Insufficient support?

Looking for ways to treat infectious diseases at a low cost marked the start of Jim Yong Kim's career in 1987. The medical doctor was highly successful, serving more than 100,000 tuberculosis patients in Haiti. Now as head of the World Bank, Kim is once again trying to battle a deadly disease. He has pledged $200 million (150 million euros) to help fight the Ebola outbreak in West Africa, with an additional $60 million coming from the African Development Bank.

"This money will go for very basic support," Kim says. "For medical supplies, medical staff and also to help the people who are facing economic hardship as a result of this epidemic."

The program will run under the auspices of the World Health Organization (WHO). The WHO had already launched an emergency response plan on August 1st. It said it would collect about $100 million in emergency funds for Guinea, Liberia and Sierra Leone, the three countries hit the hardest by the virus.

Responsibility to protect

"We have a responsibility to that particular region of Africa," World Bank president Kim says. "We are going to do everything we can - not only to provide support in the short term - but to really think about building the kind of public health systems that the people of those three countries deserve."

Weak public health systems in the region are the main factor contributing to the rapid spread of the deadly disease, with the current outbreak the worst on record. The virus spreads only via bodily fluids and is thus not as contagious as influenza, which is airborne.

However, since hospital access is limited in rural areas, many afflicted with the disease are being cared for by their families at home. When relatives, for example, clean up the vomit of an Ebola-infected family member, they are at high risk of contracting the illness.

Nurses on strike

Even in places where professional health workers are in charge of patients, they often lack basic protection. That is why many health centers have shut down in the wake of the epidemic, including in Liberia's capital, Monrovia.

"The health workers think that they are not protected, since they don't have the requisite material to protect themselves against the Ebola disease," Amos Richards, a physician's assistant from Monrovia told Reuters. "So, many of the health workers, including physician's assistants and nurses, are staying home."

Plastic suits and gloves

The arrival of basic protective equipment, such as plastic suits and gloves for doctors and nurses, can thus make a huge difference on the ground. "We have already provided protective equipment, and we know that there needs to be more," says Gergory Hartl of the WHO in Geneva. "Because that is something which gets used and needs to be replenished on a regular basis."

He adds that the WHO plans to send hundreds more medical staff to the affected countries. "We have around 150 staff who have already been in and out of the country. And we have set up a regional operations hub in Conakry for Guinea, Sierra Leone and Liberia to respond specifically to this outbreak. So, we are present in all of the affected countries."

Overwhelmed and on their own

The aid workers' presence, however, cannot always be felt on the ground. The disease is most prevalent in remote areas that are hard to reach and have thus received insufficient help so far, says Max Gertler from the aid organization Doctors Without Borders. The German doctor at Berlin's Robert Koch Institute has just returned from a trip to Lofa County in northern Liberia, a region near the borders to Guinea and Sierra Leone. In many of the villages there, doctors reported cases of Ebola.

"The only person I found there was the district health officer, who was on his own and totally overwhelmed by the epidemic," Gertler says. "At that time, I did not encounter any representatives of the WHO supporting the local health authorities."

Gertler recounts that the district health officer was trying to get to remote villages by motorbike in order to get a broad overview of the situation. Bringing in equipment represents an additional hurdle. "You have to find trucks; you have to find drivers," he says. "And then the roads are really bad, and transport takes a lot of time. That's why it's all the more important that international funds will be available soon, so that the work on the ground can start."

At the moment, it does not look as if the international reaction to the Ebola outbreak will be remembered as a success story - unlike the tuberculosis program that World Bank president Jim Yong Kim started in 1987. Of the money the WHO has announced it will spend in the fight against Ebola over the coming months, only about $30 million has been fully funded thus far, the organization says.