October 2, 2015 By: Winstanley R. Bankole-Johnson
It’s over eighteen (18) months now since the dreaded Ebola virus disease hit the sub-region, starting off in the neighbouring sister Republic of Guinea, thence through Liberia and unto Sierra Leone. To say that its wake caught our healthcare delivery infrastructure pants down would be a serious understatement, because beyond the buildings and the uniformed personnel manning them, we had absolutely nothing – (“arrarrah!!!!” – as we would say in Krio). And as we later proved, beyond the politically influenced high sounding “official” directorate titles they carried (and of course a dexterity to dissipate subventions from both the Consolidated and donor support funds through endless “talk shops”), those on whom responsibility for our medical care devolved almost wished they were in more mundane professions, like Cobblers (Shoemakers) instead, when the disease struck.
Money and Time
Between its wake and our appreciation of the stark realities about the disease, tens of our compatriots had died. Needlessly. And by the time rudimentary precautionary measures were being advised, the death toll had spiked exponentially. In those early days, in our state of haplessness and utter confusion, those on whom we had always relied upon for advices on global health issues – the WHO/UN – dithered, leaving us to almost wrongly conclude that once one became infected with the disease, palliative care was the only panacea. “An Ebola Vaccine does not exist!!” they advised. “And even if arrangements were to be put in place for its development, two major constraints would first have to be overcome-: (1) Money and (2) Time”.
According to experts interviewed over the global airwaves, not less that US$5billion would be required to research, develop and successfully test an effective anti-Ebola vaccine. Yes, major drugs manufacturers were willing to do that but they unfortunately lack the required financial resources to do so. As a continent, African governments were either too poor to pre-finance such an elaborate project, or too corrupt to prioritize their citizens health care emergency needs, and on account of which neither the civilized world, nor any drugs manufacturers were prepared to cough up that amount to the rescue Africans in dire need. What probably they did not audibly express, but which was easily surmised was that their reluctance was predicated on a general knowledge of the aggregates of our leaders offshore account balances in their various capital cities.
With regards to timelines, the UN/WHO/UNMEER etc advised that even if the required US$5billions was coughed up in an instant, the earliest and anti-Ebola vaccine could be researched, developed, tested and clinically cleared as fit for use by humans was a minimum of a clear eight (8) months. That was around August 2014.
Soon the Dollars started flowing in – reluctantly perhaps as it was all about Africa. But by the time the projected US$5billion mark was almost achieved, the amount required was hiked to over US$7bilion.
Under intense pressure from their citizenry to do something, our sub-regional governments could only desperately hope (and pray as usual) for some divine climatic weather interventions (scorching sunlight and heat rays) that could halt a further spread of the virus to at least abate the scourge.
Questions
Twelve (12) clear months now down the line, (August 2014 to date) instead of the sub-region being updated by WHO/UNMEER with information on the status of the anti-Ebola vaccines – “Zmapp” or anything close to its efficacy – the development towards which so much was donated, we are being told about “Trial Vaccines”. Yet not one of the sub-regional governments has been bold enough to question the UN/UNMEERR about this disarrangement. Where we are today was certainly not what we bargained for or were expecting. Whatever happened to the billions of dollars set aside for the manufacturing of an anti-Ebola vaccine – “Zmapp” or whatever?
Those are not questions for the National Ebola Response Center (NERC). They are ad-hoc managers of the EVD crisis and will fold up once the disease is overcome. It’s a question I would like our sub-regional governments to pose to the WHO/UNMEER.
Protocols
Apologies if anyone finds my curiosity bland, but I consider it disheartening that whilst these “trial vaccines” still do not have a generic name, newly infected individuals do not have an automatic right to its administration, except with their prior consent. How for God’s sake do the WHO/UNMEER (and even governments) expect weak, feverish, dehydrated and emaciated victims to communicate such consent under the circumstances is hard to fathom. Further, a lot of inter-agency/governmental protocols would appear to surround access to the trial vaccines, with priority consideration for special categories of persons such as Health Workers, even over a year after Ebola crossed into our sub-region.
Pundits believe the UNMEER/WHO are too slow to endorse the clinical efficacy of the trial drugs/vaccine and would have been more responsive had the disease been at the back yards of any European or Asian country. The way they effectively and easily handled several heamorreagic and other diseases that blighted their landscapes, like the SARS and H1N1 swine and bird flu viruses, is perhaps what probably that postulation.
Asymptomatic
And who knows, had production of more “Zmapp” or the correct Ebola vaccine antidote been accelerated and clinically approved by the WHO/UNMEER for use in Africa, none of the side effects victims experience from the various drugs now in use such as persistent headaches, joint pains, impotence and vision impairment would not have been occurring. That fact is underscored by evidence that apart from those who died because of delayed medical interventions, all cured former Ebola victims from the Western hemisphere have since been clearly asymptomatic.
So whilst I would agree that a myriad of introspective questions still need to be asked (much sooner hopefully) about how the disease managed to reach here and why we allowed our own healthcare systems to have degenerated into such disarray at its outbreak, we must not lose sight of the fact that as with other areas of governance under periodic international surveillance, the local WHO offices in the entire Mano River sub-region must share some blame for not measuring up as promptly as was expected of a responsible global health monitoring agency when the disease struck.
I shall close with my profound gratitude to our international partners for speedily re-capacitating our emergency health care services to enable us face future disease outbreaks. That aside, my question-: “Where are the vaccines?” remains germane.