The 2014 outbreak of Ebola in West Africa is unprecedented in its scale, and carries with it significant security as well as economic and public health consequences for West Africa. As of late September, over 6,000 cases of infection have been identified in five countries: Guinea, Liberia, Nigeria, Senegal and Sierra Leone. There is no known cure for the virus, and although experimental treatments are under development, they will not be available in any large quantities before the end of the year. Healthcare and emergency workers are able only to attempt to mitigate the harm caused by the virus to the infected through palliative care, and to attempt to contain the spread of the outbreak. The virus is particularly contagious in its final stages, and is spread through contact with body fluids. As a haemorrhagic fever, the outbreak brings significant dangers to healthcare workers while treating patients, a fact borne out by the high number of healthcare workers on the infection list – an estimated 10% of all infection cases.

Having begun in late 2013, the outbreak was identified in early 2014, first in Guinea and Liberia, then in Sierra Leone and Nigeria. Most recently, cases of infection have been identified in Senegal. The virus has quickly overwhelmed medical and emergency capacities in Liberia and Guinea, with substantial international and NGO aid flowing into these areas to attempt to contain the  further spread of the virus. The UN World Health Organisation (WHO) warned in September 2014 that the outbreak had reached a critical point, and that the outbreak now threatens to overwhelm containment efforts. The confirmed infection list has nearly doubled between August and September, illustrating the significant acceleration of the outbreak.

Ebola outbreaks have previously been noted for intense (but limited) appearances, followed by a relatively rapid ‘burn-out’. However, because of the sheer scale of the West Africa outbreak, there are expectations that the current outbreak has sufficient momentum to continue for months.

Local social and economic impact of the outbreak is severe

The Ebola outbreak has caused significant human suffering, and is expected to far exceed its current body count, which, as of late-September, has rapidly closed in on 3,000 fatalities. Moreover, the outbreak, and especially, containment efforts that include the closing of borders and the instigation of quarantine zones, has resulted in significant economic harm to the region. The African Development Bank (AfDB) has cautioned that the impact of the outbreak on economic development in the region is likely to be severe.  Less easily measurable but nonetheless substantial, the outbreak has caused substantial social upheaval, disrupting lives and causing major tension within communities and against government and international authorities.

Aside from critical resource and capacity shortages, medical and emergency workers face the added challenge of sometimes hostile local populations. Rampant fear and the spread of rumours have resulted in attacks on healthcare workers and treatment facilities. For example, in an August riot in Liberia, a treatment facility was looted and patients were forcibly expelled by a crowd who saw the presence of the patients as a threat to the community (and in so doing, likely exposed themselves to the disease). Fear of stigmatisation is believed by healthcare authorities to be keeping many infection carriers at home, rather than seeking medical help.

Cultural practises in West African countries, such as washing of the bodies of recently deceased, as well as widespread distrust of Western or international medical practises have also hindered treatment and containment efforts. Distrust of and resentment towards government efforts are also running high. Heavy-handed containment strategies, such as the three-day ‘lock-in’ in Sierra Leone over 19-21 September, may well turn out to have been counter-productive: by further stigmatising the infected it has also likely left long-lasting rifts between governments and those communities hardest hit. Prior to the lock-in, food prices spiked dramatically. While in Freetown, a team of aid workers burying dead bodies was attacked by a group of protesters who had defied the order to remain indoors.

Within some infection hotspots, economic activity has slowed down or stopped entirely. Parts of Liberia and Sierra Leone are especially affected by this, where the local populace have taken to their homes for safety. The instigation of quarantine zones has further impacted economic activity and has also introduced additional suffering as people struggle to meet even basic food requirements. This problem has led to some instances of violent backlash from the local populace, particularly in Liberia, around Monrovia. The UN World Food Programme (WFP) has warned of significant food shortage risks in some areas.

Transnational trade has also been severely impacted by the outbreak. Affected countries and neighbouring states have closed their borders in an effort to prevent the spread, although this tactic is of minimal help. A large proportion of the transnational trade that occurs in the area is informal, and across non-official (i.e. unmonitored or controlled) border crossing points. To illustrate this problem, Nigeria’s Immigration Service (INS) oversees 84 official border crossing points around the country, but acknowledges the existence of between 1,000 and 2,000 informal crossings. The problem of porous borders is a major and persistent security threat to the region. That said, the closing of borders and fear of the outbreak amongst the local populace has also resulted in a dramatic drop in even informal cross-border economic activity.

The political impact of the outbreak is being felt in affected countries. Liberia has suffered especially, with medical services already severely compromised by decades of war and with the Second Liberian Civil War having only ended in 2003. Liberian President Ellen Johnson Sirleaf has warned the international community that Liberia’s medical services are at breaking point, and that the state faces a grave threat to its stability. Political fragility is likely to remain extremely high even in the aftermath of the outbreak as social upheaval, economic damage and the collapse of medical and emergency services will have shaken confidence in the government.

West African regional trade and security relations likely to be affected in the long term

The West Africa outbreak is unusual not only because of its location (Ebola is not typically found in West Africa), but also because of the way that the disease has spread across the region. A combination of highly porous borders and significant capacity shortages in emergency and medical services in the affected areas has allowed the disease to overcome early containment efforts.

The 2014 Ebola outbreak has perhaps shone a spotlight on regional vulnerabilities. The threat of a potential international spread of the disease has also galvanised international attention to the problems and risks associated with the state of healthcare in Africa.

Regional cooperation between affected countries has increased levels of cooperation, but may also lead to negative effects in the long-term. It is likely that border closures during containment efforts and the resulting decreased trade could persist for some time. Some states may choose to unilaterally bolster their border security, perhaps even overtly ascribing blame on other countries for the outbreak.

The 2014 outbreak is likely to continue into 2015, and it remains highly possible, based on warnings of the WHO that the virus could break its current containment and spread geographically further before it finally does end. Not only is the body-count expected to continue to rise, but the longer the outbreak persists, the deeper the social, political and economic scars will be.

This article is extracted from the October 2014 edition of CAI’s Africa Conflict Monitor (ACM) –. The essential +/-70 page monthly report that dissects conflict developments and trends across the African continent to guide businesses, governments, academics and other stakeholders in Africa’s growth and stability.

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Written by Conway Waddington ⁽¹⁾

Notes:

1. Conway Waddington is a Regional Analyst with ACM. He has written and presented at international conferences on Sub-Saharan African security and conflict, with a particular focus on West Africa. Conway has contributed to International Business Times, African Defence Review, the Institute for Security Studies (ISS), and the Terrorism Research and Analysis Consortium (TRAC) amongst others.