Ebola can only be beaten by tackling poverty in Africa

There is not going to be a new plague in Britain. It is necessary to be vigilant about health workers returning from Ebola hotspots such as Sierra Leone, and it is only a proper recognition of the risks they have run that they are properly checked in decent conditions when they return. But it is not going to happen here.

The last recognised outbreak of plague in Britain ended with the great fire of London in 1666, although that is probably less than the whole truth. There may have been small outbreaks right into the 20th century. Both scientists and historians are still trying to explain why 1666 was its last serious appearance.

There won’t be one answer. But some possibilities are clear. For example, without necessarily understanding why, the Black Death’s contagious nature was so well understood that it was considered perfectly acceptable to wall up an entire household if one member showed symptoms. Whole villages were left to die. Plague bowls, where charitable neighbours might leave alms, can still be found on parish boundaries.

Other explanations range from viral mutation and possible misdiagnosis to statistical over-inflation. Yet among the many unknowns, the dark holes of our knowledge, is what happened to wealth and wages in the aftermath of a major outbreak. In 2008, a group of academics reassessed GDP in England from 1300–1700, challenging the idea that it had hardly changed over 400 years. They found that rather than stagnation in individual earnings, there was steady growth from the second half of the 17th century, particularly after the Black Death. One obvious explanation is that a sharp fall in population forced up wages, and higher wages encouraged what the academics called an “industrious revolution”.

One piece of evidence historians now think they can be firm about is a differential rate of death. Many more poor people died than rich people. According to figuresgleaned from clergy, senior clerics, bishops and such like, died at the rate of about one in four while for those working among the rural poor, the rate was nearer one in two. That is, poverty kills.

It is now nearly a year since this tragic story began to unfold. It should have been contained much sooner: prevention and treatment should have been delivered at scale with urgency. But Ebola has become a metonym for the way the west sees the African story, a continent that lives under a perpetual cloud of fear.Listening to the NHS staff returning from fighting Ebola in Sierra Leone, it is obvious that poverty still kills as efficiently as it always has. One doctor on BBC Radio 4’s Today programme this morning explained that their clinic had no access to any special treatment, but that simply by rehydrating patients they were immediately seeing better than 50% recovery rates. He added that there was not yet any scientific evidence that the new vaccines or treatments made a difference. It may be that outcomes that are just as good and much, much cheaper will come from the absolute fundamentals of good basic care and hygiene.

It is also a brutal reminder of an everyday fact in rural Africa – that poverty kills. For thousands of families no good will come of the disease. But for the wider continent and for the next generation, something could. In 2015, the UN isreviewing the development goals that it originally set in 2000. Here’s a thought. Make sure the new list includes tackling some of the structural barriers that stand between ordinary Africans and a growing income. Pull down trade barriers, and enforce government transparency. The way to end diseases of poverty is, after all, by ending poverty.