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Submitted by Susan Elden on

Hi Patricio, I hope you will forgive me for disagreeing with part of your piece. I agree completely that it requires a broader development agenda, one health and UHC. However,I do not agree that Ebola in West Africa should be tackled the same way as 1976. In fact, that is part of the problem is that we think the solutions lie in health and principles of outbreak management. We think we know the answers and don't listen to our communities. It requires time, trust,communication and conflict-sensitive approaches as much as soap and clean water. Many of the areas affected have had years of conflict and broken trust, many years of receiving no health care or having their fevers diagnosed as malaria. Are there sufficent numbers and trained healthworkers to differentiate an ebola fever from a malaria fever? It struck me when one Minister from an affected country pronounced that "community ignorance" was greatest threat EVD. Many of these areas are poor and have a history of civil war and conflict. When will we stop delivering our top-down approaches to communities and when will we start working with, for and through communities and place them at the centre of our efforts?