FOREIGN tourists have yet to return to the west African coast following last year’s Ebola epidemic that infected 25,000 people and killed more than 40% of them. But should visitors come, little would strike them as out of the ordinary. Charnel houses once again function as hospitals. Some practices have changed: hygiene is a greater concern when handling the dead. But other habits such as shaking hands—avoided last year to prevent transmission—are again as common as ever.
Liberia is doing so well that the government and foreign aid agencies declared it virus-free on May 9th, 42 days after the last victim was buried. On April 30th the American army closed a treatment facility for medical workers in the capital, Monrovia, that it opened in a hurry last November. It received only 42 people, but it stiffened the resolve of doctors and nurses by assuring them of excellent care, should they have become infected.
The other two countries walloped by the epidemic are recovering more slowly. Sierra Leone’s schools reopened in mid-April and new Ebola cases are down to a trickle. But complete eradication is proving tricky; unsanitary conditions in slums aid transmission. A recent infection in the Moa Wharf township of Freetown, the capital, led police to put it into quarantine; when seven of its residents fled, they were chased across the city. Amnesty International, the human-rights lobby, says the government is abusing emergency laws. Officials retort that “strong hands” are needed to beat the virus.
Guinea, where the outbreak began in December 2013, is now the worst-affected of the three, with a dozen or more new cases a week. The town of Forecariah close to Sierra Leone has the highest incidence. Cross-border transmission is the main threat to countries where the virus has died out.
Another concern is infection through unprotected sex with male survivors. The virus has been found in their semen long after they tested negative. In a recent case a 46-year-old man infected a lover almost 200 days after he first showed symptoms, far later than previously thought possible.
Overall, though, the fight against the virus is being won. Perhaps too fast. Pharmaceutical researchers have been racing to develop a vaccine but need patients to test it. While they welcome the decline in cases, a complete victory would undermine work aimed at fighting the next outbreak.
Ebola in graphics: The data behind the crisis
Ebola may be almost beaten, but it has taken a heavy toll on public-health services in west Africa. Some doctors and nurses died, and others fled. Confidence in those remaining is weak. Attendance at clinics in Sierra Leone plummeted by 70%, according to Médecins du Monde, a charity. Mortality rates from diseases other than Ebola have shot up. Liberia’s president, Ellen Johnson Sirleaf, says her country’s already feeble medical sector has collapsed.
Do-gooders in America and elsewhere promise to sustain aid after the epidemic fades. Barack Obama held a presidential summit with west African leaders at the White House last month. On May 4th Bill Clinton attended a Liberian conference on “long-term recovery”. Bill Gates has pledged $75m for a global disease surveillance network. But locals fear the West’s attention span may be too short.
