Brendan Smith (Cavan-Monaghan, Fianna Fail)
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The rapid rise in Ebola-related deaths is sounding alarm bells right around the globe. International leaders have been slow to ramp up the necessary humanitarian support in order to combat the crisis emanating from West Africa. In this instance the authorities appear to be failing to act to combat the spread of the virus. If the international community had acted in a co-ordinated and concise manner at the beginning of this outbreak, I believe we would not be witnessing the current situation.

Deaths have occurred in Spain and in Germany, bringing the threat of an outbreak even closer to home. The warning from the head of the UN mission for Ebola emergency response, Anthony Banbury, that the disease is, "winning the race", is extremely worrying and highlights the need for a comprehensive humanitarian response plan from the European Union and from the rest of the international community. Europe has always acted in a much speedier manner than other parts of the international community but it needs to do more. Furthermore, the fact that the Irish Medical Organisation has expressed concern about Ireland's contingency plans in the event of an Ebola case, is something which should concern us.

Last week, the assistant director general of the World Health Organisation, Dr. Bruce Aylward, stated that the fatality rate of Ebola has reached 70%. He stated that this is a high mortality disease and that the UN health agency is still focused on trying to isolate sick people and provide treatment as early as possible. It is important to note that previously the WHO had said that the death rate was around 50%. Dr. Aylward stated that if the response to the Ebola crisis is not stepped up within 60 days, a lot more people will die and a very great effort will be required to deal with the spiralling number of cases. He added that in the past four weeks there have approximately 1,000 new cases per week, although this figure includes suspected, confirmed and probable cases.

Given the background which I have outlined I sought this Topical Issue matter and I am pleased that the Minister of State, Deputy Sean Sherlock is taking it. I compliment him on his visit to West Africa. Our former colleague, Barry Andrews, is chief executive of GOAL and he stated that the Minister of State's visit was very important and very useful. He and his colleagues in the different non-governmental organisations appreciate that support.

This matter was discussed during Question Time almost two weeks ago. It is important that the Minister of State has this further opportunity to outline the response. I ask what protocols have been put in place to ensure that Irish NGO workers travelling to Africa have the proper equipment and training to tackle the crisis. I ask the Minister of State to outline what will be the arrangements for them on their return to this country. Our aid workers travelling to Africa to help combat this disease should be commended for their bravery and their selflessness and should be supported with the best possible equipment and training. I listened to presentations from GOAL and from Doctors Without Borders at the joint committee a number of weeks ago. They provided the committee with details of the huge suffering and hardship that so many communities are experiencing, in particular in three countries in West Africa.

I commend the Minister of State on his visit to the region and I hope that the statement from the Foreign Ministers Council meeting yesterday will result in Europe having a better co-ordinated plan and greater co-operation between member states. It was disappointing to hear that the level of funding provided by EU member states and by the European Union as a whole, is not adequate. The British Foreign Secretary has suggested that the €500 million committed by the member states and the European Commission needs to be doubled. I ask the Minister of State to say whether Ireland intends to propose at the heads of government meeting later this week that the European Union and the rest of the international community should provide without further delay the necessary resources to tackle this very serious outbreak.

Seán Sherlock (Cork East, Labour)
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I thank Deputy Smith for raising this issue and I thank him for his kind words.

It is appropriate to have this discussion on Ebola today, given the rapid deterioration in the situation in West Africa over the past month and with cases appearing elsewhere in the world. This debate is particularly timely, given that the Ebola crisis was discussed at the EU Foreign Affairs Council meeting yesterday and will be discussed at the European Council later this week.

The latest World Health Organisation figures are alarming - well over 9,000 people infected by Ebola, and over 4,500 deaths in West Africa. Despite all the efforts of the international community, the likelihood is that the situation will deteriorate further before it improves. I met Mr. Banbury when I was in Freetown in Sierra Leone. He indicated to us that the crisis would get worse before it gets better. Ireland has been very actively engaged at all levels in addressing the crisis on the ground and internationally.

As the Deputy is aware, I travelled to Sierra Leone at the start of the month and witnessed at first hand the devastating impact of Ebola there. I came away from my visit with three strong impressions. There was a key gap in leadership and co-ordination, which I am glad to say is now being filled by the UN emergency Ebola mission, UNMEER, headed by Mr. Nabarro and co-ordinated by Mr. Banbury. There remains important funding needs and this has been recognised in yesterday's motion at the Foreign Affairs Council. There is a need to scale up capacity for isolation and treatment. There is an urgent need for more international health care professionals to staff the isolation and treatment centres.

Ireland is one of a very small number of EU member states with an embassy in Freetown. I was struck during my visit by the very strong advocacy and co-ordination role being played by the Irish ambassador-designate, Ms Walsh, and her small and dedicated team. Ireland is working closely with international partners and others, including the US and the UK and the government of Sierra Leone, in the fight against Ebola. The question of co-ordination is a key issue if the Ebola virus is to be tackled effectively in the West Africa region and if its spread to other countries is to be prevented. This was discussed at the Foreign Affairs Council in Luxembourg yesterday which was attended by the Minister, Deputy Charles Flanagan. The Council's decisions yesterday represented an important further step in EU efforts to tackle the crisis by reaffirming the need to work together in a co-ordinated way and to pool our strengths.

I wish to assure the Deputy that as a result of visiting Sierra Leone it is my view that Ireland must use its influence at the United Nations and through the European Council to support the need for a pan-European or strong EU response to this crisis. The bilateral response is a powerful one but it is not sufficient to tackle the nature of this crisis. There is a clear need for health workers and other key personnel to be represented on the ground. The Council meeting yesterday recognised the need to support international health responders. It agreed that the EU will provide appropriate care for them, including the possibility of medical evacuation if necessary.

We must now work urgently to ensure it is implemented in full.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I thank the Minister of State for his response. In his latter comments, the Minister of State said the EU will provide support for medical evacuation. I presume this will be done for citizens of all member states of the European Union, because I do not think we would have the capacity or aircraft necessary to carry out a medical evacuation.

There have already been more than 4,500 deaths in west Africa from this particular virus. Yesterday in Strasbourg, the Commissioner for International Co-operation, Humanitarian Aid and Crisis Response spoke about the possibility of 10,000 new cases of Ebola per week by mid-December. This is really frightening, when we consider that at present the World Health Organization's figure is 1,000. Surely this statement by a member of the European Commission demonstrates the need for the European Union to double the funding level and commitment made available to date.

A particular issue which may be more relevant to the Minister for Health, who is with us this afternoon, is a statement by the Irish Association for Emergency Medicine that it is not reassured by Department of Health and HSE claims of full preparedness should the virus reach our shores. This issue needs to be addressed, and I hope the Minister, Deputy Varadkar, will be able to deal with it in a public statement.

I compliment the people who have gone out to work in extremely difficult circumstances. I also compliment the officials from the Department working in the region, all of the Irish NGOs and our colleagues from every country who are working against the tide to try to bring some semblance of normality to communities which have lost everything. I heard a representative from an NGO of another country state that perhaps the true level of deaths is not being recorded due to the nature of the virus and the fact many people are losing their lives in very remote communities. Does the Minister of State share this worry?

Seán Sherlock (Cork East, Labour)
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I can only speak for Sierra Leone. I concur absolutely with the Deputy on his remarks on the efforts of the NGOs. The work done by GOAL, Concern, Plan and other agencies is extremely effective. The Irish Government's response is that we need to be flexible in our approach and Irish Aid, which is very close to the NGO community, is being allowed to pivot towards the Ebola response. The big concern I have as Minister of State with responsibility for official development assistance is we must be mindful of the fact that we need to ensure we do not spark a humanitarian crisis in all of this. The nutrition programmes being delivered need to continue apace.

Instinctively, I think the Deputy is right about the underreporting. It is only a matter of weeks since I was there, and it was at that juncture the UN had come to Sierra Leone in particular. Now that Mr. Banbury has been appointed as co-ordinator, our ambassador is working very closely on liaising with the Sierra Leone Government to ensure we assist in building the infrastructure to treat people medically on the ground, and this response is happening. It is a fair assumption that where there was no international involvement until relatively recently, and instead reliance on the Sierra Leone departments of health, social welfare or education to deliver programmes with the NGOs, there was a certain lack of capacity and the NGOs were punching above their weight. Now we have international co-ordination and various governments have responded proactively.

I agree absolutely the European response needs to be rapid. The resolution yesterday, arising from the Luxembourg meeting, is significant because it recognises for the first time the need to ensure we protect health workers who go out there. A live issue we were dealing with when I was there was the need to ensure local Sierra Leonean health workers were paid, because they had not been paid for quite a period of time. It is difficult to expect an Irish or Spanish health worker to go there if the Sierra Leonean health workers are not being paid and are staying away. There was a strike at one stage. These are the issues we are dealing with. We are very effective and making solid progress on these issues. I agree the international response needs to be more proactive, but for our part as members of the European Union we have had an influence in bringing this to bear, in terms of our interventions through the Minister, Deputy Flanagan, at the Foreign Affairs Council yesterday. We are keeping a daily watch on this because we want to ensure where possible cases are dealt with medically within the region. This is the most effective way of dealing with cases.