Ebola, Malaria -- Now Yellow Fever

"[Factories producing the vaccine] are above the capacity of production. They don't produce more than 2.4 million doses per month. That hampers what we are doing."
"We need to vaccinate 24 million people [in Angola]."
Hernando Agudelo, WHO representative, Luanda, Angola

"It is tragic, because we have an intervention that makes the disease entirely preventable."
Ray Arthur, director, Global Disease Detection Operations Center, U.S. Centers for Disease Control and Prevention

Photo for The Washington Post by Nichole Sobecki     Women grieve over the casket of a young boy who had died two days prior in Luanda, Angola. The family said doctors had been uncertain whether the cause of death was yellow fever or malaria.

An old scourge has returned with a vengeance; even though there is a solution with the use of a vaccine against yellow fever, one that eighty years earlier was created in a laboratory in New York. But it is seldom in the countries that most require their citizens to be immunized that the vaccine becomes an instrument of avoidance decreed by the nation's public health agency. An epidemic has raised its ugly head in Angola, where the vaccine was not distributed and used to inoculate the vulnerable.

Angola now has over three thousand suspected cases of yellow fever to cope with while in neighbouring Congo yellow fever is making inroads to create the largest urban epidemic of the disease seen in decades. Over 400 people haven't recovered from its effect, and families are in mourning. In an age where the easy movement of people by air means that communicable diseases can be spread with lighting speed, concerns are growing that Chinese workers will carry the virus from Angola to Asia. There too, in that massively populated country, few have been inoculated.

Stockpiles of the vaccine are in steep decline resulting from the strain realized in response to the explosion of yellow fever. The major manufacturers producing the vaccine are unable to produce sufficient to enable the kind of vaccination campaign capable of swiftly halting the disease spreading to other places in the region. This new international health threat is adequate proof that global health institutions like WHO are unprepared to face the reality of Africa's transition toward an increasingly more urbanized and interconnected continent.

Angola now has networks of highways and the presence of airlines permitting greater numbers of people to travel far and fast. That far and fast capacity to move people from one area to another in the world has been of inestimable assistance to the diseases awaiting the opportunity to rage and range far and wide. From their sinister beginnings in remote locations that are sparsely populated, diseases like yellow fever have made immense inroads into crowded urban areas.



The World Health Organization took precautions to warehouse six million doses of the vaccine 'just in case' a public health emergency might someday emerge. Now that it has, that six million doses has proven sadly insufficient to counter the fast-moving epidemic characterizing yellow fever's capacity to cross borders. A campaign to vaccinate six million people in Luanda has left millions of others unvaccinated. The fears are that if areas in rural China needed immunization the skyrocketing demand for vaccines could never be met.

Each dose of the yellow fever vaccine takes roughly a year to produce, making it impossible to react with the speed required to meet the needs of an expanding epidemic. Urban epidemics are especially threatening, considering the swiftness with which disease can spread in areas of dense populations which have never been vaccinated.