THE BLOG
10/22/2014 03:45 pm ET Updated Dec 22, 2014

Ebola: Learning From Past Mistakes

ISSOUF SANOGO via Getty Images

Global health epidemics bring out the best and the worst in humanity. We can certainly not be proud of the anger of parents outside a school somewhere in Europe where an innocent 9-year-old boy back from vacation in Guinea was branded as a potential carrier of Ebola. Nor should we be proud of the economically catastrophic cordon sanitaire set up by rich countries around West Africa, something that could be straight out of Albert Camus' The Plague.

But we look up to the healthcare professionals who risk their lives to work in regions affected by Ebola. Witness the obituary of Sheik Humarr Khan, the virologist who led Sierra Leone's Ebola response and who died from the disease at the age of 39 on July 29, 2014. Khan is but one example of the thousands of professionals who risk their lives daily to care for people with Ebola.

We now know that Ebola is a global public health crisis. Guinea, Liberia and Sierra Leone are finally receiving some of the urgently needed human and logistical support to fight the Ebola epidemic and the industrialized world recognizes that the implications of Ebola extend a lot further than the nearly 10,000 documented cases.

Ebola casts a harsh spotlight on global health politics and on almost 50 years of health development assistance in Africa. Of course, spectacular progress has been made in recent years in the field of healthcare. Infant mortality has fallen by over 50% in the last 20 years.

Nevertheless, what the current Ebola crisis teaches us is the importance of primary healthcare, which is the bedrock of public health. This does not mean spectacular measures but putting in place the solid foundations without which it is impossible to sustainably raise the health level of a population. For decades, unfortunately, the slow and gradual implementation of robust primary health systems has been sacrificed in favor of quicker and more visible results.

How else can we explain that, after all the billions spent, health systems and services in the countries afflicted with Ebola have either crumbled or are close to breaking point?

Of course, the two countries hardest hit by the current crisis, Liberia and Sierra Leone, have only recently emerged from years of devastating civil war. But that doesn't explain everything.

Today it is more obvious than ever that many African countries do not have good epidemiological surveillance systems in place that permit the rapid and effective flow of information on health threats. Similarly, training and capacity building of national health personnel has not received the priority it merits and the few public health professionals on the ground are under-paid, under-recognized and do not have the facilities, transportation and logistics required to operate effectively.

Also, health promotion has focused on priority infectious diseases which, while justified, has meant that there is less money for the basic social infrastructure services such as water, sanitation and housing which effectively slow the propagation of infectious disease epidemics. Perhaps more importantly, the focus on high profile disease "causes" in Africa has resulted in our forgetting the basic tenet of public health -- a holistic approach to the integration of people, resources and systems to ensure basic quality standards to guarantee the health and well-being of every citizen.

It is time to build exemplary health systems in the African countries. Without this, we will see a full fledged epidemic eventually turning into a persistent health threat for the planet, destroying all that has been built up in terms of gains in health, life expectancy and well-being across a swathe of Africa.

We must also emphasize the responsibility of the international community which tolerates hundreds of billions of dollars of spending on arms while reducing the budget of the World Health Organization. The result is that the WHO does not have the staff numbers and resources necessary to respond to an emergency such as Ebola. In two years, the WHO budget has been reduced by 12% and 300 jobs have been cut from the workforce. The budget devoted to "responses to health crises" has fallen from 469 million to 228 million dollars. Let's remind governments that health and global health security are our most precious possessions.

We have the opportunity to learn from our mistakes and build solid health systems in the countries currently bearing the brunt of the Ebola epidemic. The importance of a rigorous, normative approach to the implementation of primary health systems and the building of a cadre of trained public health professionals cannot be overstated. The industrialized countries have an obligation to assist with expertise, crisis management and funding.

But what is even more important is African leadership and African funding, especially as it is likely that, even in the face of the clear lessons from Ebola, the major health funders are too constrained by inertia and vested interests to change direction quickly.

Fortunately, I see a real willingness among Africa's leaders to step up to the challenge. We must promote effective south-south cooperation in Africa to unlock new and sustainable funding to invest in health systems. This is the only way to prevent further loss of human lives.