西アフリカのエボラアウトブレイクの要因として、"The Guardianは、1976年のザイールのエボラアウトブレイクや2003年の東アジアのSARSのときから、大きく弱体化したWHOを挙げる。
A devastating report in the New York Times shows that WHO has been savagely run down in recent years, with the most eviscerating cuts made in the very departments vital for the containment of epidemics. One department was closed down entirely, another key section had its staff cut by two-thirds, and staff in the field, especially in Africa, were similarly reduced. The reasons were both financial and ideological. Countries cut contributions to WHO after the financial crisis and, at the same time, the idea took hold that the organisation should concentrate its efforts on helping nations build their own capacity to respond to emergencies rather than providing that capacity itself in the first instance.


This was theoretically reasonable, but did not happen in practice, especially in poorer parts of the world. The result was that WHO simply walked away from the lessons of its own successes, stripping itself of the means to act effectively when Ebola emerged again. Tellingly, the disease spread for three months before it was spotted, and it was an NGO, Médecins sans Frontières, that first categorised it as a major outbreak. The head of MSF, Dr Joanne Liu, told the UN last week that the battle to contain Ebola was being lost.

これは理論的には合理的だったが、特に世界の貧しい地域で、実際には実現しなかった。結果として、WHOは自らの成功の教訓から歩み去り、エボラが再出現したときには有効に機能する手段を失った。そして、エボラの感染拡大に気づくまでに3か月を要し、大規模なアウトブレイクであると最初に判断したのは国境なき医師団だった。国境なき医師団の代表者Dr. Joanne Liuは国連に対して、先週、エボラ封じ込めの戦いに負けつつあると述べた。

The weak health systems of Liberia, Sierra Leone and Guinea, she implied, have become centres for the spread of Ebola rather than its control, as carers fall ill and patients flee. Dr Liu called on wealthy countries to send military biohazard teams to west Africa, a measure worth immediate consideration. Beyond that, there must be a resolve never to let the WHO fall into such an eroded state again.

Dr. Joanne Liuの言うところ、リベリア・シエラレオネ・ギニアの脆弱な医療体制は、医療関係者が感染し、患者が逃走するという形で、エボラの制御ではなく感染拡大の中心となっている。Dr. Joanne Liuは豊かな国々に対して、ただちに検討する価値のある手段たる、軍のバイオハザード部隊の西アフリカへの派遣を求めている。さらに、再びWHOが弱体化するような状況に陥らせない決意が必要である。

["The Guardian view on why the Ebola epidemic is spreading"(Editorial) (2014/09/07) on The Guardian]
Nurses at Liberia's largest hospital have gone on strike, demanding better pay and equipment to protect them against the Ebola epidemic which has killed hundreds in the west African state.


["Ebola: Liberian nurses strike over lack of protective equipment" (2014/09/02) by AFP]

When a starving Ebola patient escaped from a treatment center in Monrovia and staggered through a crowded market in search of food, bystanders who scattered in his path voiced their anger − not at him but at Liberia's president. To many in this impoverished West African country, President Ellen Johnson Sirleaf's government has not done enough to protect them from the deadly virus.

Ebola has killed more than 1,000 people in Liberia since its arrival six months ago. Across West Africa, the death toll from the world's worst Ebola outbreak has surpassed 1,900. Panicked residents said the patient was the fifth to escape in recent weeks from the understaffed ELWA hospital. Dozens watched anxiously as workers in protective clothes bundled the struggling patient into a truck and drove him back. "The patients are hungry, they are starving. No food, no water," said one terrified woman in the crowd.

飢えたエボラ患者がモンロヴィアの治療センタを抜け出して、食べ物を求めて、市場の人混みに紛れ込んだ。そのとき、彼の行く道にいた傍観者たちは、彼にではなく、リベリアの大統領に怒りの声を上げた。この貧しい西アフリカの国の多くの人々にとって、Ellen Johnson Sirleaf大統領の政権は、エボラ対策を十分に行っているとは言えない。


[JAMES HARDING GIAHYUE AND BATE FELIX: "Ebola outbreak stirs anger in fragile Liberia" (2014/09/06) by Reuters]
人員不足も深刻であり、国境なき医師団の代表者Dr Joanne Liuは2014年9月2日には、各国に軍の派遣を求めた。
"Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it," Liu said.

"In west Africa, cases and deaths continue to surge," she said. "Riots are breaking out. Isolation centres are overwhelmed. Health workers on the frontline are becoming infected and are dying in shocking numbers.

"Others have fled in fear, leaving people without care for even the most common illnesses. Entire health systems have crumbled."

She said Ebola treatment centres had been reduced to places where people went to die alone.

"It is impossible to keep up with the sheer number of infected people pouring into facilities. In Sierra Leone, infectious bodies are rotting in the streets," she said. "Rather than building new Ebola care centres in Liberia, we are forced to build crematoria."

"To curb the epidemic, it is imperative that states immediately deploy civilian and military assets with expertise in biohazard containment. I call upon you to dispatch your disaster response teams, backed by the full weight of your logistical capabilities. This should be done in close collaboration with the affected countries. Without this deployment, we will never get the epidemic under control."


[Sarah Boseley:"Ebola outbreak: call to send in military to west Africa to help curb epidemic" (2014/09/02) on The Guardian]

物資不足と人員不足がまず解決に向かわないと、エボラアウトブレイクの制御はおぼつかない。それでなくとも、旧世紀末から今世紀初頭の内戦などで、ギニア・シエラレオネ・リベリアでは政府不信が強く、エボラの実在を強固に否定する人々がいる。それには、植民地支配の時代の影響もあるとの指摘もある。そろそろ、"Too little, Too late"を脱することができれば...
posted by Kumicit at 2014/09/09 07:06 | Comment(0) | TrackBack(0) | Disease | このブログの読者になる | 更新情報をチェックする



コメント: [必須入力]