answer than the grandiose philosophical ones, perhaps because we expect a more concrete answer. I try to put Ebola in the context of the great burden of health problems of Africa. What does it mean? As a researcher and a health care worker,
what can I do about it?

Members of the Lassa Fever research team in Guinea.

Although perhaps one of the most dramatic, Ebola is far from being the biggest threat to health in sub-Saharan Africa. Sometimes, it seems that Africa almost courts misery, reading like the script of a bad action movie, everything happening at once-disease, natural disasters, war, epidemics-a Hollywood producer would likely throw it out as too unbelievable. As the Ebola epidemic started to wane, I finally had a few minutes to get to know some of my co workers-the human beings behind the surgical masks.

One day, in between screening patients, a young nurse named Christine told me her story-the story of Africa's other epidemic. Her father, mother and brothers, all dead from AIDS; she and her sisters are left behind, trying to make the best of things. She recounted the tale almost casually, not because it wasn't tragic but because, tragically, it wasn't unusual. What's more, suffering caused by malaria and tuberculosis is so common that people generally fail to recount stories about it at all.

Cameroonian girls.

To survive to old age in much of sub-Saharan Africa, it seems you have to run the gauntlet. Only a strong disposition, and perhaps a good dose of luck, buys you longevity. Children survive the respiratory and diarrhoeal illnesses of childhood, only to face new threats of AIDS and Ebola, wars and automobile accidents. Too often, if one thing doesn't get you, another will. Dr. Matthew was once abducted by the Lord's Resistance Army-a rebel group active in northern Uganda-held for a few days and then released. He survived that round, but wasn't so fortunate in the Ebola category.

In some ways, the situation in Gulu seems to typify the biological, social and political upheaval seen across much of the African continent. In response to this apparent chaos, outsiders often tend to throw up their hands, say "what a mess", and turn their attention towards the fate of the Euro or whether new markets will be opening in China. And the frustration is understandable, for easy answers are not forthcoming.

When something as dramatic and deadly as Ebola breaks out, a host of resources are mobilized and a United Nations-worth of organizations converge on the epicentre to help put out the fire. They generally do an effective job, but return just a few months later and one usually finds that it's back to business as usual. Short-term financial commitments for a high-profile outbreak are relatively easily forthcoming, but long-term support for the public health infrastructure necessary to truly understand the epidemiology of these diseases, and thus possibly prevent them in the future, is scarce.

This is unfortunate, as long-term investigations exploring their natural history-where they come from, how they are transmitted from one person to another-would ultimately have far more of an impact on health than the measure of our emergency response to any single given outbreak. The point is not that one is more important than the other, but rather that if there was more of the former, there would be a lot less need for the latter.

What are the impediments to long-term scientific research in developing countries and, through it, better health? An initial, fundamental but perhaps philosophical, question harkens back to a debate that has raged since the late eighteenth century when politicians argued over whether the new United States of America should be an "isolationist" or "interventionalist" nation. "Globalization" being the word of the day, it seems the latter sentiment has prevailed. But while we perhaps accepted this economically, we have stopped short of a true commitment to health on a global scale. Rather, we are witness to a call to return to a sort of bioscience "isolationism", with Governments of many industrialized countries reorienting their budgets toward those health problems deemed to be in the "national interest".

Youths with gun in rebel-held area od the Democratic Republic of the Congo.

But whereas nations have boundaries, pathogens have none. With regard to health and disease, what national interest can be separated from our collective international one? Examples of this connection are rife: the importation of West Nile encephalitis into the United States in 1999, a patient with Lassa fever transported from West Africa to Chicago, protection from the threat of biological warfare. Myriad arguments can be made to support how engagement overseas can lead to increased economic and political stability and improved health for all. But even if we discount them, does a rich nation really need a reason to engage with a poor one?

If researchers at many African institutions have little to do these days, it is not

Continued 3 of 5

Previous page of this article.