Ebola: The Dog That Has Not Barked

Especially in Sierra Leone and Liberia, the Ebola news gets worse and worse, with victims and deaths seeming to grow exponentially. Yet the disease does not appear to have spread east along the Gulf of Guinea from Liberia. Given the general porosity of African national boundaries, why and how has the march of the disease seemingly stopped at the Liberia/Ivory Coast border? (In Nigeria, the index case arrived in Lagos directly by air from Monrovia; all of the Ebola cases in the country appear to have been related to him, and his contacts have been traced and quarantined.)

Nigeria is far away from Liberia. It is about 1,250 miles by road from Monrovia to Lagos, a long way for travelers by truck, bus or on foot. By contrast, Ivory Coast shares a long border with Liberia. Further, like Guinea, Sierra Leone and Liberia, Ivory Coast is recovering from a civil war. However, Ivory Coast is more developed than the three epicenters of Ebola, even if its much vaunted infrastructure was badly damaged in the civil war that ended only in 2011, and unrest continues. Yet, Ivory Coast does not have the disease, and the country may be serving as a barrier to Ebola moving toward the east. It is true that Ivory Coast has taken seemingly draconian measures. It has closed its borders and restricted air traffic through Abidjan from Ebola-infected cities. These flight bans will soon be lifted “in solidarity with infected countries.” There is anecdotal evidence that medical personnel are knowledgeable about what to do should the disease appear, including quarantining victims and tracing their contacts and the government has already inacted several public health initiatives including a law making the consumption of rodents illegal.

Maybe the explanation for Ivory Coast being spared the disease is the prophylactic measures it has taken. Yet West African national borders are notoriously porous. It is hard to imagine that foot traffic between Liberia and Ivory Coast is at a standstill. There is also the possibility that the disease has arrived in Ivory Coast, but its presence is not yet known to the authorities. Still, if the disease stays out of Ivory Coast, then the measures taken by the Abidjan government should provide a useful model for stopping the spread of the disease in the future.