (4). In developing countries such as Liberia and Qasim, preparation for the economic impact of disease is key in minimizing destruction. In such dramatic cases as the 2014 West African Ebola outbreak, protection will not stop all harm. However, the more that governments put into preventative efforts, the less likely it will be that damage will be so detrimental. Research and Funding Research and progression in the fight of disease is key to slowing its progression and stopping the soaring fatality rates all together. Unfortunately, developing countries like Liberia, Sierra Leone and New Guinea don’t have the resources available to fund major research. Only when a disease comes to a major world power do we tend to see more efforts and funds go into disease research. The World Health Organization reports that no licensed Ebola vaccinations currently exist and only two potential options are being evaluated. Meanwhile, the virus continues to spread into both remote villages, and major urban areas (Ebola Virus Disease). There is no way to stop Ebola if we do not begin searching for a biological cure. Fenner 8 When support is provided to these struggling nations, they improve quickly. However, they cannot do this themselves. According to Caitlin Rivers and colleagues of the Network Dynamics and Simulation Science Lab, “[c]ompared to contact tracing alone, there is a small reduction in the number of hospitalized cases… but a stronger decrease in the number of community, funeral and overall cases depending on the efficacy of the hypothetical pharmaceutical” (12). For such an international problem, few financially sound countries have supported research and prevention for Ebola outside of their own countries. Stopping travel does not stop Ebola. We need research and vaccinations worldwide to fight the epidemic at its source and abolish it altogether. Conclusion In order to solve the major problem that is Ebola, the developed world needs to come together in efforts to protect those of less fortunate backgrounds. Smaller nations especially need outside aid if they are to continue on the path to a better way of life for citizens. As death consumes so much of a small economy, nations left to fend for themselves will only see stunted commercial growth as their work force declines and the number of orphans and disabled citizens rises. Disease in a developing country is devastating. Loss of life is enough to harm a powerful country, not to mention one which is relying on the growth of the people. As Qasim grows into a Middle Eastern democracy, it is important that its people stay healthy and able to work. Without a strong workforce, our economy will weaken and our growth, both economically and comprehensively, will be stunted. The lack of awareness, research and preparation which, in Fenner 9 part, led to the 2014 Ebola outbreak proves just how easily an epidemic can take an unprepared region by surprise and threaten an entire lifestyle. Fenner 10 Works Cited "Assessing the Socio-economic Impacts of Ebola Virus Disease in Guinea, Liberia and Sierra Leone: The Road to Recovery." United Nations Development Programme (2014). United Nations Development Programme. Web. 5 Apr. 2015. <www.undp.org/content/dam/liberia/docs/EBOLA INFORMATION/BASIC INFORMATION/EVD Synthesis Report 23Dec2014.pdf>. Bausch, Daniel, and Lara Schwarz. "Outbreak of Ebola Virus Disease in Guinea: Where Ecology Meets Economy." PLOS Neglected Tropical Diseases 8.7 (2014): 1-5. PLOS Neglected Tropical Diseases. Web. 5. Apr. 2015. <http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003056#pntd0003056-g004>. "Ebola Virus Disease." WHO. World Health Organization, 1 Apr. 2015. Web. 13 Apr. 2015. <http://www.who.int/mediacentre/factsheets/fs103/en/>. "Ebola Virus Disease: Background and Summary." WHO. World Health Organization, 3 Apr. 2014. Web. 11 Apr. 2015. <http://www.who.int/csr/don/2014_04_ebola/en/>. "Estimating the Future Number of Cases in the Ebola Epidemic - Liberia and Sierra Leone, 20142015." Morbidity and Mortality Weekly Report 63.3 (2014). Centers for Disease Control and Prevention. Web. 5 Apr. 2015. <http://www.cdc.gov/mmwr/preview/mmwrhtml/su6303a1.htm?viewType=Print&view Class=Print>. Fenner 11 Gatherer, Derek. "The 2014 Ebola Virus Disease Outbreak in West Africa." Journal of General Virology 95: 1619-624. Journal of General Virology. Journal of General Virology. Web. 5 Apr. 2015. <http://vir.sgmjournals.org/content/95/Pt_8/1619.full.pdf html>. Jalloh, Mohamed. "Analyzing the Economic Consequences of an Epidemic Outbreak: Experience from the 2014 Ebola Outbreak in West Africa." Journal of Natural Sciences Research 4.21 (2014): 1-7. International Knowledge Sharing Platform. Journal of Natural Sciences Research. Web. 5 Apr. 2015. <http://www.iiste.org/Journals/index.php/JNSR/article/view/16780/17318>. Obilade, Titilola. "The Political Economy of the Ebola Virus Disease (EVD); Taking Individual and Community Ownership in the Prevention and Control of EVD." Healthcare 3 (2015): 3649. Healthcare. Virginia Polytechnic Institute and State University. Web. 11 Apr. 2015. <http://www.mdpi.com/2227-9032/3/1/36/htm>. Rivers, Caitlin, et al. "Modeling the Impact of Interventions on an Epidemic of Ebola in Sierra Leone and Liberia." Network Dynamics and Simulation Science Lab. Cornell University Library. Web. 15 Apr. 2015. <http://arxiv.org/abs/1409.4607>. "Socio-Economic Impacts of Ebola on Africa: Revised Edition." Economic Commission for Africa (2015). United Nations Economic Commission for Africa. Web. 5 Apr. 2015. <www.bharatafricabiz.com/resources/facts_n_figures/ebola_report_rev_jan2015_en.p df>. Fenner 12 Vallenas, Cota. "Ebola Diaries: Changing Health Worker Culture." WHO. World Health Organization. Web. 11 Apr. 2015. <http://www.who.int/features/2015/ebola-diariesvallenas/en/>. Yamin, Dan, et al. "Effect of Ebola Progression on Transmission and Control in Liberia." Annals of Internal Medicine 162.1 (2015): 11-20. American College of Physicians. Web. 5 Apr. 2015. <annals.org>.