Health Systems, Health Inequities, and Ebola: A Reflective Essay

Desklib provides past papers and solved assignments for students. This essay analyzes the impact of health systems on Ebola and global health inequities.

Assessment 1
Reflection on the link between health
systems and health inequities

Contents
Introduction......................................................................................................................................3
Ebola, its source and way of transmission...................................................................................4
Development of Ebola vaccines in comparison with other diseases having vaccines.................5
Public Health Management and Prevention of Ebola in Wealthy vs Poor nations.....................7
Conclusion.......................................................................................................................................9
References......................................................................................................................................10

Introduction
The following essay focuses on the importance of globalisation and its impact on health along
with having a brief analysis of how the globalisation has an impact on health. Condition of Ebola
is taken for reference which is a global condition in the health system. A brief explanation is
made about the source of the condition and the way it transmits along with focusing on the issue
why it so much time to create a vaccine compared with other conditions having vaccines.
Further, the steps taken for prevention of the condition and public health management are
studied.

Ebola, its source and way of transmission
Ebola is a very rare and deadly virus disease found in humans and nonhuman primates. The
viruses causing Ebola are mainly found in sub-Saharan Africa. It is caused by being infected
from a group of viruses within the genus Ebolavirus (Beeching et al, 2014). The viruses that
come under that group are Ebola virus, Sudan virus, Tai Forest virus, Bundibugyo virus, Reston
virus and Bombali virus. Out of all the viruses stated above only four viruses are known to cause
disease in people which are Ebola, Sudan, Tai Forest and Bundibugyo viruses. The Reston virus
causes the disease in nonhuman primates and not in humans. About the Bombali virus, it is
unknown whether it causes the disease in Humans or nonhuman primates. The virus is an
animal-borne virus with its main source being bats (Maxmen, 2018).
Bats carrying the virus transmit it to other animals as well as humans. The spread of Ebola virus
in humans is caused by direct contact of body fluids of an infected person who is still alive or
may have died from Ebola disease. The virus transmits when a person touches the infected body
fluids or objects contaminated with infected body fluids and enters the body through open body
parts like broken body, membranes of eyes, nose and mouth. Direct contact with body fluids,
blood or tissues of infected animals or humans also results in transmit of the virus (Erika, 2014).
The virus gets transmitted through sexual contact as well. After getting infected, the person
doesn’t show signs or symptoms of the Ebola virus instantly and the virus doesn’t spread until
the person shows symptoms of illness. Once the person starts showing symptoms of illness, they
can transmit the virus to others.

Development of Ebola vaccines in comparison with other diseases having vaccines
In an Ebola outbreak, there is a fatality rate of 30 per cent or more. More than ten thousands of
people have been affected by the disease from its discovery in 1976. Majorly of the cases were
reported in 2014-16 in West Africa. The spread of the virus from infected, in densely populated
areas or in Ebola treatment areas may lead to outbreaks. For the purpose of preventing any future
outbreaks, development and distribution of vaccines is very necessary. One of the newest tools
for controlling Ebola is an experimental vaccine. Around 7,500 doses of the vaccines are
available to the public health authorities making efforts to stop the spread of the disease. The
distribution and availability of vaccines is good news to be considered, but the question which
remains unanswered is that what took it so long to develop a vaccine for Ebola.
Development of vaccines is a very complex process involving both private and public parties
involving a lot of funding. In the case of slow vaccine development for Ebola, investment
consideration and political reliabilities played an important role. Technology should not be
considered the main barrier in vaccine development for Ebola. Vaccine development is a process
to identify a pharmaceutical formulation which can provide immunity from the disease, or
prevent it's spreading and preventing the side effects of own as well as the disease. For the
process of vaccine development, a surface protein or a genetic code needs to be identified which
can trigger the required immune response. After that, a killed or weakened pathogen needs to be
identified which can be used to carry the created material used to activate the immune system in
the body of an infected person. Saying that all these steps weren’t able to be completed in the
case on Ebola would be completely wrong.
In a developed world where a number of safe and effective vaccines for serious diseases like
smallpox and anthrax are available and hundreds of researches are going on in numerous vaccine
laboratories all around the world, which shows that technology had no barrier in the creation of
vaccines for Ebola. A potential vaccine for Ebola has been in existence from 15 years but it
hasn’t been gone through all clinical tests and thus can’t be used on a large scale. In the 2000s, a
vaccine was created and tested on mice which provided them immunity from Ebola. After that,
another vaccine was created which provided the same results and helps in identifying and
resisting the Ebola virus. It was used in the 2014-16 West African epidemics, and the decline in
Ebola cases after that prevented further study, development and improvement of the vaccine on a
large scale. Reduce in the number of cases of Ebola after the 2014-16 epidemic, provided a state

of low return on investment for the drug companies which resulted in the project of vaccine
development of Ebola getting stalled or not even being able to start. In the case of smallpox, such
type of issues wasn’t seen which resulted in the development of a proper vaccination for
smallpox. The disease was continuously causing severe fatality which resulted in drug
companies as well as government to take serious actions for the development of an effective
vaccine. In the case of due to a decrease in the cases of the disease, the drug companies predicted
less return on investment and stopped showing interest in effective vaccine development.
This resulted in the same condition which was before the 2014-16 epidemic that is considering
Ebola as a neglected tropical disease and that resulted in the loss of thousands of lives. Now that
the face of epidemic has ended the main question remains how to move ahead of the phase 1
trials, for the purpose of getting efficient data and develop a safe and effective vaccination as
soon as possible (Berkley, 2015). There are numerous challenges that need to be overcome for
developing a safe and effective vaccine in a short period of time. The first issues arise is that
should the candidates go through all the stages of experiments from Phase 1 to Phase 3.
This model provides highly reliable data for an efficient vaccine. But this will increase the
fatality rate which will result in the administration is causing issues. Another issue arising in the
development of a vaccine for Ebola is that the vaccines production and stability issues which
requires cell-based production of Ebola vaccines and storage at low temperatures. This reduces
the feasibility of trails and future campaigns of vaccination. In the context of African epidemic,
the next issue that arose is that most of the communities don’t prefer western medicines and
taking medical services from foreign medical staffs so for that purpose, it is important to
communicate with the communities and engage with them to share views and opinions. The next
major obstacle is the identification of the key target population to be immunized. The health
organisations have to take right decision to use the available vaccine effectively with the general
population as well as doctors, nurses working in treatment facilities so that proper monitoring
can be done about the e3ffectiveness of the vaccine and decide whether to continue its use or not.

Public Health Management and Prevention of Ebola in Wealthy vs Poor nations
The public health management focuses on the structure and administration of public health
organisation which have an impact on the health programs and reimbursement of health services.
Improving health conditions of the peoples is a challenging process both in the developed and
developing countries. The public health management focuses on engaging health care managers
more in public health issues and focus on removing the implementation gap persisting in various
areas of public health. There is a similarity in the task that public health management performs in
all the countries involving the wealthy and poor countries, but a gap in their performance arises
based on the financial aspect. Public health management in wealthy countries includes proper
management of every related item along with the availability of proper funding. This helps the
public health manager to properly focus on the health issues arising in the society and take
proper steps to prevent or stop any rising health issue and maintain a healthy environment
(Woolcock, 2018). However, people in poor countries have less access to health services, which
makes it tough for the public health manager to maintain a healthy environment. Less availability
of proper funds on time also creates a barrier in proper health management in poor nations.
Public health management in poor nations is always at a disadvantage in every aspect. The
government is not properly able to focus on the health services, and the poor citizens face more
issues as they are given even less or no attention. Due to less availability of funding the private
health manager is unable to implement their policies, monitor the health conditions and take
required actions (Shankpal, 2013).
Prevention of Ebola has a different aspect in both wealthy nations as well as in poor nations.
Talking about the wealthy nation, they have all the resources required to take proper steps for the
prevention of Ebola. Availability of latest technology helps in doing researches and develop
preventive measures. Availability of required funds on time makes the nation to purchase
required materials to develop preventive measures. A nation being wealthy also states that the
people have enough funds to buy the required medicines to get cured and take proper treatment
and also buy equipment to prevent spread from an infected person regardless of the price. While
in poor countries, the situation remains completely different. The government and even private
health organisation don’t have access to the latest technology to develop effective preventive
measures and that too in the required period of time. Unavailability of required funds makes
things get worse as they cannot buy technology or equipment from other countries. Even if they

somehow manage to develop preventive measures, it would cost very high which will make it
impossible for the citizens to buy the medicines, or take treatment due to low financial condition
(Goozner, 2015).
The same was the issues that were faced during the 2014-16 West African epidemic. Africa
being a poor country wasn’t able to take proper steps to develop preventive measures and proper
vaccines that can be used to cure the infected peoples or prevent the spread of Ebola during the
epidemic which resulted in the loss of thousands of lives while the other wealthy countries like
the USA and UK and the private drug companies were able to develop required vaccines to
prevent the spread of the disease. After that also the private drug companies saw it as an
opportunity to make huge profits and selling the required vaccines and equipment at high prices
until public health organisations and NGOs look into the matter to make the vaccines available to
the general public by setting up treatment camps nearby infected areas and provide treatment
facilities to everyone.
From the study and analysis of West African epidemic situation, it can be stated that a nation is a
healthy nation only if it is a wealthy nation.

Conclusion
The following essay provides a reflection of the link between health systems and health
inequities. Starting with the description of Ebola, its sources are discussed along with how it gets
transmitted from one infected person or animal to another person, which provided the viruses
responsible for causing the disease and its mediums of transmission. A proper study made
showed the responsible reason which prevented the preparation of effective vaccines for Ebola
even if vaccines have already been developed for the same level of severe diseases including
smallpox. Further, at last, the public health management and prevention of Ebola was studied by
taking in reference wealthy nations and poor nations which provided various issues that poor
nations have to face to manage health conditions in comparison with wealthy nations properly.

References
 Beeching, N., Fenech, M., & Houlihan, C. (2014). Ebola virus disease. 349(7987), 26.
 Erika Check Hayden. (2014). Infectious disease: Ebola’s lost ward. Nature, 513(7519),
474-477.
 Maxmen, A. (2018). Ebola detectives race to identify hidden sources of infection as
outbreak spreads. Nature, 564(7735), 174-175.
 Berkley, S. (2015). Share the risks of Ebola vaccine development. Nature, 519(7543),
263.
 Woolcock, M. (2018). Enhancing Public Health Outcomes in Developing Countries:
From good Policies and Best Practices to Implementation. Working Papers: Center for
International Development at Harvard University, 340.
 Shankpal, P. (2013). THU0478-HPR Health professionals & rheumatoid arthritis care in
resource poor settings. Annals of the Rheumatic Diseases, 71(Suppl 3), 740.2-740.
 Goozner, M. (2015). The civic side of population health management. Modern
Healthcare, 45(20), 26.