Ebola Virus Disease: Global Health and Social Determinants

This essay provides a comprehensive overview of Ebola virus disease (EVD), examining its global impact and the social determinants of health that influence its spread and management. It begins by describing the virus, its transmission, and the challenges in developing effective vaccines compared t...Read More

Running Head: GLOBAL PERSPECTIVE ON SOCIAL DETERMINANTS OF HEALTH – EBOLA1
GLOBAL PERSPECTIVE ON SOCIAL DETERMINANTS OF HEALTH – EBOLA
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GLOBAL PERSPECTIVE ON SOCIAL DETERMINANTS OF HEALTH– EBOLA2
GLOBAL PERSPECTIVE ON SOCIAL DETERMINANTS OF HEALTH – EBOLA
With continuous technological advancements, the world is becoming smaller as
information is more easily passed on from one person or country to another. It is more difficult to
use the traditional distinctions between countries as either developed, developing or
underdeveloped. This is because three or two worlds can exist in the same geographically located
country. In many countries formerly termed as developing, there may exist wealthy middle-class
families who consume akin or even better domestic products as compared to their counterparts in
developed countries. However, in the case of diseases and infections, the social gradient is a vital
issue. Social gradient describes the differences in socio-economic status between countries. The
spread of infections and diseases such as HIV/AIDS is more rapid in poor countries, that is, those
with low socioeconomic status (Beckfield, Olafsdottir & Bakhtiari, 2013). This paper discusses
Ebola, a serious and often fatal disease that affects primates. It describes its transmission as well
as its vaccination details in comparison with some other diseases. The paper also deliberates
public health management and prevention of Ebola in the context of wealthy versus poor nations.
Ebola Virus Disease (EVD), as the name suggests is caused by infection with a virus,
genus Ebolavirus of the Filoviridae family.The other genera in the Filoviridae family are
Marburgvirus and Cuevavirus.Five species have been recognizedwithin the genus Ebolavirus:
Bundibugyo,Zaire, Taï Forest, Sudan,andReston. EVD first appeared simultaneously in two
outbreaks in Africa, particularly in Yambuku (Democratic Republic of Congo) and in a location
that is now called Nzara (South Sudan) in 1976. The disease takes its name from Ebola River,
located near a village where it first appeared in DRC(WHO, 2018).Sudan ebolavirus,
Bundibugyo ebolavirus, and Zaire ebolavirus associated with large outbreaks of the disease in
Africa. The 2014 to 2016 outbreak in West Africa was caused by the Zaire ebolavirusand was

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the most complex and largest epidemic since its discovery in 1976. It involved more fatalities
than all other outbreaks combined as it spread across countries from Guinea to Liberia and Sierra
Leone(Awah, Boock&Kum, 2015).
The virus is considered zoonotic as it is introduced to humans from animals through close
contact with the organs, secretions, blood or other organs of an infected animal’s body.The fruit
bats of the Pteropodidae family are thought to be natural hosts of the Ebola virus.Monkeys,
gorillas, forest antelopes, chimpanzees, and even porcupines are other animals that can transmit
EVD to humans. The disease then spreads from one human being to another through direct
contact with bodily fluids and materials or surfaces that have been contaminated with the fluids,
such as clothes and beddings (Malvy et al., 2019). Even after the death of an infected person, the
virus can be transmitted if the burial ceremony entails direct contact with the body. As long as
their blood and secretions contain the virus people remain infectious.Male survivors are thus
advised to observe safe sex or abstain from all kinds of sex until their semen has twice tested
negative for Ebola virus (WHO, 2018).
The interval from the infection with the Ebola virus to the onset of the disease’s
symptoms (incubation period) ranges from 2 to 21 days. The signs and symptoms of Ebola
include body weakness, diarrhea, and fever, lack of appetite, headaches, vomiting, joint and
muscle pains, and stomach pains. Some patients also experience rash, chest pains, difficulty in
breathing and swallowing, coughs, internal and external bleeding, hiccups, and sore throat as
well as red eyes. Findings in the laboratory entail low platelet count and white blood cells as well
as enhanced liver enzymes.
Ebola disease is associated with abnormal inflammatory responses, immune suppression,
viral replication, electrolyte losses, and major fluid as well as high mortality. The cycle of virus

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replication leads to the generation of new genomes of the virus in ample quantities to ensure viral
propagation. The extracellular viral genome is secure from degradation by enzymes and can be
introduced into other target cells to further the replication cycle. The Ebola virus produces
multiple viruses by combining host and virally encoded enzymes alongside the cell structures of
the host (Malvy et al., 2019). These characteristics coupled with the rapid propagation of the
disease have made it difficult to come up with a vaccine that successfully prevents Ebola as
compared to other conditions such as malaria, poliomyelitis, hepatitis B, tetanus, tuberculosis,
measles and meningitis which already have effective vaccines. However, there has been some
progress on vaccination, for instance, an experimental vaccine called rVSV-ZEBOV whereby no
Ebola cases were reported 10 or more days afterward among those who received the vaccination.
On the other hand, several cases were reported by people who did not receive the vaccination
(WHO, 2018). Nonetheless, there is no treatment available or licensed prophylaxis of the disease
and therefore case management is primarily dependent on the management of multiple organ
failure(Malvy et al., 2019).
Ebola has been termed as an African disease, spread via African culture such as unsafe
burial practices. While it is not entirely false that people’s practices and traditions in Africa can
lead to the rapid spread of Ebola, continued spread can be attributed to neoliberalism which
brings about economic policies that accentuate the free market as the main driver of allocation of
resources, innovation and consequently economic growth. Markets cannot dependably supply
treatments during an epidemic in places where there is corruption, poverty and lack of reliable
infrastructure. Also,in many West African countries, public facilities that are required to control
and prevent outbreaks of infectious diseases are inoperative as a result of political instability
(Hooker et al., 2014).

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Public Health Management and Prevention of Ebola. The twenty-first century is
marked with interactions amongst numerous social, cultural, environmental, economic,political
and governmental processes (globalization). This integration leads to free movement of people,
goods, and services from one part of the world to another which creates new problems in regard
to public health. It brings about a quicker spread of illnesses while at the same time introducing
new pandemics to indigenous peoples. Even though the outbreaks of vaccine-preventable
diseases such as diphtheria and measles can be dealt with, the reports of drug-resistant pathogens
are accumulating. Other health issues in the world today include increasing rates of physical
inactivity and obesity as well as climate change and environmental pollution that adversely
affects human health (Labonté, 2018). With the world becoming a global village, serious
decisions concerning health are more centralized. This means that events taking place at one
location can affect the whole world but it is the responsibility of the individual country to acquire
services and vaccinations affordable to them to tackle health problems.
Nevertheless, poor countries are more affected by these issues as compared to wealthy
economies. This can be accredited to their ability to handle these issues and prevent adversative
impacts on their people. Also, there is better-developed infrastructure which ensures that
treatments can reach the affected areas as soon as possible in case of epidemics. The public
health system is better managed and well-coordinated as compared to that of underprivileged
nations which confirmsthat the health of the people of the nation is taken care of. During the
Ebola outbreak of 2014, for example, there were thousands of deaths in Africa while in the
United States the mortalities were countable. This attributes to the socio-economic status of the
country as it has the means to control the epidemic. African countries, on the other hand, lack the
resources to control such an outbreak and by the time the governments are able to take action,

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numerous people have died from a serious and frequently fatal illness such as Ebola. Some
governments cannot even be able to take action by themselves and thus have to recruit the help
of wealthier countries which often takes time. Even if there are quite rich people in Africa, the
governments have copious economic problems and such individuals cannot possibly take the
problems of the whole country in their hands.
The disparate nature of the 2014 Ebola outbreak indicates the inequalities that exist in
health systems around the world(Beckfield, Olafsdottir & Bakhtiari, 2013, p. 1016).WHO’s
approach to global health in 1978 was meant to reduce the inequalities that existed in health care
service provision around the globe. The organization introduced Primary Health Care (PHC) to
acknowledge that disproportions existed in health status and that health embraces more than
health services as it also rooted in people’s psychological conditions. Although PHC was a good
idea at the time, its effectiveness has lessened over time, partly as a result of globalization but
also due to its exclusivity, that is, it mostly focussed on first-level care. Fairness in health care in
countries that experience poverty is very difficult due to the political issues these nations face.
Colonialism also affects health in that the weak countries try to emulate the ways of life
of the strong and dominant countries. This may include their public health system comprising of
aspects such as water and sanitation. This affects health in that the weaker, often poorer countries
do not try to come up with their own means of providing clean water and sanitation to its
citizens. They imitate the build-up of the systems of dominant and economically advanced
countries which are too expensive for them to establish. This, therefore, leads to inadequate
sanitary conditions and lack of clean water in these countries which further the problems of
infectious diseases. Imitation of eating habits of richer countries also enhances the issues of
chronic conditions in poor and weaker countries that were not previously present (Labonté,

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2018). These conditions coupled with the presence of infectious illnesses render poor nations
unable to deal with emergency health problems such as the occurrence of Ebola.
In summary, it is evident from this text that Ebola virus disease (EVD) is a serious and
fatal condition among human beings. As its name suggests, the disease is caused by a virus of the
Filoviridae family, genus Ebolavirus. It affects both animals and human beings whereby it is
introduced to humans through close contact with body organs, fluids, and secretions of infected
animals such as chimpanzees, monkeys, fruit bats, forest antelopes, and gorillas. The disease
then spreads from one human to another through direct contact with their bodily fluids such as
blood and semen or via contaminated surfaces and materials including beddings and clothing.
Ebola’s first incidence was in 1976 in Sudan and the Democratic Republic of Congo.The
outbreak in 2014 to 2016 in West Africa was the greatest and most complex epidemic of EVD in
history. Ebola has led to the death of numerous persons in Africa as compared to wealthier
countries such as the United States of America. Poor countries are more unpleasantly affected by
Ebola as compared to richer economies as they do not have the means to control the spread of the
disease.

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References
Awah, P. K., Boock, A. U., &Kum, K. A. (2015). Ebola Virus Diseases in Africa: a commentary
on its history, local and global context. The Pan African Medical Journal, 22(Suppl 1).
Beckfield, J., Olafsdottir, S., & Bakhtiari, E. (2013). Health inequalities in global
context. American Behavioral Scientist, 57(8), 1014-1039.
Hooker, L., Mayes, C., Degeling, C. J., Gilbert, G. L., &Kerridge, I. (2014). Don't be scared, be
angry: the politics and ethics of Ebola. Retrieved from
https://www.mja.com.au/journal/2014/201/6/dont-be-scared-be-angry-politics-and-ethics-
ebola
Labonté, R. (2018). Reprising the globalization dimensions of international health.
Malvy, D., McElroy, A. K., de Clerck, H., Günther, S., & van Griensven, J. (2019). Ebola virus
disease. The Lancet. Retrieved from
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33132-5/fulltext
World Health Organization. (2018). Ebola virus disease. Geneva: WHO. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease