The World Health Organization (WHO) said this week that Ebola may end up infecting 20,000 people. It released its "roadmap" to respond to the outbreak, a plan anticipated to span the next six to nine months.

Ebola is a virus which causes hemorrhagic fever. It is extremely deadly with a kill rate reported as high as 90 percent in the past, though so far in this particular epidemic just over half those infected have died. Transmission is through contact with blood, body fluids, and tissue.  

Already 1,552 people have been killed and 3,062 infected, with most cases reported in the last three weeks. WHO officials indicate the actual number is likely much higher due to under-reporting. 

U.S.-based Centers for Disease Control (CDC) director Tom Frieden echoes the WHO's grim assessment, stating earlier this week that the virus "has the upper hand" in the West African countries of Liberia, Guinea, and Sierra Leone. It has also spread to Nigeria.

At this point, the outbreak cannot be seen only as a public health crisis, but instead must be understood as a humanitarian one. Its spread is sufficient now to be impacting all sectors of society in the affected countries.

And its management was botched from the beginning.

Back in spring, while aid groups like Medecins sans frontieres (MSF) desperately called for greater international support to contain the epidemic, the international community effectively did nothing. 

Meanwhile, local governments were alternately unwilling or unable to mobilize early on, causing a dangerous lag in response. 

The infection eventually spread to include two white Americans, a doctor and a nurse, who, along with a Spanish priest, also white, were evacuated from Africa and repatriated to their own countries. 

In addition, they were offered an experimental antiviral medication, ZMapp, never before used in humans. The Spaniard subsequently died, while the Americans are recovering in the U.S.

This has created an ethical mess. No one knows if the drug works (or potentially causes harm) in humans, and its use in these uncontrolled conditions makes conclusions as to its effectiveness impossible to draw. 

In such circumstances, it is also very difficult to determine to whom a miniscule amount of untested medication should be offered. There are issues of informed consent, distribution of extremely limited resources, and so on.

However, the ethics of offering the antivirals to three white foreigners, when those overwhelmingly affected are African, is tenuous to say the very least. Moreover, this occurred while leading Ebola expert, Umar Khan, a Sierra Leone physician, was infected by Ebola. He subsequently died. He was never offered the medication, despite being in the optimal position—as much as anyone could be—of making an informed decision to consent (or not) to the treatment.

Never mind the fact that millions of dollars were spent on state-of-the-art, highly specialized intensive care for the foreign patients, while in Africa, healthcare workers are pleading for masks, gloves, and other basic protective equipment.

That the optics are bad is a vast understatement. And in a continent with a long history of colonization and betrayal, optics and trust are overwhelmingly important.

Already, efforts at infection control have been hampered by mistrust of Western intervention, which has led to a reluctance on parts of the population to seek treatment and has even resulted in violence in some instances.

The tragedy of this outbreak extends far beyond the immediate victims of the virus. It is breaking already stretched healthcare infrastructure. It is affecting other aspects of the healthcare systems. Lifesaving surgeries are being cancelled for fear of intraoperative transmission. Much needed healthcare workers, a limited resource in the region, are becoming infected and dying. The current WHO estimate puts the number of health professionals at 240 infected, and 120 dead, with figures sure to rise.

And this says nothing about the economic dimension. Trade in and between the countries in the region has ground to a standstill as borders and transportation arteries are slammed shut in efforts to contain spread of the virus. Economies matter everywhere, of course, but in a region where survival is tenuous for many at the best of times, economic crisis can be a matter of life and death.

While the West looks to its own shores in preparation for infection containment, it's in the fitness of things to consider those most vulnerable. While no one wants to see Ebola land here, our systems can handle this infection.

But over in Africa, the WHO estimates that US$500 million is needed to fight the epidemic. Money that simply is not available. 

More will be needed to rebuild what will certainly emerge as dreadfully compromised infrastructure, not to mention the shattered lives of those left behind.

The international community must step up to the plate. And we must do so now.