A health worker in protective suit carries equipment on October 1, 2014 at MSF's (Doctors Without Borders) Ebola treatment center in Monrovia. Liberia has been hit the hardest by the worst-ever outbreak of Ebola, which has killed more than 3,000 people in west Africa. The latest UN data released on September 27, 2014 said 1,830 people have died from the killer virus in Liberia so far, and 3,458 people have been infected. AFP PHOTO / PASCAL GUYOTPASCAL GUYOT/AFP/Getty Images (Credit: Getty Images / PASCAL GUYOT)
Thomas Eric Duncan is in a Dallas hospital with Ebola because of an unfolding disaster in international health.
Duncan's story is familiar by now. Personnel at a Dallas hospital failed to raise a red flag when he showed up sick and told them he'd recently traveled from Liberia, an Ebola hot spot. That mistake is changing the "can't happen here" mindset at hospitals across the country.
Now the question of how to mount an effective worldwide response to the Ebola plague is raised -- but the answer is a shock to those who think they live within the familiar confines of their friendly nation state. That's what will make it hard to adopt the solution that works.
The Ebola crisis is producing refugees from the first deeply affected countries -- Liberia, Guinea and Sierra Leone. Many refugees are dirt poor. But some are well-to-do, and some of those will figure out real quick that the place to get treated, if they can get there, is the United States or Europe. And that is exactly where they will set out to go, by hook or by crook. It won't be long, I predict, until an Ebola victim crops up at a New York-area hospital. The same goes for other world capitals.
How should we respond to this fast-spreading and very dangerous epidemic?
Major countries should appoint one of the world's experienced experts in the management of epidemics to head an emergency worldwide effort to contain and roll back the Ebola scourge.
Nations participating in the effort should give this individual extraordinary powers, like a general leading allied forces, and a generous budget with full discretion on spending. A ceiling might be 0.01 percent of a nation's gross domestic product. For Europe and the United States combined, this would generate an initial pot of roughly $4 billion. And the Ebola czar should be given power to draft medical units from the armed forces and public health units of those nations in the emergency alliance.
The fact that you, like me, are saying that this will not happen is a sign of two things: how out of date and lazy we have been in our thinking about global health issues, and how difficult it will be to mount an effective effort to contain Ebola. The world is changing a lot faster than our institutions.
There are reports that a major pharmaceutical company is making progress on an Ebola vaccine, and that early animal trials are showing success. We must hope so.
But two questions stand out: Why did no one make it a priority when the current outbreak was first reported in March? And how do we establish an effective global effort as rapidly as possible?
Stay tuned. The Ebola drama may be coming to a neighborhood near you.