Anybody with $20M to spare – to end Ebola in West Africa in 2 weeks?
09/01/2014 | by Yaw Nyarko
In a perfect world, the Ebola virus raging in 3 countries in West Africa could be contained in a few days and ended in 2 weeks. The incubation period of the virus from first contact to the time symptoms are visible is from 2 to 21 days. Until the symptoms start one is not contagious. Death occurs within 2 weeks after symtoms begin, or else you survive. The death rate is around 60%. So, if all those with symptoms could immediately be isolated or brought to a hospital, the virus would be contained. All that is needed for containment is a room to put the patient in with nobody allowed in unless due protections are taken. That is the perfect case.
Now to reality. The big problem in Liberia in particular is that nobody really trusts the government or the medical system – the former is perceived as corrupt, and the latter is known to be ineffective. People are therefore not reporting themselves into the hospitals when they know or suspect they have symptoms or have been in contact with someone with symptoms. Why go to hospital, endure the stigma, and get no treatment when you can wait it out and see if you heal naturally? So, where does the $20M come in? Can we not provide an incentive for people to get tested? How about a $1000 gift to all those who come in as soon as they get symptoms? That amount is a lot of money for many poor people in Liberia. Many would reason that there is a chance they are dying, so why not leave money behind for loved ones? Family members who may gain the $1000 upon the death of their relative may see an incentive to encourage that relative to go to the hospital to check in. Also, if the payment is administered properly, admittedly a big if, some respect may return to the hospitals. Plus, is that not a humane thing to do – giving some money to poor dying people while solving a national calamity at the same time? The loss of economic activity in Liberia and all of West Africa, which is suffering by association, is certainly in excess of the $20M. Why $20M? The World Health Organization WHO predicts that 20,000 people may be infected at the peak of the crisis even in the best scenario. $1000 for 20,000 people gives you the $20M. Perhaps some economics can help solve this major medical problem.
Some questions you may be asking. Question: Why give money for this disease but not others? Answer – There is a major negative externality here – people do not consider the effects on others of their behavior. In particular their decision not to get treatment affects not only themselves but also others. Question: Isn’t $20M a large number for a poor nation? Answer: Aid agencies are sloshing around much larger amounts. Of course there are many details which will need to be worked out – the amount, the administration, etc. But the principle is one that may be very helpful.