April 18, 2024
medical practice

When Ebola breaks out again, whose fault will it be?

Michael Cook

There has been a moral failure to confront serious epidemics

The West African ebola outbreak has been largely contained. Now the world can sit back, breathe a sigh of relief and mutter, “that was a wake-up call”.

Not.

The message of two ethicists from the University of Toronto is that the Ebola epidemic signals a profound moral failure on the part of complacent Western nations. Like an alarm clock at the bedside, they keep hitting the snooze button rather than grapple with the hard questions of developing emergency plan and fixing battered healthcare systems. “We either have collective amnesia or collective narcolepsy,” write Maxwell J. Smith and Ross E.G. Upshur in an Oxford University Press blog, based on their article in Public Health Care Ethics.

“In practice, this translates into not only investing in global outbreak surveillance infrastructure, but also strengthening health systems in the worst-off countries. This latter crucial point has been acknowledged, but unfortunately has largely received only lip service.”

The SARS and H1N1 influenza outbreaks taught public health experts and governments valuable lessons. But once learned, they were quickly forgotten.

By failing to adequately engage communities in outbreak response, instituting travel bans and restrictions, and declining to share valuable data and tissue, this outbreak saw the adoption of policies and practices that fostered distrust and ran antithetical to the ethics lessons we have purportedly ‘learned’ from past outbreaks. It is as if past lessons have been wiped from our collective memory.

They point out that the main obstacle to successfully combating epidemics is moral, not technical. There is simply not enough commitment. “We cannot entirely prevent infectious disease outbreaks from occurring,” they write, “however, we can strive to ensure our moral failures are not repeated.”

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Ebola
epidemics
public health

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