Why an Ebola epidemic is spinning out of control

Editor’s Note: Laurie Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize-winning journalist.

Story highlights

Laurie Garrett: Ebola epidemic in Sierra Leone, Guinea, Liberia worst ever, could be controlled

She says poor governance, ignorance, hysteria have stoked opposition to health care

She says key doctor in Ebola fight now stricken, adding new fear that no one can escape

Garrett: Lacking governance, desperately poor citizens superstitious, avoid treatment

CNN  — 

The Ebola epidemic now raging across three countries in West Africa is three-fold larger than any other outbreak ever recorded for this terrible disease; the only one to have occurred in urban areas and to cross national borders; and officially urgent and serious. At least 1,090 people have contracted the awful disease this year, though the epidemic’s true scope is unknown because of widespread opposition to health authorities in afflicted Guinea, Liberia and Sierra Leone.

This week, 39-year-old physician Sheik Umar Khan – labeled the country’s hero for his brave leadership of the epidemic fight – died from Ebola, adding yet another public fear: that even the doctors cannot escape the disease.

Laurie Garrett

But as terrifying as Ebola is, the virus has been controlled in the past, and can be again. The current crisis, which threatens an 11-nation region of Africa that includes the continent’s giant, Nigeria, is not a biological or medical one so much as it is political. The three nations in Ebola’s thrall need technical support from outsiders but will not succeed in stopping the virus until each nation’s leaders embrace effective governance.

As was the case in Kikwit, Zaire, in 1995 – an Ebola outbreak I personally was in as a journalist – there is no vaccine or cure for the disease. The key to stopping its spread is rapid identification of the sick; removal of the ailing and deceased from their homes; and quarantine and high hygiene measures to prevent transmission of the virus to family members and health care workers.

In the absence of such measures, Ebola will kill upwards of 70% of those it infects, as the virus punches holes in veins, causing massive internal hemorrhaging and bleeding from the eyes, ears, mouth and all other orifices.

Guinea, Liberia and Sierra Leone are among the poorest, least governed states in the world. About half of the nations’ adults are illiterate. The 11.75 million people of Guinea have a per capita annual income of merely $527, and their combined male/female life expectancy is 58 years. In 2011, the government of President Alpha Conde spent $7 on average per capita on health.

Life is no better for the 4.2 million people living in neighboring Liberia, where per capita income is $454, life expectancy is 62 years and the government of President Ellen Johnson Sirleaf spends $18 per capita on health. In Sierra Leone, the 6 million residents have a per capita income of $809 per year, life expectancy is merely 46 years, and the government of the President, Dr. Ernest Bai Koroma, spent $13 per capita last year on health.

Since Ebola first broke out in March in Guinea, fear has gripped the region, coupled with suspicion and wild rumors. Some have proclaimed the epidemic “divine retribution” for past sins. In April, Guinean health officials failed to quarantine an Ebola patient who reportedly spread the virus from a remote area to the capital – a lapse that undermined government credibility.

In April, a mob claiming that foreigners were spreading diseases