Time for Australia to join the war on Ebola

The Abbott government is committed to dealing with fast-spreading global threats at the source. Unless it's a global health emergency, which is how the World Health Organisation describes the Ebola epidemic.

The government is finally readying a plan for Australia to help supply teams of medical volunteers to manage the disaster at its source in West Africa, but it has been most reluctant to move.

It seems to have a curiously split personality on how to deal with fast-growing global problems. On matters of war and terrorism, it is fast and decisive in trying to address the problem at its source. And the government has been super keen to meet US requests for assistance.

Yet in the face of a great epidemic, its first preference was to pretend that a Fortress Australia approach is best. And to stonewall requests for help from Britain and the US.

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Australia over the past century has discarded the concept of Fortress Australia in one realm after another. On security, on immigration, on trade, on investment, on poverty, Australia understood that active participation is the best way to protect itself and advance its interests.

Because Australia is one of the world's most interconnected nations, any great global problem ultimately will become Australia's problem too.

And so too with Ebola. It is fantasy to think that the virus can be contained in Africa. As we already know, a small number of cases have arrived in Spain and the US.

The British medical journal The Lancet has studied the top destinations for air travellers leaving the three most affected African states.

It found that six of the top ten destinations are other countries in Africa. But  three of the others are in Europe - Britain, France and Belgium – and the tenth is China. The 13th most popular destination was India.

The man who led Hong Kong's successful campaign against the deadly SARS virus in 2003, Dr Malik Peiris, director of the school of public health at the University of Hong Kong, says that five cities in Asia would be at the front line in preventing Ebola from spreading:  Beijing, Shanghai, Guangzhou, Hong Kong, and Mumbai. Australia has direct flights to all. We'd better hope they're effective because if the virus gets through their borders it will be in one or both of the world's most populous countries. India has a lousy health system. China's is better but it has a record of suppressing bad news.

What if the world just tried to seal off the three infection centres, ban flights from Sierra Leone, Liberia and Guinea? The head of the US public health authority, Tom Frieden of the Centres for Disease Control (CDC) says: "Isolating countries won't keep Ebola contained and away from American shores. Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries, and that we will have more patients who develop Ebola in the US."

In other words, you could close the official and obvious routes but people desperate to escape the epidemic will still find a way, by land or sea, to sneak out. We just won't know where they've gone.

To October 29, there have been 13,567 confirmed, probable, and suspected cases of Ebola, according to the World Health Organisation. Of those, 4951 people were reported to have died.

The US's CDC in late September projected that "without additional interventions or changes in community behaviour, CDC estimates that by January 20, 2015, there will be a total of approximately 550,000 Ebola cases in Liberia and Sierra Leone or 1.4 million if corrections for underreporting are made."

Or, according to work by a leading Australian economic modeller, Warwick McKibbin, this could be on the low side. He mapped the way that three flu pandemics of the 20th century moved around the world, and projected it onto the modern world economy.

"We found that in today's integrated world similar pandemics may kill between 1.4 million and 144 million people," McKibbin wrote of the research he'd done for the ANU and Lowy Institute.

The economic cost? Between $US340 billion for the most smallest episode, based on the flu precedents, and $US4.4 trillion for the biggest.

A key conclusion: "To have response plans tuned to protecting borders is politically attractive but far more costly than focussing on the source of the disease," McKibbin wrote in the Financial Review last week.

Front-line agencies dealing with the disease in West Africa have been asking the Australian government for personnel and expertise since mid-September. At the same time, Australia supported a UN Security Council resolution calling for urgent supplies of expert medical personnel and materials.

The British government first requested Australian medical staff later the same month. The Australian Medical Association urged the government to send medical teams over a month ago.

It's risky work, of course, and no one is suggesting staff be ordered to go. The Nurses Association received more than 350 applications from nurses volunteering to go. The US has made repeated requests for Australian assistance with personnel. Still Australia has sent money but no medical personnel.

Seventy per cent of Australians can see the logic that the government has, to now, refused to acknowledge, according to a Morgan poll last week.

In recent days there have been encouraging signs that the rate of reported new infections is slowing in one infected country at least, Liberia.

The precise reason is unclear, but a senior WHO official, Bruce Aylward, cautioned against assuming the problem was in check: "It's like saying your pet tiger is under control."

The head of the UN mission to control Ebola, Anthony Banbury, said: "We either stop Ebola now or we face an entirely unprecedented situation for which we do not have a plan."

It's past time for the Abbott government to produce Australia's plan.

Peter Hartcher is the international editor SMH