Explaining and responding to the Ebola epidemic

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Explaining and responding to the Ebola epidemic Solomon Benatar Abstract The Ebola epidemic in West Africa is not merely a biomedical problem that can be seen in isolation and dealt with only through emergency medical rescue processes. The ethical dilemmas surfaced by this epidemic are also not confined to the usual micro-ethical problems associated with medical care and medical research. The pandemic, as one of many manifestations of failed human and social development that has brought the world to dangerous ‘tipping points’, requires deep introspection and action to address upstream causal processes. Keywords: Africa, Ebola, Causal explanations, Public health, Social development, Tipping point, Ethics, International relations, Global political economy, Human rights, Climate change, Progress The Ebola epidemic in West Africa is not merely a biomedical problem that can be seen in isolation and dealt with only through emergency medical rescue processes. The ethical dilemmas surfaced by this epidemic are also not confined to the usual micro-ethical problems associated with medical care and medical research. The most superficial explanation for the Ebola epidemic in West Africa is that it is merely a biomedical problem arising from transmission of an animal virus to humans. A deeper explanation relates to failure to install well-known public health measures necessary to prevent the rapid spread of infection, and failure to develop vaccines and drugs for use in good time [1]. These are notable failures, given several small epidemics since the emergence of Ebola in 1976 and knowledge of the rapidly fatal outcome of this infection. The deepest, less easily perceived and largely ignored explanation is that the epidemic is one of many manifestations of failed human and social development that has brought some countries (for example Liberia [2]), Sierra Leone and the world [3-5] to dangerous ‘tipping points ’ ’as exemplified by:  Widening disparities in wealth and health with

extensive severe poverty  Resurgence and global spread of old infectious

diseases – tuberculosis, malaria

Correspondence: [email protected] Bioethics Centre, Philosophy Department, Upper Campus, University of Cape Town, 3.03 Humanities Building, University Ave, Rondebosch, Cape Town, South Africa

 Rising drug resistance  Emergence of new infectious diseases: HIV, SARS,

Ebola etc.  Reduction in energy, water and food security  Failure to achieve human rights and human

potential more extensively  Major economic crises, corruption, exploitation and

unrepayable debt  Escalating social conflict, proliferation of



  

fundamentalist groups, ethnic and religious conflict, anarchy and displacement of millions of people Failure to reproduce caring social institutions such as educational, health and other infra-structural services Ongoing population growth Wasteful consumption patterns by the privileged Global warming and environmental degradation

Upstream causal forces that include the structure of the glob