The Ebola outbreak: a symptom of privatisation and austerity

There is a clear link between the outbreak of Ebola Virus Disease, the poor investment in public sector health systems in West Africa and the austerity measures imposed in Europe.

Public Services International (PSI) and the European Federation of Public Service Unions (EPSU) share the criticism expressed by Spanish health unions Federación de Servicios Públicos de UGT FSP-UGT and Federación de Sanidad y Sectores Sociosanitarios CCOO at the International Summit on Nursing and the Ebola Virus, called by the International Council of Nurses (ICN) and the Spanish Nursing Council (CGE), 27-28 October, in Madrid.

The irresponsibility of the Ministry for Health, Social Services and Equality of Spain and of the Regional Council of Health of Madrid was revealed in their failure to manage the first case of acquired Ebola infection outside Africa.

The situation was worsened by their violation of existing Health and Safety legislation, and blatant disregard for the voice of Health and Safety committees that have trade union participation. Despite the outrageous accusations leveled at Teresa Romero, the nurse who became ill, the national and regional governments are alone to blame.

The lack of Occupational Health and Safety policies and protocols - and lack of coordination - led to the infection of the technical nurse who cared for a patient with EVD repatriated to La Paz – Carlos III public hospital in Madrid.

The hospital had been a renowned, well-equipped centre for infectious disease control, but due to budget cuts was in the process of being downgraded into a care facility for older persons under the austerity policies of the national and regional administrations.

Spanish trade unions have long called for participation and consultation in health policy-making, but both the Ministry and Regional Council rejected their approaches and demands. The result is cuts in supplies, education, training, and of personnel in the health services – 30,000 jobs in national health service have been cut in the last two years.

“Not only is there a total lack of participation of trade unions in training programs for professionals, but there has been a dramatic loss of know-how and knowledge-management due to needless staff cuts” says Pilar Navarro Barrios of Spain’s FSP-UGT.

Privatization and budget cuts - even to cooperation with developing countries and aid to nongovernmental organizations working in West Africa - are root causes of the Ebola cases that have occurred in Spain and to Spanish nationals in Africa.

The grievously high loss of health care workers and the tragic scale of the outbreak in West Africa are similarly due to the senseless imposition of austerity policies and the entirely shortsighted failure to repair and invest in the growth of public sector health infrastructure and health systems in the three most affected countries – Guinea, Liberia and Sierra Leone.  

In 2001, the Abuja Declaration of the African Union called for the share of national budgets to reach 15 per cent for health, but current levels are still abysmally low.  Loans from the International Financial Institutions favour extractive industries and private sector enterprise, and even national measures to invest in public infrastructure meet with admonitions on overspending.

Public Services International and its own European Federation of Public Service Unions stand with the Spanish health unions in their demands to hold the administration accountable, to upgrade the public sector health system, and raise the level of protection of the public and of all workers who are at risk of exposure to EVD.

This includes measures not only for health care workers, but also cleaners and waste-handlers, transport workers, and all first responders: emergency health personnel, fire-fighters and uniformed personnel called into emergencies.

The European Union has finally named the EU Commissioner for Humanitarian Aid and Crisis Management as a Coordinator for the EU response to Ebola. This will be a key position from which coordination of national measures for the protection of the public - and of the workers who serve them - can and should be forcefully exercised.

PSI and EPSU urge the new Coordinator to be pro-active in consulting with all stakeholders, engaging the trade unions, and supporting effective tripartite solutions.

The fault lines caused by austerity budgets and forfeited improvements to health systems must be at the center of a shared response to EVD, built on participation and trade union consultation and negotiation, not only at the local, national and regional levels, but also globally.