Has Ebola focus led to other killer diseases being ignored?

http://www.bbc.co.uk/news/world-africa-32020643

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The world is focusing on the Ebola outbreak in three West African states but what about malaria and measles?

A year of battling Ebola in Sierra Leone, Liberia and Guinea has seen unprecedented effort and resources poured into one outbreak over such a short time.

That has also meant that the more common killer diseases - malaria, tuberculosis and measles - have to a large extent been neglected.

A study published in the journal, Science, earlier this month warns that measles could cause as many deaths as Ebola after vaccinations were disrupted.

"We project that after six to 18 months of disruptions, a large connected cluster of children unvaccinated for measles will accumulate across Guinea, Liberia and Sierra Leone," the study says.

'Devastating'

It finds that the number of children susceptible to measles in the three countries is expected to double, resulting in between 2,000 and 16,000 additional deaths.

It is a worrying prediction in countries that had weak health systems even before the Ebola outbreak.

Sierra Leone had some of the highest rates of death from tuberculosis, malaria and measles in the world, according to the World Health Organization (WHO).

The burden of Ebola, and the devastating impact it has had on the country's health system, compounds the problem.

'Big killers'

Furthermore, a report by medical charity Medicins Sans Frontieres says the Ebola outbreak has affected the attitudes of people towards modern healthcare.

"The trauma of Ebola has left people distrustful of health facilities, has left health workers demoralised and fearful of resuming services, and has left communities bereaved, impoverished and suspicious," the report says.

Nearly 500 health workers - most of them local - have died as a result of Ebola leaving even the most caring professional wary of rushing to help a mother in labour.

The expatriates have a specific brief - to deal with Ebola, and the remaining local work force will be expected to deal with the other health concerns.

Fighting the other big killers in the affected countries is going to be even more challenging.

'Trauma'

WHO says it has sent out a new guidance to the affected countries to help them maintain and restart immunisation programmes.

"We are calling for the intensification of routine immunisation services in all areas, and for mass measles vaccination campaigns in areas that are free of Ebola transmission," says Jean-Marie Okwo-Bele, director of the WHO's Immunization, Vaccines and Biologicals Department.

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It has also recommended mass drug administration of anti-malarial medicines to all eligible people in areas heavily affected by Ebola.

People infected with malaria have been unable to get treatment during the Ebola outbreak, either because they have been too afraid to seek help at health centres or because such facilities have been closed.

But shipping in loads of drugs and enlisting the services of the remaining health workers is not going to be enough.

Health promotion - getting communities to trust the health system enough to seek care, assuring health workers that they can operate in a safe environment and reinstating normal services in health facilities and streamlining them - is where the real work is.

But with new cases still emerging each week, the focus is no doubt still going to be on Ebola.