Migration and trade: how could yellow fever spread beyond Angola?

Imogen Braddick

Approximately 2,149 suspected and confirmed cases have been reported in Angola, including 277 deaths. The outbreak of yellow fever in Angola poses a threat to the entire world, particularly Asia. There are approximately 100,000 Chinese migrant workers in Angola who could potentially carry the virus home. Immunisation against yellow fever is practically non-existent in China and six unvaccinated workers from China returned from Angola with the virus. Asia is yet to experience a major outbreak of yellow fever, but expanding migration and globalisation make the continent highly susceptible to an epidemic. 

If we don’t want to virus to spread, we must reach the countries where people are not vaccinated against  yellow fever. We need rapid mobilisation to contain the outbreak in Angola. Increasing links between China and the African continent pose a risk to Asia, where yellow fever is virtually non-existent. The UN and the World Health Organisation (WHO) have already shipped 9 million doses of vaccine to Angola, but that is only enough for about a third of the population. Stocks are rapidly running out as health officials attempt to contain the outbreak in Angola. Drop in oil prices is also damaging Angola’s ability to combat the virus and treat the sick; the health service is free and funded entirely by the state. But the state budget depends entirely on oil. Declining oil prices correlates with a declining social welfare system. Containing the virus and preventing deaths will be even more of a challenge.

Globalisation has meant that people are travelling more than ever, enhancing their ability of picking up a virus and bringing it home. There are numerous reasons for strict border control as more people are migrating for a better quality of life and employment opportunities, but potential health risks are an important factor. The WHO stated that the recent outbreak in urban areas of Democratic Republic of Congo highlights the threat of international spread, especially to Namibia and Zambia where their populations aren’t usually vaccinated against yellow fever. An epidemic has the potential to wipe out the majority of a healthy, working population who create the foundation for economic growth and development. China is emerging as a huge economic superpower with the world’s largest population, predicted to account for 25.6% of global output by 2020. 54% of the total population live in urban areas; yellow fever is easily spread amongst urban areas with large, overcrowded populations. 

How is it going to spread to China’s urban population? Migration and trade. China has an increasingly important position in Africa – there is a rising demand from China for Africa’s commodities and emerging economies are becoming more dependent on Africa for their imports. Nigeria, Algeria and Angola are the key oil exporters. China is a key aid donor and provides many concessional loans to African countries – China’s presence in Africa is growing and showing few signs of slowing down. Stronger economic ties means more migration.

If yellow fever spreads through China, it has the potential to reach other parts of Asia. A new challenge for China may be to limit migration to parts of Africa or enhance border control to check for serious health risks. Special attention must be placed on returning migrants from Angola and other potentially endemic areas. Although the risk of establishment of a local cycle of transmission in China is minor due to the current climatic condition, if it starts to spread rapidly from person-to-person it may become a major risk. Climate change experts have also suggested global warming as a cause of outbreaks of yellow fever in unusual destinations; mosquitoes can now survive in conditions where they could not survive several decades ago. The WHO must figure out a way to stretch supplies before it spreads beyond Africa and parts of Asia. A healthy, working population is vital to economic growth, reducing poverty and enhancing development; prioritising health, whether it be through restrictive migration and trade, should be a top priority for middle-income and emerging economies across the South.