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Australia joins Ebola fight as epidemic slows


The first contingent of Australian health workers deployed under the Federal Government’s contract with private provider Aspen Medical has arrived in Ebola-struck Sierra Leone.

A team of six doctors, eight nurses and three environmental health officers are currently undergoing in-country training and are set to begin working alongside around 200 local staff at a 100-bed British-built Ebola treatment centre at Hastings airfield, near Freetown, late this week.

AMA President Associate Professor Brian Owler, who has been a vocal critic of the Government’s tardy response to the Ebola epidemic, which has so far left more than 6000 people dead, said he was pleased that Commonwealth-funded health workers were finally contributing to the international effort to tackle the deadly outbreak.

Australian doctors and nurses working for humanitarian organisations such as the Red Cross and Medecins Sans Frontieres have been in west Africa virtually since the outbreak began, but for months the Abbott Government rebuffed calls from allies and the international community to join the relief effort citing concerns about the logistical challenges of evacuating any Australian health workers who may become infected with the disease.

It eventually acquiesced last month, and engaged private health services firm Aspen Medical on a $20 million contract to staff and operate a 100-bed British-built Ebola treatment centre in Sierra Leone.

A/Professor Owler said he was satisfied with the Government’s decision to contract Aspen to undertake the task following meetings with company officials and an inspection of its arrangements.

“I have had several meetings with Aspen officials, and have visited their headquarters in Canberra to get assurances about standards of training, equipment and care and evacuation arrangements should health workers become infected with the virus,” he said. “The AMA is satisfied with the organisation of the deployment and the opportunity that has been provided for the hundreds of Australian health workers who want to volunteer to provide care and save lives.”

Under an arrangement struck with British authorities, any Australian staff who contract Ebola will be treated at a British-operated hospital in nearby Kerry Town dedicated to treating international health workers

The risk of infection is far from negligible. By early this month, 622 health workers had been infected with Ebola, 346 of whom had died, according to the World Health Organisation.

But, significantly, a substantial proportion of infections did not occur at Ebola treatment centres but at other health facilities, underlining the need to adhere to infection control measures in all health settings, the WHO said.

By the end of last month, Aspen had received 400 expressions of interest from health workers, and 200 had lodged formal applications.

While Australian health workers are expected to comprise only a fraction of the 220 staff needed to operate the treatment centre at any one time, because they will each serve six-week rotations (including two weeks of in-country training), and because the deployment is expected to last months, if not years, Aspen has said it will need a substantial pool of workers to draw upon.

While Aspen is gearing up the Australian effort, other countries, most notably the United States, Britain, China and France, are continuing to build on their contributions.

US President Barack Obama has asked Congress to approve a further $US6 billion in emergency aid to fight the outbreak, while the UK and China are building more Ebola treatment centres – though charity MSF has warned the international effort is still falling short of what is required.

MSF International President Dr Joanne Liu said it was “extremely disappointing” that countries with biological disaster response capabilities had not yet chosen to use them.

Nonetheless, the Australian deployment has come amid signs progress is being made in containing the outbreak, particularly in Guinea and Liberia.

Signs outbreak is stabilising

In its most recent update, the WHO struck a cautious but hopeful note in its assessment of the outbreak, reporting that the rate of new infections had stabilised in Guinea and Liberia in the past five to six weeks, though transmission of the virus in Sierra Leone remained “intense”, and it has spread to Mali, where at least seven people are confirmed to have been infected.

In Guinea, where 1327 people have died, there were 77 new cases in the last week of November, down from 148 the week before, while in Liberia – where 3145 people have died – there were 48 cases in late November, down from 78 the previous week.

The situation in Sierra Leone remains much more concerning, where there were 537 new cases in the last week of November (up from 385 the previous week), including 202 in the capital, Freetown. 

Confidence about bringing the outbreak under control has been boosted by a build-up of resources.

The WHO said each of the three west African countries hardest hit by the disease now had sufficient facilities to isolate and treat at least 70 per cent of all new Ebola infections, to conduct laboratory tests within 24 hours and to safely bury 70 per cent of all who die from Ebola – each of which were considered key benchmarks in stemming the epidemic.

“At a national level, there is now sufficient bed capacity in Ebola virus disease (EVD) treatment facilities to treat and isolate all reported EVD cases in each of the three countries, although the uneven distribution of beds and cases means there are serious shortfalls in some areas,” the Organisation said. “Similarly, each country now has sufficient and widespread capacity to bury all reported EVD-related deaths.”

Despite this progress, the disease remain deadly for many of those who catch it.

The WHO reported a case fatality rate across west Africa of 72 per cent among all confirmed cases, and it was still a high 60 per cent among patients who were hospitalised.

In addition to those who fall ill, the disease is also taking a heavy social and economic toll.

Almost half of Liberians who had a job when the outbreak started are now unemployed, and the World Bank said the disease had crippled the economies of affected countries.

In estimates released last week, the World Bank said Sierra Leone’s growth rate had tumbled from 11.3 per cent before the outbreak to 4 per cent now and a likely minus 2 per cent next year, while Liberia’s growth rate had been slashed from 5.9 per cent to 2.2 per cent now and 3 per cent next year, and Guinea’s had been cut from 4.5 per cent to just 0.5 per cent, and was likely to drop to minus 0.2 per cent in 2015.

Adrian Rollins