{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:24:41Z","timestamp":1777857881899,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,9,21]],"date-time":"2015-09-21T00:00:00Z","timestamp":1442793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Health Serv"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:p>While the current Ebola epidemic spiraled out of control to become the biggest in history, the global public health response has been criticized as \u201ctoo little, too late.\u201d Many, like the World Health Organization, are asking what lessons have been learned from this epidemic. We present an analysis of the political economy of this Ebola outbreak that reveals the importance of addressing the social determinants that facilitated the exposure of populations, previously unaffected by Ebola Virus Disease, to infection and restricted the capacity for an effective medical response. To prevent further such crises, the global public health community has a responsibility to advocate for health system investment and development and for fundamental pro-poor changes to economic and power relations in the region.<\/jats:p>","DOI":"10.1177\/0020731415606554","type":"journal-article","created":{"date-parts":[[2015,9,21]],"date-time":"2015-09-21T21:34:24Z","timestamp":1442871264000},"page":"643-656","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Ebola epidemic exposes the pathology of the global economic and political system"],"prefix":"10.1177","volume":"45","author":[{"given":"David","family":"Sanders","sequence":"first","affiliation":[{"name":"School of Public Health, University of the Western Cape, South Africa"},{"name":"People's Health Movement, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Sengupta","sequence":"additional","affiliation":[{"name":"People's Health Movement, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"Scott","sequence":"additional","affiliation":[{"name":"School of Public Health, University of the Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,9,21]]},"reference":[{"key":"bibr1-0020731415606554","volume-title":"International Health Regulations","author":"World Health Organization","year":"2005","edition":"2"},{"key":"bibr2-0020731415606554","unstructured":"World Health Organization. Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. http:\/\/www.who.int\/mediacentre\/news\/statements\/2014\/ebola-20140808\/en\/. Published August 8, 2014. Accessed September 1, 2015."},{"key":"bibr3-0020731415606554","volume-title":"Ebola Response Roadmap","author":"World Health Organization","year":"2014"},{"key":"bibr4-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5496"},{"key":"bibr5-0020731415606554","unstructured":"World Health Organization. Ebola situation report 18 February 2015.\n                      Ebola Situat Rep\n                      . 2014. http:\/\/apps.who.int\/ebola\/en\/ebola-situation-report\/situation-reports\/ebola-situation-report-18-february-2015. Accessed February 23, 2015."},{"key":"bibr6-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411100"},{"key":"bibr7-0020731415606554","first-page":"1","volume":"6","author":"Gomes MFC","year":"2014","journal-title":"PLOS Curr Outbreaks"},{"key":"bibr8-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1126\/science.1260695"},{"key":"bibr9-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1411471"},{"key":"bibr10-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1409903"},{"key":"bibr11-0020731415606554","doi-asserted-by":"publisher","DOI":"10.7326\/M14-1880"},{"key":"bibr12-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.11176"},{"key":"bibr13-0020731415606554","author":"Lakoff A","year":"2015","journal-title":"Limn 5: Ebola's Ecologies"},{"key":"bibr14-0020731415606554","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70377-8"},{"key":"bibr15-0020731415606554","unstructured":"Report by the Director General of the World Health Organization, 25 January 2015, Geneva, Switzerland\n                      . Geneva; 2015. http:\/\/www.who.int\/dg\/speeches\/2015\/executiveboardebola\/. Accessed September 1, 2015."},{"key":"bibr16-0020731415606554","unstructured":"World Health Organization. Ebola Virus Disease Factsheet No 103. http:\/\/www.who.int\/mediacentre\/factsheets\/fs103\/en\/. Accessed February 23, 2015."},{"key":"bibr17-0020731415606554","unstructured":"Vidal J. Ebola: research team says migrating fruit bats responsible for outbreak.\n                      The Guardian\n                      . http:\/\/www.theguardian.com\/society\/2014\/aug\/23\/ebola-outbreak-blamed-on-fruit-bats-africa. Published August 23, 2015. Accessed Spetember 1, 2015."},{"key":"bibr18-0020731415606554","unstructured":"Public Health Agency of Canada. Ebolavirus, Pathogen safety data sheet \u2013 infectious substances. http:\/\/www.phac-aspc.gc.ca\/lab-bio\/res\/psds-ftss\/ebola-eng.php. Published 2014. Accessed September 1, 2015."},{"key":"bibr19-0020731415606554","doi-asserted-by":"publisher","DOI":"10.3201\/eid1209.05-0979"},{"key":"bibr20-0020731415606554","unstructured":"Centers for Disease Control. Ebola factsheet. http:\/\/www.cdc.gov\/vhf\/ebola\/pdf\/ebola-factsheet.pdf. Published 2014. Accessed September 1, 2015."},{"key":"bibr21-0020731415606554","doi-asserted-by":"publisher","DOI":"10.18356\/34bf7a52-en"},{"issue":"6","key":"bibr22-0020731415606554","first-page":"8","volume":"8","author":"Bausch DG","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"bibr23-0020731415606554","unstructured":"Wallace R. Neoliberal Ebola?\n                      Farming Pathogens: diseases in a world of our own making\n                      . http:\/\/farmingpathogens.wordpress.com\/2014\/04\/23\/neoliberal-ebola\/. Published April 23, 2014. Accessed September 1, 2015."},{"key":"bibr24-0020731415606554","unstructured":"Liberian communities statement on expansion of Sime Darby and Golden Veroleum plantations. farmlandgrad.org. http:\/\/farmlandgrab.org\/post\/view\/21381. Published December 3, 2012. Accessed September 1, 2015."},{"key":"bibr25-0020731415606554","volume-title":"How the World Bank, IMF and WTO destroyed African agriculture","author":"Bello W","year":"2008"},{"key":"bibr26-0020731415606554","volume-title":"The Heart of the Matter: Sierra Leone, Diamonds & Human Security","author":"Smillie I","year":"2000"},{"key":"bibr27-0020731415606554","unstructured":"Kenny C. The Ebola outbreak shows why the global health system is broken. http:\/\/www.bloomberg.com\/bw\/articles\/2014-08-11\/the-ebola-outbreak-shows-why-the-global-health-system-is-broken. Published 2014:1\u201311. Accessed February 18, 2014."},{"key":"bibr28-0020731415606554","unstructured":"Cornia G, Jolly R, Stewart F, eds.\n                      Adjustment with a Human Face: Ten Country Case Studies\n                      . Oxford, UK: Oxford University Press; 1988."},{"key":"bibr29-0020731415606554","unstructured":"Dumont J-C, Zurn P. Immigrant health workers in OECD countries in the broader context of highly skilled migration. In: Martin J, ed.\n                      Internal Migration Outlook\n                      . 2nd ed. Paris, France: OECD Publishing; 2007. doi:doi.org\/10.1787\/migr_outlook-2007-en."},{"key":"bibr30-0020731415606554","first-page":"1","volume":"7031","author":"Mills EJ","year":"2011","journal-title":"BMJ"},{"key":"bibr31-0020731415606554","first-page":"323","volume":"2","author":"Say L","year":"2006","journal-title":"Lancet"},{"key":"bibr32-0020731415606554","unstructured":"Trenchard T. Sierra Leone charges state employees in graft probes.\n                      Reuters\n                      . http:\/\/www.reuters.com\/article\/2013\/03\/09\/us-sierraleone-corruption-idUSBRE92716N20130309. Published March 8, 2013. Accessed September 1, 2015."},{"key":"bibr33-0020731415606554","unstructured":"Information Sheet ZMapp. http:\/\/www.mappbio.com\/zmapinfo.pdf. Published 2014. Accessed September 1, 2015."},{"key":"bibr34-0020731415606554","unstructured":"Ebola in West Africa Impact on Health: ACAPS Briefing Note \u2013 26 September 2014\n                      . http:\/\/acaps.org\/img\/documents\/b-acaps_briefing_note_ebola_impact_health_26_sept_2014.pdf. Published 2014. Accessed September 1, 2015."},{"key":"bibr35-0020731415606554","unstructured":"Hinshaw D. Ebola virus: for want of gloves, doctors die.\n                      The Wall Street Journal\n                      . August 16, 2014. http:\/\/www.wsj.com\/articles\/ebola-doctors-with-no-rubber-gloves-1408142137. Accessed September 1, 2015."},{"key":"bibr36-0020731415606554","unstructured":"Crist C. Searching for causes of the ebola outbreak, and for a way to stop the next one.\n                      Wired\n                      . http:\/\/www.wired.com\/2014\/08\/ebola?outbreak?causes\/. Published August 18, 2014. Accessed September 1, 2015."},{"key":"bibr37-0020731415606554","unstructured":"Douglas S. Courage, death and survival: on the front lines of the Ebola outbreak.\n                      The Globe and Mail\n                      . http:\/\/www.theglobeandmail.com\/news\/world\/courage-death-and-survival-on-the-front-lines-of-the-ebola-outbreak\/article19979697\/. Published August 8, 2014. Accessed September 1, 2015."},{"key":"bibr38-0020731415606554","unstructured":"Harker J. Why are western health workers with Ebola flown out, but locals left to die?\n                      The Guardian\n                      . http:\/\/www.theguardian.com\/commentisfree\/2014\/sep\/15\/ebola-doctor-death-olivet-buck-sierra-leone. Published September 15, 2014. Accessed September 1, 2015."},{"key":"bibr39-0020731415606554","unstructured":"Strange H. Ebola patients flee as armed men raid Liberia clinic.\n                      The Telegraph\n                      . http:\/\/www.telegraph.co.uk\/news\/worldnews\/africaandindianocean\/liberia\/11039693\/Ebola-patients-flee-as-armed-men-raid-Liberia-clinic.html. Published August 17, 2014. Accessed September 1, 2015."},{"key":"bibr40-0020731415606554","unstructured":"Team of 8 health officials, journalists on Ebola awareness trip killed in Guinea.\n                      The Niger Times\n                      . http:\/\/www.thenigertimes.com\/2014\/09\/team-of-8-health-officials-journalists-on-ebola-awareness-trip-killed-in-guinea.html. Published September 21, 2014. Accessed September 1, 2015."},{"issue":"6877","key":"bibr41-0020731415606554","first-page":"1","volume":"345","author":"Legge D","year":"2012","journal-title":"BMJ"},{"key":"bibr42-0020731415606554","unstructured":"Youde J. Can the world health organization lead? Do we want it to?\n                      The Washington Post\n                      . http:\/\/www.washingtonpost.com\/blogs\/monkey-cage\/wp\/2014\/08\/08\/can-the-world-health-organization-lead-do-we-want-it-to\/. Published August 8, 2014. Accessed September 1, 2015."},{"key":"bibr43-0020731415606554","unstructured":"Freeman C, Sanchez R. US to send 3,000 troops to Ebola hit Liberia.\n                      The Telegraph\n                      . http:\/\/www.telegraph.co.uk\/news\/worldnews\/ebola\/11100332\/US-to-send-3000-troops-to-Ebola-hit-Liberia.html. Published September 16, 2015. Accessed September 1, 2015."},{"key":"bibr44-0020731415606554","unstructured":"Bill & Melinda Gates Foundation Commits $50 Million to Support Emergency Response to Ebola.\n                      Bill and Melinda Gates Foundation\n                      . http:\/\/www.gatesfoundation.org\/Media-Center\/Press-Releases\/2014\/09\/Gates-Foundation-Commits-$50Million-to-Support-Emergency-Response-to-Ebola. Published September 10, 2014. Accessed September 1, 2015."},{"key":"bibr45-0020731415606554","unstructured":"Sifferlin A. World bank: Ebola\u2019s economic impact could be \u2018catastrophic\u2019.\n                      Time Magazine\n                      . http:\/\/time.com\/3394147\/ebola-world-bank\/. Published September 17, 2015. Accessed September 1, 2015."}],"container-title":["International Journal of Health Services"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0020731415606554","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0020731415606554","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0020731415606554","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:03:13Z","timestamp":1777507393000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0020731415606554"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,21]]},"references-count":45,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1177\/0020731415606554"],"URL":"https:\/\/doi.org\/10.1177\/0020731415606554","relation":{},"ISSN":["0020-7314","1541-4469"],"issn-type":[{"value":"0020-7314","type":"print"},{"value":"1541-4469","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,21]]}}}