‘We must do more, and do it faster,’ said Tony Banbury, the UN Secretary General’s Special Representative on Ebola, and Head of the UN Mission for Ebola Emergency Response (UNMEER), last week. We need ‘more staff to be deployed to the districts where the disease is. We need more Ebola treatment facilities, more community care centres, more partners on the ground to staff these centres, we need greater mobility. And we need money to pay for it all.’
So it was not much to ask that the world’s most powerful leaders would seize the opportunity of the G20 Summit in Australia (15-16 November) to address the acute global health and humanitarian crisis of Ebola.
Some governments have already made generous pledges of finance and medical staff since the WHO declared this Ebola outbreak a ‘Public Health Emergency of Global Concern’ in August this year. Yet instead of ambitious new commitments to help implement the UN plan, the G20 issued a statement on Ebola that was more talk than action.
Yes, G20 countries want to ‘extinguish’ the outbreak, and will ‘do the necessary,’ but no new cash or human resources were pledged. Their statement seemed to back away from specific commitments from governments; it could only ‘invite’ other governments to respond, whereas it ‘urges’ the pharmaceutical sector, the World Bank and IMF to do so.
There is one apparently new commitment in the statement: a further $300m from the IMF, with an unspecified split between concessional loans, debt relief, and grants. This is in the context, however, of the combined debt of Sierra Leone, Liberia and Guinea being $3.6bn, which is already costing them $100m in debt service in 2014, and will be more next year. Considering the devastating impact of Ebola, these countries need grants and debt cancellation, not new debt.
To be fair, the G20 statement is a little better on solutions for the longer-term. The G20 recommitted to implementing the WHO’s International Health Regulations (which they are legally obliged to have already completed by 2012), that focus on disease surveillance and response capacities. The statement flagged that some G20 countries have initiatives to support countries in West Africa and elsewhere to implement the regulations too.
The World Bank re-announced its idea to develop a contingency fund for health crises, which would provide ready cash in the event of a future outbreak. The fund is supposed to provide a financial incentive for pharmaceutical companies to invest in vaccines and treatments for diseases afflicting developing countries, by assuring them that any vaccine or drug that they produce be paid for (out of this fund) if another epidemic hits. Clearly global financing for rapid response to outbreaks could be a useful vehicle for global actions. However, such solutions must also enhance local capacity to respond to outbreaks, and rapidly mobilise sufficient human and financial resources to help the countries in need.
The Ebola crisis highlights the failure of the current research and development (R&D) system which relies on market incentives for developing vaccines and medicines for public health needs. Financing R&D for vaccines and medicines for Ebola and similar outbreaks needs to happen now. R&D cannot wait till an outbreak is declared a global emergency. Instead the vaccines and medicines must be developed, and be ready for production and distribution at that time.
We will await the details of those proposals. The immediate priority must be focusing on the current outbreak, where there is still a need for greater international response. The UN has set itself a target to get a hold on the epidemic by 1 December which would require treating 70 per cent of patients, and ensuring that 70 per cent of all burials are done safely. We are now 13 days away from this deadline, and the G20 had an opportunity to push the international response towards this goal. Unfortunately, it didn’t take it.
There is still a long way to go to turn this epidemic around, to reduce suffering and to save lives. This crisis cannot be summarised by numbers of cases and deaths – it is reaching into the heart of these countries, spreading fear and social breakdown. Oxfam is working with people who have lost five members of their family in a single week to Ebola. This kind of devastation is not easily overcome.
The impact also goes far beyond Ebola cases. A major collapse of health services means that deaths and illnesses from other diseases are going unchecked. It is difficult to imagine what can happen to women who have difficult labours when no health service is available for them, or for children that can’t get treated for malaria or pneumonia.
We urge G20 countries to rapidly deliver the promised financial and medical support to the affected countries in order to help bring an end to the suffering of their citizens.
The G20 has missed an important opportunity in the fight against Ebola. Now they have 13 days to prove they can still be world leaders.
Debbie Hillier is Humanitarian Policy Advisor for Oxfam GB