CGPH FACULTY: Lee Riley
DATE OF PUBLICATION: October 2014
REGION: Africa
REFERENCE: Synder R, Marlow MA, Riley LW. Ebola in urban slums: the elephant in the room. The Lancet Global Health, Early Online Publication, 30 October 2014 doi:10.1016/S2214-109X(14)70339-0
SUMMARY/ABSTRACT: A host of factors has been cited as causes of the current Ebola virus disease (EVD) epidemic in west Africa: local cultural practices, poverty, inadequate health infrastructure, and the region’s recent strife-filled history. These factors alone, however, cannot completely explain the epidemic’s uncontrolled nature. There is an “elephant in the room” in the international discourse concerning this epidemic: urban informal human settlements or slums. The primary factor contributing to slum dwellers’ disproportionate disease burden—their invisibility and neglect—also makes them an ideal vehicle for the epidemic. EVD is only the beginning and only one disease; even if we are to control the current epidemic, the future introduction of this and other highly contagious and virulent microbes to and from global slums is inevitable. It is not sufficient just to talk about poverty, lack of health-care access, cultural practices, etc. It will be impossible to stem this epidemic and prevent future epidemics of emerging diseases without addressing the underlying structural and socioeconomic determinants of disease unique to slums. Experts and politicians must acknowledge their existence now and divert resources towards improving the conditions of urban slums.
ACCESS: Link to Lancet