Liz Szabo --- USA Today
There is no end in sight to the Ebola outbreak in West Africa, according to the head of the World Health Organization.
"No one is talking about an early end to the outbreak," writes Margaret Chan, director-general of the World Health Organization, in today's New England Journal of Medicine. She says the outbreak is likely to last "many more months."
Chan blames the size and severity of the outbreak – which has killed 1,350 people – on poverty. At least 2,473 people have been diagnosed with the virus.
"The hardest-hit countries – Guinea, Liberia and Sierra Leone – are among the poorest in the world," Chan writes. "They have only recently emerged from years of conflict and civil war that have left their health systems largely destroyed or severely disabled and, in some areas, left a generation of children without education."
Ebola is one of a half-dozen major disease outbreaks recently caused by war or the devastation left behind by conflict, says Peter Hotez, president of the Sabin Vaccine Institute and founding dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. In Syria, for example, health workers have diagnosed 36 cases of polio since the beginning of the civil war.
In Guinea, Liberia and Sierra Leone, "there is no confidence in government or its ability to respond," Hotez says. "This is all a consequence of public health breakdown."
In West Africa, only one or two doctors are available for every 100,000 people, Chan writes, and "even hospital capacity for infection control is virtually non-existent." Nearly 160 health workers have been infected, and 80 have died, Chan writes.
Poverty also has driven the spread of the Ebola virus by forcing people to cross borders to find work. The intersection of these three countries is the "designated hot zone," she writes.