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Ebola in Texas

A man sickened with Ebola in Texas has already made international news and the implications of case have multiple implications not only in healthcare, but in society and politics as well.

The first and most important thing is that Texas grossly underfunds public health in the state.  Under funding public health care means that citizens are at higher risk for falling victim to an epidemic disease like Ebola because there are insufficient resources (including training for the emergency room hospital workers to be able to recognize the disease's symptoms) to respond to the epidemic early and contain it.

Texas Republicans have cut back public health funding, undoubtedly because they see it as big government, to the point where the state with one of the fastest growing populations in the country ranks 34th nationally, according to a 2013 report by the Robert Wood Johnson Foundation. This is not new news. Texas gubernatorial candidate Wendy Davis gets the gift of a new talking point in an already tight election race.

When it comes to public health, government is the appropriate institution to respond to these kinds of crises. What most people don't know is that public health response to disease came from the business sector in the 1600s as global trade began to expand.  A ship that arrived into a port carrying diseases could quickly devastate a major trading center and hurt a country economically.  Business demanded better regulations around screening ships to protect their profits.

The sadder implications of the case in Texas is the likely social response.  Undoubtedly due to an already hostile culture toward outsiders in the state, we will likely see increased attacks on individuals perceived to carry the disease --most likely immigrant Africans since the man came from Liberia.  We don't actually know if he is Liberian, and that's important to remember.  He could easily be an aid worker or other professional based in Liberia who was home visiting family members.

Nationally I suspect we will start to see travel moratoriums put in place for countries where the disease has been detected.  This has big economic implications for these countries, many of which already struggle economically.  Their health systems were already made vulnerable enough by economic policies advocated by conservative political groups which advocate underfunding of healthcare systems in favor of private sector responses.  In a case like Ebola, you can't wait to have a bidding war among private healthcare providers to respond to an epidemic. Health systems around the world need to be appropriately funded so that workers have the resources, protection, and support they need to respond quickly and effectively to public health crises like Ebola. Without it, we are all at risk.

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