With each new case of the Ebola virus reported by the media, there is also more speculation about a pandemic if Ebola gets out of West Africa, which unfortunately it has. A pandemic is an epidemic that spreads across continents. The world has experienced pandemics at least as far back as the Middle Ages, when the Black Death killed about one-third of the world's population, to more recent pandemics like smallpox, tuberculosis and most recently HIV/AIDs. In the early 1900s, the U.S. experienced the deadly Spanish influenza. Since about the middle of the 20th century, we have experienced at least four major epidemics: polio, Asian flu, swine flu and HIV/AIDS.
While the risk of an Ebola epidemic in the United States is believed to be small, it is a significant threat that will become even more serious if cases outside of West Africa become more numerous. As governments and health professionals focus on improving detection and treatments, it is fair to ask: What could we have done to better contain the risk? There is no single or simple answer. But one controllable condition is obvious: global poverty.
In December 2013 in The New York Times, Lomborg wrote, "More than 1.2 billion people around the world have no access to electricity. ... Most of them live in sub-Saharan Africa and in Asia. ... Even more people — an estimated three billion — still cook and heat their homes using open fires and leaky stoves."
These statistics are staggering in a world with a total population of 7 billion. At a U.N. Millennium Summit in 2000, 189 countries pledged to halve "extreme poverty and hunger" and "reverse the spread of HIV/AIDS, malaria, and other major diseases" before 2020. Although the U.N. claims to be making steady progress to achieve its millennium goals, there are still somewhere between 1.2 and 1.6 billion people who live in devastating conditions of poverty, without access to commercial electricity, potable water, adequate healthcare or nutritional diets. They suffer high disease and mortality rates and these are the conditions that are the breeding ground for Ebola.
The Ebola virus has been found in African monkeys, chimpanzees and other nonhuman primates, according to leading health experts. Those experts believe that the virus is spread through butchering and eating infected animals and exposure to infected waste products. Dr. George Rsi, an infectious disease expert, believes that the regular support that any Western hospital provides can reduce the mortality rate in half. The lesson seems clear that good hygiene, good food handling practices and modern public health facilities would reduce the risk of infectious diseases in developing countries and the potential threat of a pandemic. These are conditions that could have been more effectively addressed over the past few decades.
The Lomborg argument about misallocation of resources is not new. Analysts and policy experts have long been making the case that eradicating energy poverty and its consequences would accomplish far more than squandering billions of dollars on a threat — human-caused climate change — that has clearly been exaggerated. The 2010 World Energy Outlook chapter on Energy Poverty has this to say: "Access to modern forms of energy is essential for the provision of clean water, sanitation and healthcare." The improved standard of living that comes with access to commercial energy also allows countries to improve their infrastructure, which would include a modern public health system. The Ebola outbreak in West Africa occurred for several reasons, but the dominant one is that West Africa is less prepared to deal with it.
Past decisions on the allocation of resources can't be undone, but the developed world can reset its priorities and concentrate on a serious problem that it knows how to solve — energy and global poverty. That is the best way to make sure that the risk from the next epidemic is reduced and doesn't become a pandemic.
O'Keefe is CEO of the George Marshall Institute and president of Solutions Consulting, Inc.