AFRICA - The numbers are scary
Africa is used to epidemics of one sort or another. Since the 1980s the principal concern had been HIV/Aids, where the figures alone are truly horrendous. Although Africa represents around 15 per cent of the world’s population, Sub-Saharan Africa alone accounted for a reported 70 per cent of all those living with HIV and 70 per cent of all Aids deaths in 2011. Out of the 34 million HIV-positive people worldwide, 69 per cent live in Sub-Saharan Africa. There are roughly 23.8 million infected persons in all of Africa. And 91 per cent of the world’s HIV-positive children live in Africa.
More than one million adults and children die every year from HIV/Aids in Africa. In 2011, 1.7 million people worldwide died from Aids. Since the epidemic of HIV/Aids established itself, more than 75 million people had contracted the illness, and over 36 million had died from an HIV-related cause. Of these, 71 per cent of HIV/Aids-related deaths in 2011 were people living in Africa. Due to a lack of anti-retroviral drugs and health care providers in 2010, only 5 of the 10 million HIV-positive patients in Africa were able to receive treatment. Because of HIV/Aids, the average life-expectancy in Sub-Saharan Africa was 54.4 years of age. In some countries in Africa, it was less than 49 years. HIV/Aids also has a serious gender implication. An untreated pregnant woman had a 20–45 per cent chance that her infant would contract the virus from pregnancy; 59 per cent of HIV-positive people in Africa are women, the majority of children diagnosed with HIV get the virus from their mothers.
In 2014 the panorama took on a frightening new dimension. In 1976 the Ebola virus, named after a river in the Democratic Republic of the Congo (DRC) (then known as Zaïre) some 1,150km north-east of Kinshasa, was identified in an Antwerp laboratory. An outbreak of infection by the previously unheard of virus in the local town of Yambuku had killed 280 people, according to the US-based Centres for Disease Control and Prevention (CDC). Over the following decades, Ebola mysteriously manifested itself periodically in small, occasionally lethal, outbreaks in Central and Eastern Africa. The largest of these were all in the DRC (still Zaïre at the time); the first was in Kikiwit which killed 250 people. Ebola showed itself again in the DRC in 2002–03, this time killing 178. A further epidemic in 2007 killed 264. In 2000–01 an outbreak in Uganda killed 224. Until 2014, all the outbreaks had been of this order, taking place in Sudan (now South Sudan), Gabon, and in South Africa, where a laboratory accident killed one person. In relation to the size, scale and spread of HIV/Aids, medical scientists could be forgiven for considering the Ebola threat to be limited.
In 2014, that perception changed. The Ebola virus had three specific characteristics. The first was that scientists had yet to identify where the virus lived in between outbreaks. The prevailing theory was that as a parasite, it lived on the body of a bat, or even an insect. The second was that it could rapidly spread through the slightest contact with blood and bodily fluids. One critical loophole in initial medical safety precautions was that medical staff had left their eyes uncovered, allowing the virus to infect via eye moisture.
Africa’s porous borders meant that the prospect of controlling movement was remote. The 2014 outbreak was traced to a two-year old boy who died of the virus in Meliandou in Guinea. The task of identifying those who might have had contact with an infected person was horrendous. In the family of the dead boy, three deaths – of his mother, his sister and his grandmother – were traced. But by then the virus had travelled, not only within Guinea, but also to neighbouring Liberia and Sierra Leone. By late October the official death count had risen to over 5,000. The real figure (many deaths were beyond the reach of medical services) could well have been double that given by official sources. The principal fear of African health administrators was the likelihood of the virus establishing itself in one of Africa’s (or any other continent’s) major cities – Lagos in Nigeria was an obvious worry. Although there were many promises, aid and human resources from developed countries was slow to materialise, leaving non-governmental organisations (NGOs) and charities to do what they could. Médecins Sans Frontières (MSF) appeared to be leading the way in the infected countries.