The World

What Can We Learn From How Nigeria Contained Ebola? Not That Much.

A teacher demonstrates to pupils washing procedures to prevent the spread of the Ebola virus at a school in Lagos on Oct. 8, 2014.

Photo by Pius Utomi Ekpei/AFP/Getty Images

Nigeria and Senegal could be declared Ebola-free by the World Health Organization in a few days, after clearing the requisite 42-day period with no new cases. In all, 20 people were infected in Nigeria with eight fatalities. Only one person in Senegal became infected, but that victim has recovered.

The news is cause for a cautious sigh of relief, if not total celebration. Though the global outbreak is still far from contained, the prospect of it getting loose in Lagos—Africa’s largest city and a major international commercial center—was one of the more terrifying scenarios we’ve had to contemplate over the last few weeks.

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The success these countries had in containing the outbreak is going to prompt some discussion of what lessons can be learned for other places fighting Ebola. The Financial Times attributes Nigeria’s achievement to a “rare national effort that saw the Lagos state government, federal institutions, the private sector, and global non-governmental organizations all pulling in the same direction to defeat the disease.” That national effort included a presidential decree that gave officials access to phone records and a strict system to monitor potential cases, one that involved tracking down more than 800 people who may have had contact with the infected.

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But arguably, Nigeria didn’t actually do a very impressive job. A single Liberian man, who traveled to Nigeria in July, infected 11 hospital staff in the time between his admission to a hospital and when his test results were received. There might have been more infections if not for a doctors’ strike that reduced the number of people who came in contact with him. One doctor told the New York Times, “At the time, nobody was prepared for it.”

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The advantage Nigeria had was that its outbreak began with this one man, who was immediately taken from the airport to a clinic, at a time when Ebola was already a crisis. By contrast, international agencies and authorities in the three countries at the epicenter of the outbreak—Guinea, Liberia, and Sierra Leone—didn’t wake up to the severity of the disease until dozens were already infected.

Rather than demonstrating the effectiveness of any particular method of Ebola control, the case of Nigeria, and the less severe case of Senegal, confirm what we’ve known about the disease from the beginning. Despite its high mortality rate, Ebola is relatively difficult to transmit from person to person, and under normal circumstances, it’s relatively easy to contain with common-sense public health measures: isolating those infected, limiting the exposure of health care workers, and tracking those who may have come in contact with them. For a variety of reasons, this was not done in Liberia, Sierra Leone, and Guinea until it was too late.

Despite early lapses, Nigeria—a country that’s not known for reliable public institutions or health care infrastructure—was able to get the outbreak under control. And despite the early lapses in Dallas, the U.S. should be able to do the same.

Of course, that’s not much comfort if you live in one of the countries where it’s already out of control. 

Read more of Slate’s coverage of Ebola.

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