What does the recent Ebola situation have in common with the global malnutrition crisis?
It seems like the only health-related news these days deals with the recent cases of Ebola that have appeared in Texas. In many ways, the Ebola situation in Africa draws parallels to the malnutrition crisis observed in developing nations, where millions are affected by deficiencies of essential nutrients such as vitamin A, iron, and iodine. But if we in the Western world are hardly impacted to the same degree by either Ebola or malnutrition, why should we feel compelled to help?
In a viewpoint article published in JAMA, ethicists Rid and Emanuel put forth a three specific reasons for why it is so important to help combat Ebola in developing nations. First, they cite the obligation of humanitarian assistance, or the idea of being a “good Samaritan”. They state that you are under a moral obligation to help someone in dire need if the cost or imposition is minimal. They state that Ebola treatment and containment measures have proven effective and can be realized at a relatively low cost. With respect to malnutrition interventions, we know the impact that fortification and supplementation can have on nutrient intakes both in developed nations and in the developing world, and that the cost of these interventions is minimal and carries a virtually non-existent risk.
Second, they cite the obligation of global justice, meaning that as national borders do not hold a moral significance, then all people regardless of nationality are entitled to the same health and social resources. By committing resources to these global health concerns in developing nations, we can help to strengthen health systems and infrastructure in the long term. Ebola, much like malnutrition, can have devastating impacts on the population of these developing nations. Without a healthy and robust population, there can be little investment into the future of these nations.
Finally, they cite the need for fair benefits from research, meaning that any benefits observed by testing in a population must be made available to them. It is not possible to learn much about Ebola in Western nations – most Ebola research can only be done in specific affected African regions. We know of the clinical consequences of vitamin deficiencies in large part due to their widespread prevalence in the developing world, and as such we are under an obligation to help those populations thrive by applying the knowledge we have gained.
Experts believe that, despite all this recent attention, Ebola is not expected (thankfully!) to become a truly “global” epidemic. Malnutrition, however, remains a global health crisis despite all the work that has been done to eradicate it. It continues to be important to recognize that even though we (thankfully!) may not see some of the drastic consequences of either Ebola or severe malnutrition on a regular basis here in the United States, it remains our moral obligation to continue to combat them even in areas well beyond our borders.
Rid A, Emanuel EJ. Why should high-income countries help combat Ebola? JAMA 2014; 312(13): 1297-1298.
Fulgoni VL, et al. Food, fortificants, and supplements: Where do Americans get their nutrients? J Nutr 2011; 141(10): 1847-1854.
Gostin LO, et al. The Ebola epidemic: a global health emergency. JAMA 2014; 312(11): 1095-1096.