Just weeks after Sierra Leone discharged its last patient, a new study reflects on the lessons learnt from the recent outbreak of Ebola, comparing it with that of AIDS in Africa in the early 1980s. The authors conclude that both Ebola and AIDS spread rapidly due to the slow international response and the failure of various public-health systems to deal with the root causes of the epidemics.
"For AIDS, initially it was more important to place blame and stigmatise potential sources of the disease than it was to work towards knowledge mobilisation and prevention activities. For Ebola, the magnitude of the problem was underestimated and the severity of the outbreak largely ignored."
Alan Whiteside and Nicholas Zebryk in the Canadian Journal of African Studies name fear and stigma as major factors in allowing disease to spread: "[They] threaten the ability to identify cases, provide care, and bring the epidemic under control." In the case of the AIDS epidemic, public fears of both the disease and those infected by it reduced once public understanding of the illness increased. Ebola's much more infectious nature may always lead to higher levels of fear, but "demonising the epidemic and its victims will not help."
Both Ebola and AIDS, in their view, are diseases that mainly take hold in countries with inadequate health-care systems or where people -- including gay men in Africa -- cannot access care. The 'virtually non-existent' health systems in Liberia, Sierra Leone and Guinea made monitoring disease difficult, and increased the likelihood of future outbreaks. Worse, their conflict-damaged infrastructure simply could not respond -- and what responses were made were based on fear, not science, a pattern seen in the early days of AIDS.
With the current outbreak of Ebola on the wane, and decades of science behind HIV/AIDS, the authors admit that the two diseases pose different challenges: "With Ebola, the major challenge is infection control. With AIDS … it is to be able to cover the long-term financial costs of treatment."
"In many ways, Ebola can be described as 'AIDS on steroids', although in the long run it may be more easily controlled.," the authors conclude.
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