The three West African countries – Guinea, Liberia and Sierra Leone – that have been the main sites of the current Ebola outbreak share decades of political turmoil, historical injustice and extreme poverty.
Professor Michael Selgelid, director of the Centre for Human Bioethics at Monash University – one of six World Health Organisation Collaborating Centres for Bioethics worldwide – says the current Ebola crisis is an injustice on many levels.
Professor Selgelid, an international authority on ethical issues associated with infectious disease control, has been centrally involved in WHO’s deliberations on Ebola.
“The disease has been around for 40 years, so we should have already done more research and development of Ebola medications,” he said.
“This was presumably not done because Ebola has historically affected poor countries, which are not an attractive target for private, profit-driven pharmaceutical companies, on whom we rely too heavily for medical R&D.”
However, as it spreads, Ebola has been mutating.
“The more individuals of a species that a pathogen infects, the better adapted it becomes to that species. Ebola could, theoretically, become more transmissible and this could be disastrous for rich as well as poor countries,” Professor Selgelid said.
“From an ethics and humanitarian perspective, we should have conducted more studies during and after the earlier, small-scale outbreaks. We should not have waited for Ebola to become a global emergency to get this research happening.”
He said the Ebola crisis had amplified numerous fundamental issues that bioethics has to address, such as the rights of the individual versus the common good in the context of infectious diseases and public health.
For example, many ethical challenges – such as whether healthcare workers have an obligation to care for people infected with Ebola, whether to use measures including isolation, quarantine or travel restrictions, and how to best allocate scarce resources in emergencies– have previously been evident in outbreaks such as SARS and H1N1 influenza.
Read more about Professor Michael Selgelid’s work in “Ebola and the ethics question” in the February 2015 issue of Monash: Delivering Impact magazine.