There is a strong sense of apocalypse as the World Bank and International Monetary Fund hold their annual meetings in Washington DC on 10-12 October. Part of that comes from the blunt warnings from Bank President Jim Yong Kim that the future of Africa may be at stake if there is no overwhelming, coordinated international response to the Ebola outbreak. He spoke of worst-case losses to Africa of US$32 billion as economies in West Africa are hit by restrictions on production, trade and transport.

The United Nations Secretary General Ban Ki-moon warned that international assistance must be increased 20-fold to stop the outbreak. Tom Frieden, Director of the United States Centers for Disease Control, added more urgency: ‘We have to work now so this won’t become the next AIDS’. Western concern has accelerated as Ebola patients have arrived in the USA and Spain. Given that this outbreak began in November 2013, Kim is right to say the international system has failed miserably to tackle it.

As head of the world’s biggest development agency and a public health expert, it may be also a mea culpa from Kim as he calls on rich governments to back a $20 bn. global health fund to react immediately to such emergencies. He should listen to the doctors from West Africa at the Bank meeting who say the healthcare crisis goes far deeper there: a chronic lack of doctors and nurses (many working abroad for better pay and conditions); sporadic supplies of electricity and running water in most hospitals and none of the specialised protection and testing equipment required.