In our Orwellian world, there is no place for the politics of inclusion. Victims are invariably excluded from the decision-making process, and Ebola patients are no exception. An entire shantytown, West Point in the Liberian capital Monrovia, was under quarantine for ten days in late August and early September this year. A gulf was opening up between the haves and the have-nots, the rulers and the ruled. The hapless people of the area were left to their own devices, effectively incarcerated in their own homes. The international media have been conjuring up images of terror, horror, death and desolation as a result of the Ebola outbreak. Despite the hundreds of humanitarian aid workers and paramedics in the West African epicentre of the disease, the end result has been the mystification of Ebola and the resultant deaths of thousands. This is not the first time that a pandemic has struck Africa. In the 1980s and 1990s there was HIV/AIDS, still a threat to millions. Malaria, tuberculosis, yellow fever and other tropical diseases kill far more people than Ebola. But Ebola is new to West Africa and very menacing. The United States treats Ebola as an adversary that must be crushed by force and not paramedics. The US Congress and the administration of US President Barack Obama are gearing up for a full-scale battle against Ebola. The House of Representatives, like the Senate, is currently Republican-controlled. The House hearing on the crisis reviewed the coordination of federal agencies in responding to Ebola, including testimonies from federal agency officials, though not Thomas Frieden, director of the Centre for Disease Control and Prevention, or Ron Klain, the newly appointed federal Ebola response chief. Meanwhile, the top American military commander for Africa, General David Rodriguez, head of AFRICOM, has been in the limelight. The US mission to combat Ebola effectively began in September and is expected to include up to 4,000 troops by the end of the year. No fewer than 2,900 US troops have been deployed in West Africa to date, ostensibly to contain the Ebola virus, which has claimed an estimated 6,070 lives this year, according to World Health Organisation statistics. A total of some 17,145 cases have been reported. And 77 new confirmed cases were reported nationally during the week to 30 November, according to the WHO, compared with 148 cases the week before. The previous three weeks witnessed a large number of new cases in the eastern Guinean districts of N'Zerekore, Macenta and Kankan. The African Union's response to the pandemic has been a fragile one, and it is hard to see the cash-strapped continental body summoning up the appetite for a fresh confrontation with yet another deadly disease. Several European nations, and especially the former colonial powers Britain and France, have also deployed troops in West Africa to combat Ebola. French President Francois Hollande was the first Western leader to visit an Ebola-stricken country, Guinea. The United Nations Mission for Ebola Emergency Response is focusing on the three West African nations of Guinea, Liberia and Sierra Leone, which have the most intense transmission of the virus. However, the existential fears ignited by Ebola may have waned. Case incidence in Liberia has stabilised over the past five weeks, and Liberia's Lofa district recently reported no new cases of Ebola for the fifth consecutive week. Yet more funding is sorely needed to halt the Ebola pandemic. No one knows quite where the money will come from, and in the meantime the victims of Ebola remain distrustful, despondent and doubtful of international efforts to contain the disease. People are pinning their hopes on the commercialisation of an Ebola vaccine, with the giant pharmaceutical companies likely to be the main beneficiaries. The fluctuation in the control of the disease is dicey, however. Why some countries have arrested the spread of Ebola and others have not is anyone's guess. As 2014 comes to a close, the situation in Sierra Leone appears to have deteriorated sharply with 537 new confirmed cases reported in the week to 30 November. The coming year will provide a test of the willingness of the Western powers to seriously tackle the virus in Africa, even as the efforts of the international media to present Ebola as an African pandemic disappoint. The impoverished African nations afflicted with Ebola are being asked to intensify their efforts to strengthen democracy in the face of such new challenges, and the hunger for better health services in West Africa has been matched by the numbers of Ebola victims. The worst-hit countries of West Africa are yearning for outside assistance. Not only does Ebola claim lives, but it has also wreaked havoc on the economies of the countries concerned. The United States is the world's wealthiest nation, with a gross domestic product (GDP) of $17.5 trillion. But instead of dispatching paramedics to West Africa Washington has been bolstering its military presence in the region, projecting US military power further. Cuba, in sharp contrast, has sent a contingent of emergency health workers and paramedics to West Africa. The West African scenario is reminiscent of the earthquake that rocked Haiti in 2010. When the Americans deployed troops to deal with the catastrophic earthquake, they found some 300 Cuban doctors and nurses already in Haiti setting up tent hospitals in the Haitian capital Port-au-Prince even before the first US marines set foot in the country. This episode shows that Americans should not allow their politicians to narrow their horizons overseas. Western nations should be taking on the ethical implications of their actions. Cuba knows that what the people in West Africa need are paramedics and not troops. At the more fundamental level, Cuba sees health care and education as human rights for its citizens and for those of fellow developing nations. The US does not. The US has the worst health care system among industrially advanced nations. How can it then be expected to provide assistance to other nations? Chillingly, the world's biggest consumer of vaccines is also the United States armed forces and in particular AFRICOM, the US Africa command responsible for Washington's military relationship with 53 African nations. But American pharmaceutical companies have not developed an Ebola vaccine because doing so was not considered to be profitable. The worst-afflicted West African nations are too poor to be considered potentially lucrative markets for the US drug companies. Cuba, a small Caribbean island nation of 11 million people, knows better how to win the hearts and minds of people in Africa. With a GDP of $121 billion, per capita GDP of $10,000 and a national budget of $50 billion, it is dispatching hundreds of medical personnel to Africa. In sharp contrast, the US is sending in more troops. But with or without US assistance, there is every reason to be optimistic about the fight against Ebola. Nigeria's containment of Ebola has been a “spectacular success story,” declared Rui Gama Vaz, World Health Organisation director for the country. With 160 million people, Nigeria has had just 20 cases, including eight deaths, a lower death rate than the 70 per cent witnessed elsewhere across the Ebola-stricken region. Nigeria first encountered Ebola when Liberian-American Patrick Sawyer flew from Liberia to Lagos, later infecting 19 people in the city of 21 million. Nigeria's success in averting a catastrophic outcome started with the action of Ameyo Stella Adadevoh, a doctor at First Consultant Hospital in Lagos, who diagnosed the Ebola virus in Sawyer. Together with Benjamin Ohiaeri, the hospital director, Adadevoh insisted on keeping Sawyer isolated despite threats of legal action by Liberian government officials demanding his release as he was to deliver a lecture at an international conference. The risk of Ebola spreading further in neighbouring West African nations is fast receding. The ultimate goal is to get rid of the disease, but before the region gets to that stage the drawing together of local and international medical and humanitarian teams is a prerequisite. Lack of public oversight is no longer an overwhelming concern, and Ebola no longer poses a devastating problem. All the altruistic talk about saving Africans must, nevertheless, be converted into action. Lessons must be drawn from the Nigerian miracle.
