Ebola 'could lead to failed states'

"Most people in Liberia do not believe the virus is real."

The Ebola epidemic threatens the "very survival" of societies and could lead to failed states, the World Health Organization (WHO) has warned.

The outbreak, which has killed some 4,000 people in West Africa, has led to a "crisis for international peace and security", WHO head Margaret Chan said.

She also warned of the cost of panic "spreading faster than the virus".

Meanwhile, medics have largely ignored a strike call in Liberia, the centre of the deadliest-ever Ebola outbreak.

Nurses and medical assistants had been urged to strike over danger money and conditions. However, most were working as normal on Monday, the BBC's Jonathan Paye-Layleh in Monrovia said.

A union official said the government had coerced workers - but the government said it had simply asked them to be reasonable.

More than 4,000 people have died during the Ebola outbreak

In a speech delivered on her behalf at a conference in the Philippines, Ms Chan said Ebola was a historic risk.

"I have never seen a health event threaten the very survival of societies and governments in already very poor countries," she said. "I have never seen an infectious disease contribute so strongly to potential state failure."

She warned of the economic impact of "rumours and panic spreading faster than the virus", citing a World Bank estimate that 90% of the cost of the outbreak would arise from "irrational attempts of the public to avoid infection".

Ms Chan also criticised pharmaceutical firms for not focusing on Ebola, condemning a "profit-driven industry [that] does not invest in products for markets that cannot pay".

At the scene: The BBC's Jonathan Paye-Layleh in Monrovia

Liberia's President Ellen Johnson Sirleaf toured Ebola treatment centres at the weekend urging health workers not to strike - and they seem to have responded to her plea.

Dr Jerry Brown, who heads a 60-bed treatment centre on the outskirts of Monrovia, said all his employees had come to work. "If we strike now more and more patients will remain in the communities, there will be more new cases," he said.

But there is still a huge shortage of beds and health workers needed to tackle the outbreak. Some patients are also complaining of other shortages.

"Since this morning we have not eaten. There is no water, no medicine," a patient told the BBC from a unit at Monrovia's John F Kennedy Memorial Medical Center. He and 15 others had been at the unit for 17 days but their recovery was now threatened, he said, appealing to the government for help. "We don't want to take the law into our own hands by bursting [out of] this place."

Health care workers are most at risk of infection

The latest outbreak has killed at least 4,033 people in Liberia, Sierra Leone, Guinea and Nigeria since it was identified in March.

Health workers are among those most at risk of catching the disease. Ninety-five have died from the virus in Liberia.

Liberia's National Health Workers Association had called for a strike to demand an increase in the fee paid to those treating Ebola cases.

The union is seeking a risk fee of $700 (£434) a month. It is currently less than $500, on top of basic salaries of between $200 and $300.

The association also wants more protective equipment and insurance for workers.

Ebola deaths: Confirmed, probable and suspected

Source: WHO

Note: figures have occasionally been revised down as suspected or probable cases are found to be unrelated to Ebola. They do not include one death in the US recorded on 8 October.

How not to catch Ebola:

• Avoid direct contact with sick patients

• Wear goggles to protect eyes

• Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated

• People who recover from Ebola should abstain from sex or use condoms for three months

How Ebola attacks

On Monday, the association's secretary-general, George Williams, said the government had put some health workers under "duress" and persuaded them to work.

The government says the scale of the epidemic means it now cannot afford the risk fee originally agreed. It warned that a strike could also harm patients.

Information Minister Lewis Brown said the government had asked health workers to be reasonable. "We are working with them the best way we possibly can," he said.

Six months after the epidemic began in West Africa, there are still only about a quarter of the treatment beds required to tackle it.

Food is now in short supply as markets are disrupted in some parts of Liberia, Sierra Leone and Guinea.

In other developments:

• A regional UN co-ordination centre to fight Ebola is being set up in Ghana

• The archbishop of Guinean capital Conakry has issued guidelines aimed at checking the spread of Ebola in churches

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