Ebola

Baroness Kinnock of Holyhead Excerpts

Thursday 6th November 2014 Lords Chamber

Asked by

[Baroness Kinnock of Holyhead]

To ask Her Majesty’s Government what assessment they have made of the international response to Ebola.

[Baroness Kinnock of Holyhead (Lab)]

My Lords, at the outset I must pay tribute to the considerable contribution that the United Kingdom and its NGOs, health workers and service personnel are making in efforts to respond to the Ebola crisis. Despite those and other great efforts, as the world now knows, Ebola continues to destroy lives, livelihoods and communities. It impairs national economies and is severely damaging what are already very fragile basic services. It is reversing years of development efforts with devastating effects and there is a danger that this epidemic could undo years of efforts to stabilise the west African region and lead to new tensions between neighbouring countries.

Against that background, does the Minister agree with Kofi Annan, who has said that:

“If the crisis had hit some other region it … would have been handled very differently”?

He went on to say:

“When you look at the evolution of the crisis, the international community really woke up when the disease got to America and Europe”.

That judgment is echoed by Dr Chan, the director-general of the WHO, who has emphasised,

“the dangers of the world’s growing social and economic inequalities”.

She said:

“The rich get the best care. The poor are left to die”.

Hearing that, does the Minister agree that Ebola is tragically highlighting the basic reality that Governments and commerce must give higher priority to investment in the prevention of disease in developing countries? Should donors not be spending much more on global health, including overcoming malaria, TB and HIV, when those plagues are fundamental causes of underdevelopment and when more has to be spent on treatment simply because too little is still being invested in prevention?

We surely need to deal now with the reality that the world has simply not prepared itself for an effective response to any severe, sustained and contagious health emergency. The progress which is claimed by some to be taking place is, to say the least, uncertain. Experts grimly tell us that we are not close to reducing mortality or stopping Ebola’s transmission, which will not happen for some time. On just one day this month, 2 November, 61 new cases were reported across Sierra Leone, bringing the nationwide toll to 4,059 cases. According to Save the Children, five people are being infected every single hour in Sierra Leone.

However, Ebola emerged 40 years ago, so why after four decades of huge scientific advance is there no vaccine and no cure? Could it be because Ebola has no R&D incentive for a profit-driven global pharmaceutical industry? Professor Peter Piot, the director of the London School of Hygiene & Tropical Medicine, who is of course the scientist who first identified Ebola, has said that it would not have been difficult to contain the outbreak if those on the ground had acted quickly. He has also said, however, that tragically:

“Something that is easy to control got completely out of hand”,

as isolation, care and tracing and monitoring contacts, which have worked before, will not prevent the spread now. He went on to say:

“It may be that we have to wait for a vaccine to stop the epidemic”.

The awful truth is that no one knows the real death toll in Sierra Leone. We do know, however, that there is the most terrible suffering and misery. I will give just one all-too-typical instance. A woman with a nine year-old child and a six year-old child lost her husband to the disease. Naturally, she had nursed him. Now she is dead and both children have Ebola. They are orphans and victims. But hugging loved ones should not be a death sentence. Obviously, as in every culture, the women of west Africa are the carers of their families. They are consequently the front-line health workers who are most exposed to and affected by Ebola. In fact, in Liberia, 75% of those infected with or killed by Ebola are women.

Even before this crisis Sierra Leone had one of the world’s highest maternal mortality rates. Now, because of the collapse of healthcare and the fear of contracting Ebola in hospital, many more women are dying in childbirth because they are afraid to go to hospital. Donors, including the UK, clearly need to take account of the higher risk that women and girls face of getting Ebola. In addition, priority should be given to sexual and reproductive healthcare, and it is vital that there is a proper response to the increased vulnerability of women and girls to violence during the Ebola crisis. Can the Minister tell the House whether efforts are being made to ensure that women are engaged at national and community level in shaping responses to this crisis?

After years of devastating civil wars, already fragile basic services are now desolated. In Sierra Leone, nearly 40% of the population do not have access to clean water and sanitation is worse than rudimentary. As a result, maintaining the level of hygiene needed to prevent the further spread of a virus which is transmitted through contact with body fluids is extremely difficult, and clearly the lack of basic services is putting at risk the lives of all those who care for Ebola patients. There is surely a need to make systematic and rapid efforts to ensure universal access to these basic services in all the hospitals, homes and schools. Without that, a future public health catastrophe is inevitable. In addition to addressing the response being made to inhibit the current epidemic, can the Minister clarify whether the Government are making a long-term response to the Ebola outbreak in west Africa that promotes the systemic changes required to deal with any future outbreaks?

The president of the World Bank has said that:

“We were tested by Ebola and we failed … miserably in our response”.

He then asked:

“Why don’t we have a multibillion dollar fund of $10bn, $15bn or $20bn … so that once there is a global health emergency it can be drawn down on … quickly?”.

He is surely right to ask that question, so what is the answer from our country and our Government? Are we going to try to win this battle or will we actually fight to win the war?