Malaria has killed 70 times more people this year – even though it’s very easy to prevent
Mystery diseases inspire a special terror in the West. Buried in our psyche lies the idea that a new Black Death will one day appear, shattering the medical protection we have built over the years. Horror films are made about killer viruses sweeping Britain but even they look mild compared to some of the hysteria emanating from the Government.
A few years ago, the Department of Health warned that another pandemic is “inevitable” and predicted up to 750,000 British deaths. “Socioeconomic disruption will be massive,” it concluded. We are, apparently, just waiting for the next big virus to strike.
Perhaps this explains the panicky reaction to Ebola. It’s hardly a new disease, having emerged (and been defeated) several times before – but it has never been as big as it is now. It’s certainly gruesome, killing seven in 10 people it infects with symptoms including bleeding from the eyes and ears. There are 4,500 dead so far and there are fears
that there could be 10,000 new infections a week by the end of the year. The US is talking about a $1 billion aid package for Africa, and Britain too is sending teams of doctors. And this is not entirely altruistic: we’re treating Ebola there, runs the subtext, to make sure it doesn’t come here.
All of this seems to confirm an old suspicion about Africa: that it is a continent of poverty and scourges, capable of incubating what might be the next big pandemic. In fact, the disease has affected just five of Africa’s 53 countries, and in two of them – Nigeria and Senegal – its progress seems to have been halted. While it is contagious (through bodily fluids, rather than by air) the largest district of Sierra Leone, Koinadugu, had (until yesterday) been able to say it is Ebola-free after observing basic border checks. The disease is spreading exponentially in certain places but Africa is not, yet, at its mercy.
A sense of proportion tends to be the first casualty of any new virus. It is not quite clear why the Department of Health thinks that the next pandemic will claim 750,000 British lives, given that this is three times the death toll inflicted by Spanish Flu a century ago. The last pandemic, the so-called Hong Kong flu of 1968, claimed 30,000 lives. While tragic, this figure is only slightly more than the official figure for the number of British pensioners who die of the cold each winter – a figure that is, shamefully, treated with a shrug. We have become rather good at guarding against mutant killer viruses, even if we still struggle to protect our elderly against the cold.
The most recent viruses to emerge have caused much panic and disruption, but proved far less deadly than (for example) measles. The worldwide death toll for the Sars virus was 770, and the H5N1 bird flu claimed 390 lives. These scares cost tens of billions of pounds of economic damage, due to the inevitable disruption associated with a worldwide scare. But the fatalities have not been as great as for conditions which are far less scientifically challenging – like drug addiction, heart disease or (in Britain) hospital-acquired infections like C-Difficile.
The panic in the United States – much of it coming from Barack Obama’s opponents – is becoming a case study in misplaced anger. Denounced as “President Ebola” in some sections of the American press, he is faulted for failing to set up an airport test that could have intercepted the Ebola victim being blamed for bringing the virus to the country. No safety net can be so tight as to catch everyone. But more to the point, where is the anger about the 40,000 Americans who die each year from preventable conditions like whooping cough and measles?
Even the concern about Africa seems to be at odds with the threats facing the continent. Since Ebola emerged seven months ago it has claimed thousands of lives in Africa, which certainly makes it deadlier than Sars or Avian Flu. But over these same seven months, 40 times as many people will have died from basic hunger and 70 times as many Africans will have been killed by malaria – both basic, avoidable conditions that have dogged mankind from the beginning of time. So where is the anger about this?
If anything, Africans dying from malaria should cause far outrage than Ebola – given that we know perfectly well how to overcome malaria. Basic tools like insecticides, mosquito nets and sanitation can eradicate the disease. With enough resources, malaria can be snuffed out – as was proved in Sri Lanka when a US-led campaign brought the annual death toll down from 92,000 to just 17. And this was in back in 1963, when the tools available to fight malaria were far harder to come by. Various agencies, like the Bill & Melinda Gates Foundation, have made striking progress in recent years, but malaria remains a bigger killer now then Ebola is ever likely to be.
The root problem is a far more basic one: poverty. The countries now battling Ebola – Guinea, Sierra Leone and Liberia – are among the poorest in the world with a pitiful health infrastructure. Foreign aid can help if it encourages a basic health service. But sending armies of aid workers can undermine a country’s ability to set up a normal health service – if the work is being done by outsiders, who are working on specific projects. Jim Yong Kim, a doctor who now runs the World Bank, has said that Ebola would have been contained if it broke out in Rwanda because it used donor money to build a proper health system after its genocide.
One of the greatest stories of the last decade is the extraordinary economic growth of sub-Saharan Africa – and how this is quickly translating into poverty reduction, cutting death rates from its everyday diseases. Child mortality is falling at the fastest rate in history. Malaria, too, is in fast decline as ordinary Africans can afford protection, rather than wait to have it handed out by an aid agency. Deaths from measles are down by 80 per cent over the last 10 years. HIV infections, so long the scourge of Africa, are down by a third over the same period. The United Nations envisages the epidemic being vanquished by the end of the next decade, which would be a monumental achievement.
Only this week, it emerged that hunger in Africa has fallen by a quarter over the past 25 years – an incredible achievement which will have saved millions upon millions of lives. Better-fed bodies can better fight disease; a mother is a hundred times more likely to die in childbirth in a poor country than she is a rich one. Steadily, Africans are closing the gap with the rich world. Blessed with the oil and minerals that fetch such a high price in world markets, the continent is becoming richer, and converting this into prosperity. The result is a golden age of poverty reduction.
Not all of the continent is growing at the same pace and in the same way, which explains why the Ebola has moved so quickly in countries which have nothing resembling a decent healthcare system. But their story is not Africa’s story. The continent is making more progress against its the main killers than at any point time in modern history, so it can realistically look forward not just for to end of Aids, but to end of poverty as we know it today. The Ebola tragedy is a setback in a greater war against disease and poverty – but it is a war which Africans are steadily winning.