The current Ebola epidemic in West Africa is the largest in the recorded history of the virus, with the potential to kill thousands and affect millions before it eventually burns itself out. Before it ends, however, it must be contained. Containment requires significant effort and resources, particularly in the face of the weak governance and porous borders that characterise the worst-affected states. The disease has also taken an enormous toll on emergency and healthcare services across the region, producing the very real threat that these services may collapse entirely, and that containment may fail, allowing the disease to begin another cycle of infection, perhaps with greater geographical spread.

Overloaded public services face collapse

At last count, nearly 6,000 cases of infection have been identified in the five countries currently affected, with an expectation that twice as many cases may actually exist. Other cases may not have been identified, partly because of the disease’s similarities to other common regional afflictions like malaria, and partly because of patients unable or unwilling to present themselves to officials.

The WHO has warned that September saw an exponential growth rate in the disease in Liberia, which faces a total medical services collapse without substantial international support.

The virus has been responsible for just under 3,000 deaths so far, but with the high mortality rate that’s been experienced so far, that is expected to continue to rise.

In August, the United Nations World Health Organisation suggested that over 20,000 people may be exposed to infection in the course of the outbreak, which is projected to last until January 2015 at the earliest. In late September, a Centers for Disease Control (CDC) ‘worst-case scenario’ projection suggested over a million people could face infection. Needless to say, the scope of those predictions are staggering.

In particular, the acceleration of the outbreak over the course of August and September has seen the number of infections double. Though the disease remains concentrated in several localities, particularly in Guinea, Liberia, and Sierra Leone, there remains the chance that it could spread further, especially if containment in those highly concentrated areas were to collapse. The WHO has warned that September saw an exponential growth rate in the disease in Liberia, which faces a total medical services collapse without substantial international support. Further worsening the situation, as many as a large percentage of victims of the disease are healthcare workers – even more significant given considering the limited number of such carers in the region.

The potential for a total collapse of healthcare and emergency services could lead to further acceleration in the rate of infection, increasing the chances for geographic spread, as well as significant social and political upheaval in those affected areas.

The economic impact of the quarantine

The imposition of quarantine zones and travel restrictions has dramatically impacted local trade – something the head of the African Development Bank has specifically noted will likely have a long-lasting negative impact on economies in the region. The outbreak of Ebola has drawn significant international attention, both to the scope and scale of the outbreak, and the manner in which local governments have attempted to cope with the disaster. International investors have no doubt been watchful, noting where crisis management failure can be attributed to poor governance: a factor to consider in potential investment. Moreover, the residual memory Ebola will likely serve as a significant cultural perception of the region for some time, another factor likely to negatively impact foreign investment and tourism.

Aside from limiting economic exchanges, quarantine zones also limit access to food. This has led the World Food Programme to mobilise resources to provide food to over a million people believed to be affected by the quarantine zones, which include severely-affected cities such as Gueckedou in Guinea, Foya in Liberia, and Kenema and Kailahun in Sierra Leone.

Overzealous efforts at containment, possibly spurred by international pressure, have led to the enforcement of travel bans that specifically affected air travel in and out of the region. While the fundamental thinking behind this fits with the goal of containment, it has been a counter-productive approach. Ebola is most contagious in its acute phase, which is precisely when an infected person is unlikely to be able to travel anywhere, let alone by aircraft. Instead, the travel ban has made it difficult for international aid workers to respond to the crisis.

The economic pressure and naturally high levels of fear and tension can also play a further destabilising role. Liberia suffered a civil war that ended in 2003, but has remained unstable since. There is a chance that quarantine efforts arising out of the Ebola outbreak may lead local militia’s to once again form up, increasing the albeit slim chance of a return to conflict.

The Ebola outbreak is already a humanitarian disaster, likely to increase in scale in upcoming months, and set to leave a long-lasting scar on the region. The economic impact of the outbreak and efforts to contain it will similarly have long-lasting consequences for regional trade. The depth of that scar depends on how resilient the affected countries are, and whether containment efforts hold, or if the outbreak manages to overwhelm them.