Ebola Outbreak May Exceed 20,000 With Costs of $490 Million

Aug 28, 2014 2:19 pm ET

(Updates with Doctors Without Borders comment in ninth paragraph. For more Ebola news, click EXT7 <GO>.)

Aug. 28 (Bloomberg) -- More than 20,000 people may be infected with Ebola before the outbreak in West Africa is controlled, and curbing the epidemic will cost at least $490 million, according to a World Health Organization plan.

The number of people falling ill is accelerating, with more than 40 percent of the infections happening in the past 21 days, the Geneva-based United Nations agency said today. In some areas, the number of cases may be two to four times higher than reported, the WHO said in its so-called road map that lays out the plan to deal with the worst Ebola outbreak on record.

By mobilizing international resources, the WHO is trying to stop Ebola transmission within six to nine months, the agency said in the document. The virus has infected more than 3,000 people and killed more than 1,550 in Liberia, Sierra Leone, Guinea and Nigeria, putting it on a pace to kill more people than all previous Ebola outbreaks combined, and prompting the WHO to declare it a global health emergency.

“This is not an issue of three countries,” Bruce Aylward, the WHO’s assistant director-general for polio, emergencies and country collaboration, said at a briefing in Geneva today. “This is a global health security issue.”

Road Map

The WHO’s road map comes five months after the first cases were reported in March. Doctors Without Borders said this year the outbreak was out of control, and has criticized the WHO for its slowness to respond and lack of leadership. Doctors Without Borders is “the greatest organization in the world” and some of its criticism was fair, Aylward said.

“They have two huge mandates: One of them is to do fabulous work in the field, and the other is to tell the rest of us how bad we are,” Aylward said. “They’re good at both of them and they’re right a lot of the time on the second one. There’s lots of gaps in what we do.”

Aylward also said Doctors Without Borders should win the Nobel Prize for its work.

Doctors Without Borders said while it welcomed the WHO’s road map, “huge questions” remain about its implementation, including training staff to set up and run Ebola centers and provide community education in affected areas.

“We have learned an uncomfortable lesson over the past six months; none of the organizations in the most-affected countries -- UN, WHO, local governments, NGOs (including Doctors Without Borders) –- currently have the right set-up to respond at the scale necessary to make a serious impact on the spread of the outbreak,” Brice de le Vingne, Doctors Without Borders’ Director of Operations, said in a statement. “For some, the limits are due to capacity constraints -- simply not able to do more -- and others may need to be encouraged to show more willingness to push the boundaries and scale up effective activities at a meaningful scale.”

Resources Required

The WHO’s cost estimate is for the global resources required over the next six months by governments, the WHO, other UN agencies and other partners. The amount is up from $430 million in a draft of the road map reported by Bloomberg News this week.

Nigeria, Africa’s most populous nation and largest economy, reported its sixth death today, after a doctor who died in the southern oil city of Port Harcourt tested positive posthumously, Health Minister Onyebuchi Chukwu said in e-mailed statement. It’s the first death outside the capital Lagos.

There’s no cure for Ebola and the outbreak has jump-started the development of drugs against the virus.

Vaccine Trial

U.S. scientists will begin enrolling patients next week in safety trials of GlaxoSmithKline Plc’s experimental vaccine, Michael Kurilla, director of the Office of Biodefense, Research Resources and Translational Research, said yesterday in a telephone interview.

The virus is spread through direct contact with bodily fluids from an infected person. It causes fever, diarrhea, muscle pain, vomiting and, as it progresses, can lead to bleeding from the eyes, ears and nose. In the past, the fatality rate has been as high as 90 percent. About 52 percent of those infected in the current outbreak have died.

Doctors treat patients by keeping them hydrated, replacing lost blood and using antibiotics to fight off opportunistic infections. The goal is for the body’s immune system to eventually beat the disease.

The WHO and aid groups have struggled to bring Ebola under control. Widespread fear of the illness and suspicion of aid workers is prompting families to hide people with the virus, and funeral practices such as the kissing of corpses have propagated Ebola’s spread. The main countries hit by Ebola are among Africa’s poorest, with rudimentary health systems, inadequate supplies and a shortage of doctors and nurses.

That shortage has been compounded by the toll Ebola has taken on health workers this year. More than 240 developed the disease in the four countries, and more than 120 have died, the WHO said on Aug. 25.

--With assistance from Anna Edney in Washington.