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Opinions of Friday, 17 October 2014

Columnist: Adjei-Kyeremeh, Nathanael

Death by denial: The striking parallels between AIDS and Ebola

Ebola Virus Disease declared by WHO as a global health emergency continues to kill many in West Africa. According to the WHO as at October 10, 2014 8,399 people had been diagnosed with Ebola and 4,033 had died. There has been panic globally as health experts struggle to bring Ebola under control.

Many Scientist have agreed that the widening Ebola epidemic is reminiscent of the health threat caused by AIDS. The director of the Centers for Disease Control and Prevention, Dr Tom Frieden likened Ebola to AIDS and urged action so Ebola doesn't become "the world's next AIDS."

It is Pliny the Elder who said, "Out of Africa, always something new". Ebola like AIDS is known to have started from Africa. Experts agree AIDS spread to cause a global pandemic because the world was slow to recognize and fight it; sadly the response to Ebola similarly had been glacially slow.

Like Ebola, AIDS is caused by a virus, HIV. Both are transmitted via bodily fluids; neither has an effective vaccine; and if not treated, both are deadly. Interconnectivity and easy mobility has helped the spread of both diseases.

A key issue that has contributed to worsening both diseases has been denial.

The response of most African leaders to the AIDS calamity was to deny or dismiss the problem. African politicians preferred to represent AIDS as either a western import or a western fabrication. Many Africans adopted a cavalier attitude to the risks of infection. In Tanzania, AIDS was said to stand for Acha Inwe Dogedoge Siachi, a Swahili phrase meaning: "Let it kill me; I shall never abandon the young ladies." In Zaire, where AIDS was known by the French acronym SIDA, university students translated it humorously as "Syndrome imaginaire pour décourager les amoureux, meaning ‘an imaginary syndrome to discourage lovers’. In South Africa where the toll of AIDS had been most severe, Anti-apartheid activists claimed the AIDS education programmes were a government plot to control population growth in order to check the Advance of African liberation. They mocked the Aids acronym saying it stood for 'Afrikaner Invention to Deprive us of Sex'. Thabo Mbeki was later to dabble in pseudoscience and denial claiming fallaciously that HIV, a virus couldn't cause a syndrome, AIDS. Mbeki sided with the popular proponent of AIDS “denialism” Professor Peter Duesberg a professor at the University of California, Berkeley. A study led by Pride Chigwedere of the Harvard School of Public Health claimed 330,000 people died unnecessarily in South Africa over the period due to Mbeki’s denialism and that 35,000 HIV-infected babies were born who could have been protected from the virus.

Ebola has suffered a similar fate of denial. In the heat of the epidemic a survey of 1000 respondents conducted by Samaritan’s purse in Monrovia—Liberia found that 92% of Liberians didn't believe Ebola existed. They believed it was a hoax created by their government to “eat money” from donors. Such denials have resulted in the ‘business as usual’ approach to handling of animals both sick and dead, handling of corpses and poor hand washing habits.

A major Liberian newspaper, published an article by a Liberian-born associate Professor of the Delaware State University, Cyril Broderick, implying the epidemic is the result of bioterrorism experiments conducted by the United States Department of Defense, among others. Unfortunately conspiracy theorists and gullible folks have latched onto this piece. Such pieces have fuelled waves of mistrust and violence even against health workers at the forefront of the Ebola control. In Freetown, capital of Sierra Leone, thousand marched at an Ebola treatment centre following allegations by a former nurse that Ebola was invented to conceal “cannibalistic rituals” at the facility

If Ebola will not tread the path of AIDS efforts must be made to intensify public education on the scientific nature of the disease, case identification and isolation must be improved. We must learn the lessons from the AIDS pandemic. Senegal provided a good example on managing the AIDS pandemic through strong political leadership and intense public education on behavioural changes. Nigeria's excellent handling of the recent Ebola outbreak has received commendation.

Ebola is crippling the economies of Liberia, Sierra Leone and Guinea. The world is awake and has recognised that in our globalized world, Ebola somewhere, is Ebola everywhere.

As long as we continue to interact with nature, Ebola will not be the pandemic that ends all pandemics. We must learn from AIDS and employ the lessons in managing Ebola. In like manner the lessons we learn from Ebola will be crucial moving forward.

Denying Ebola or dabbling in conspiracy theories has no benefit as we struggle to contain the virus. Like AIDS, Ebola is here with us; we must man up and defeat it, or deny its existence and die.

Dr Nathanael Adjei-Kyeremeh Medical Officer, St John of God Hospital Duayaw Nkwanta.