Ebola

The Ebola outbreak in West Africa caused global alarm. As one of the world's most infectious and deadly diseases the level of fear surrounding Ebola is to an extent expected. However, much of the fear is rooted in misunderstandings. Dispelling these is a major challenge in tackling Ebola and is critical to furthering our knowledge about the disease and efforts to control it.

At IDS, researchers are investigating the complex forces behind the emergence and spread of diseases which are transmitted from animals to people and are known as zoonoses. Although Ebola is now being spread by human-to-human contact, it is zoonotic in origin. Fruit bats are thought to be the most likely natural host for the Ebola virus. IDS researchers are also investigating the social contexts in which zoonoses often emerge and the contending narratives surrounding disease control. Research – drawing together social and natural science, and engaged with local people, international agencies, and national and local governments and practitioners - can lead to better theory, improved mutual comprehension, and better-informed measures and practices to manage and control disease.

Misunderstanding one: Chopping down trees causes Ebola

While there is good evidence that bats are the natural reservoir for the Ebola virus, the complex interactions that cause the disease to spillover to humans are as yet unclear.

A popular environmental narrative claims that rapid and unprecedented deforestation of primary forests is leading to increased human-bat contact in West Africa for the first time, making transmission of the disease to people from bats more likely. However, research by IDS's Melissa Leach and others has shown the upper Guinea forests have been a dynamic mosaic of forest, savannah, and farmland for centuries, with people in this region having long co-habited with bats.

Over-simplified views of one-way deforestation feed popular ideas that stereotype and blame rapacious farmers and loggers for their current disease predicament. They do not help us understand Ebola's origins. Meanwhile misleading messages that Ebola comes from eating bushmeat have dangerously deterred people's appreciation of the real risks of transmission – from bodily contact with infected humans.

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Misunderstanding two: People in Africa are ignorant of effective ways to deal with diseases like Ebola

The difficulties medical teams have sometimes had in establishing effective community relations during the current Ebola epidemic have led to some wild generalisations. People in West Africa are not living in archaic, unchanging tradition, refusing to engage with modern concepts of health.

However, the dimensions of cultural context remain real and relevant as disease possibilities, and therefore as logical explanations of worrying events and circumstances, even to the educated. People can live with multiple framings of disease and outside intervention, and can switch between them according to context. So, although outside scientific knowledge is crucial to containing the Ebola virus, local public behaviours and attitudes can and should be seen as part of cultural logics that make sense given regional history, social institutions and experience.

For this reason, an anthropological perspective is important for disease control efforts, which should include building good community relations, working with traditional authorities and seeking to understand local ideas and practices.

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Misunderstanding three: Ebola is a one-off event

Ebola is one of a group of diseases transmitted to people from animals that are known as zoonoses. Ebola is rightly gaining much attention as it was only identified in 1976, is extremely contagious and has a high fatality rate. It is also proving far more difficult to control than previous epidemics of zoonotic disease such as SARS and avian influenza.

However, since 1940, more than 60 per cent of infectious diseases newly affecting people in Africa have been transmitted via animals. Globally, the top 13 zoonotic diseases are responsible for 2.2 million human deaths every year, most in low- and middle-income countries. Even where they don't kill, their effects still devastate poor people's lives and hamper development efforts. Ebola is a terrible disease, but known deaths from it still number fewer than 8,000 to date.

To say all this is to highlight the terrible impact of other zoonoses, which receive relatively little attention. It is also to stress the importance of increasing our knowledge about neglected zoonoses. IDS researchers are working alongside vets, geographers, epidemiologists and others in multidisciplinary projects helping to tease out the complex forces behind zoonotic disease emergence and transmission, offering new theory as well as practical solutions.

It is not reason to be less concerned about Ebola. The current exponential increase in Ebola infections and the resulting terrible social, economic and political consequences demonstrates the dangers and tragedies of an unchecked epidemic. It also highlights the underlying development and health system failures that have contributed to this becoming a crisis of such proportions.

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Image credit: European Commission DG ECHO (cc on Flickr)

Ebola: Lessons for development

IDS researchers argue that there is an urgent need to look beyond the immediate, on-the-ground concerns of disease control and containment to consider the bigger and broader questions about international development. More details

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IDS publications on international development research

Comparison of Social Resistance to Ebola Response in Sierra Leone and Guinea Suggests Explanations Lie in Political Configurations not Culture

Critical Public Health 01.27 (2016)

Sierra Leone and Guinea share broadly similar cultural worlds, straddling the societies of the Upper Guinea Coast with Islamic West Africa. There was, however, a notable difference in their reactions to the Ebola epidemic. As the epidemic spread in Guinea, acts of violent or everyday resistance to outbreak control measures repeatedly followed, undermining public health attempts to contain the crisis. More details

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Real-time Monitoring in Disease Outbreaks: Strengths, Weaknesses and Future Potential

IDS Evidence Report 181 (2016)

This Evidence Report analyses the potential contribution of epidemic real-time monitoring (ERTM) initiatives to enhancing and augmenting disease surveillance systems in developing countries. More details

IDS publications on international development research

One Health: Science, Politics and Zoonotic Disease in Africa

Zoonotic diseases – pathogens transmitted from animals to people – offer particularly challenging problems for global health institutions and actors, given the complex social-ecological dynamics at play. More details

IDS publications on international development research

The Ebola Crisis and post-2015 Development

Journal of International Development 27.6 (2015)

This article argues that the recent Ebola crisis is the result of structural violence, as interlocking institutions have produced interlaced inequalities, unsustainabilities and insecurities. More details

This is the front cover to IDS Working Paper 454.

Building a Resilient Health System: Lessons from Northern Nigeria

IDS Working Paper 454 (2015)

The overarching aim of this paper is to address the issue of building resilient health systems in the context of the Ebola outbreak in West Africa which has brought renewed attention to this challenge. The paper highlights insight gained from two decades work creating resilient health systems in Nigeria—in Northern Nigeria in particular. More details

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Ebola and Lessons for Development

IDS Practice Paper in Brief 16 (2015)

As the Ebola crisis continues to unfold across West Africa and the international community belatedly responds, broader questions arise beyond the immediate challenges on the ground. More details

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Global Governance and the Limits of Health Security

IDS Practice Paper in Brief 17 (2015)

The Ebola outbreak in West Africa has exposed the limits of the current approach to the global governance of infectious diseases, which mixes public health and security interests. More details

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Strengthening Health Systems for Resilience

IDS Practice Paper in Brief 18 (2015)

In countries with high levels of poverty or instability and with poor health system management and governance, people are highly vulnerable to shocks associated with ill health, including major epidemics. More details

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Return of the Rebel: Legacies of War and Reconstruction in West Africa’s Ebola Epidemic

Practice Paper in Brief 19 (2015)

The spread of Ebola in West Africa centres on a region with a shared recent history of transnational civil war and internationally led post-conflict reconstruction efforts. This legacy of conflict and shortcomings in the reconstruction efforts are key to understanding how the virus has spread. More details

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Ebola, Politics and Ecology: Beyond the ‘Outbreak Narrative’

IDS Practice Paper in Brief 20 (2015)

The origin of the Ebola outbreak in West Africa has been traced to the likely confluence of a virus, a bat, a two-year-old child and an underequipped rural health centre. More details

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Ebola and Extractive Industry

IDS Practice Paper in Brief 21 (2015)

The economic effects of the Ebola health crisis are slowly unfolding as the virus continues to affect Sierra Leone, Liberia and Guinea. More details

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Urbanisation, the Peri-urban Growth and Zoonotic Disease

IDS Practice Paper in Brief 22 (2015)

Ebola has had significant, negative effects in the rapidly expanding, unregulated areas of peri-urban and urban West Africa. The residents of these areas maintain vital connections with rural populations while intermingling with and living in close proximity to urban and elite populations. More details

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The Pathology of Inequality: Gender and Ebola in West Africa

IDS Practice Paper in Brief 23 (2015)

The international response to Ebola has been decried for being ‘too slow, too little, too late’. As well as racing to respond, we need to consider what has happened over the past decades to leave exposed fault lines that enabled Ebola to move so rapidly across boundaries of people’s bodies, villages, towns and countries. More details

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Local Engagement in Ebola Outbreaks and Beyond in Sierra Leone

Practice Paper in Brief 24 (2015)

Containment strategies for Ebola rupture fundamental features of social, political and religious life. Control efforts that involve local people and appreciate their perspectives, social structures and institutions are therefore vital. More details

IDS publications on international development research

Ebola: Limitations of Correcting Misinformation

The Lancet (2014)

Communication and social mobilisation strategies to raise awareness about Ebola virus disease and the risk factors for its transmission are central elements in the response to the current Ebola outbreak in West Africa. More details

IDS publications on international development research

Impact and Implications of the Ebola Crisis

This rapid literature review looks at the available evidence on the impact of the Ebola crisis on four key areas: political, economic, social, and security. More details

IDS publications on international development research

Briefing: Ebola–Myths, Realities, and Structural Violence

African Affairs 114 (2014)

This briefing examines responses to the Ebola outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. More details

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