Just as the African countries were overcoming the devastating effects of the AIDS epidemic, Ebola’s most recent epidemic is causing tremendous damage to the countries were the infection by the Ebola virus is spreading most rapidly: Liberia, Guinea and Sierra Leone.

In addition, another serious crisis looms in the horizon: the countries’ economic development. The World Health Organization has issued a dramatic warning: the Ebola epidemic threatens the “very survival” of societies and could lead to failed states.

“I have never seen a health event threaten the very survival of societies and governments in already poor countries. I have never seen an infectious disease contribute so strongly to potential state failure,” said WHO head Margaret Chan.

According to an economic impact assessment by the World Bank Group, if the epidemic were to significantly infect people in neighboring countries, the financial impact of the epidemic could reach $32.6 billion by the end of 2015.

The World Bank Group has drawn two possible scenarios: a “Low Ebola” and a “High Ebola” development. A Low Ebola scenario corresponds to a rapid containment within the three most affected countries, while a High Ebola scenario corresponds with a slower containment in those countries, accompanied by broader regional contagion.

A Low Ebola scenario is possible if one considers that containment efforts were so far successful in Nigeria and Senegal.

If one considers that the epidemic began in Guinea in December 2013 and from there it spread to Liberia and Sierra Leone, the response to the epidemic has not been adequate. For example, only now the regional headquarters of the U.N. Mission for Ebola Emergency Response (UNMEER) is being set up, despite the fact that medical NGOs working in those countries have been sounding the alarm months ago.

Information and communication aspects related to the epidemic have also been inadequate. In some areas, people have become suspicious of the health authorities in the countries, and angry protesters have attacked the hospitals, which they blame for having provoked the epidemic.

Health workers have been the unsung heroes of this epidemic. The situation has become even more serious given the lack of qualified medical personnel and hospitals that are understaffed and lacking basic supplies.

Given the critical role played by a good health infrastructure to contain the epidemic, a still unasked question is: where have all the millions of dollars given to the African countries by international financial and health institutions to improve their health systems gone? In my experience as an international public health consultant, a significant portion of those loans end up in the pockets of the presidents of the countries and their friends and families, a situation that has to be urgently corrected if efforts to contain the epidemic are going to succeed.

“The enormous economic cost of the current outbreak to the affected countries and the world could have been avoided by prudent ongoing investment in health systems-strengthening,” admitted Jim Yong Kim, the president of the World Bank Group.

New investments should be devoted to improving the health and security infrastructure in the affected countries, as well as rapidly training health personnel and improving security protocols at airports and seaports of the three core countries and neighboring ones.

The World Bank Group is now mobilizing $400 million in emergency financing for the three countries most affected by the crisis. This is an enormous amount that could have done wonders if wisely spent before the start of this epidemic.

What is important is not only to provide financial aid but ensuring that the aid is adequately spent. If the epidemic is not contained soon, it will have a devastating effect on the African countries’ economies and development.

Cesar Chelala, M.D. and Ph.D., is an international public health consultant who writes about humanitarian issues.

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