The head of the World Health Organization (WHO) says Ebola poses a threat to the governments and societies of West Africa.
Dr. Margaret Chan, director-general of the WHO, said Monday that she has "never seen an infectious disease contribute so strongly to potential state failure."
In a statement to a health conference in the Phillippines, Chan warned the number of cases is "rising exponentially" in Liberia, Guinea and Sierra Leone, and said the outbreak shows how the world is ill-prepared for a severe and sustained public health emergency.
Other U.N. officials, including U.N. chief Ban Ki-moon, have sounded similar warnings about the Ebola epidemic, which has killed more than 4,000 people in West Africa.
Defying calls for a strike
Chan spke as most health workers in Liberia reported to work Monday, ignoring calls for a strike that could have weakened efforts to fight the Ebola epidemic.
The country's Health Workers Association had told members to stay home unless they received higher hazard pay promised by the Liberian government. But hospitals and health officials say the majority of nurses and physician's assistants came to work, and medical facilities were operating.
The secretary-general of the union, George Williams, accused the government of pressuring workers to defy the strike.
In an interview with VOA, Liberia's assistant health minister, Tolbert Nyensuah, said the government can't meet all the health workers' demands because it needs to keep opening Ebola treatment centers.
"So it's negotiation," he said. "And we understand that their leadership have understood this. We have to put all of our differences aside. Unite. Come together as a country. Solve this problem and then we can continue to discuss those issues."
Alphonsus Wiah, a hygienist with the Island Clinic Ebola Treatment Unit, the largest government-run Ebola center in the capital, Monrovia, said the workers were demanding $700 in monthly hazard pay on top of their monthly salaries of $200 to $300.
"This [Ebola] epidemic is not just a normal hospital disease," Wiah said. "... As I speak to you, some of our colleagues, the health workers, are dying. So, our demand was the salary structure that [the] government offered was too low, and we believe there should be an increment in the salary structure."
Workers also have complained about a lack of protective gear.
The extra money promised to workers is being paid, Reuters news service quoted Health Minister Walter Swenigale as saying.
Liberia has endured the largest number of Ebola infections of any country, according to the World Health Organization, with 4,076 confirmed cases as of October 8. The virus has killed at least 2,316, including 95 health workers out of 201 infected. The regional outbreak had infected almost 8,400 people and killed more than 4,000.
President Ellen Johnson Sirleaf reportedly toured Ebola treatment units around Monrovia Saturday and asked health workers to remain on the job, according to assistant health minister Tolbert Nyenswah.
Health Minister Walter Gweningale referred VOA to Minister of Information Lewis Brown for comment. Brown has not responded to VOA's requests for comment for the past week.
Wiah said that although the health workers took an oath to save lives, they need protection from Ebola while making a living.
He said that when the first Ebola cases were confirmed in Guinea in March, the government agreed to pay $700 a month for hazard pay. But, Wiah said, the government soon changed its mind and reduced the monthly allowance.
"We projected, according government’s first announcement, that doctors will make $1,500. Nurses will make $750, plus their government salary, then hygienists will make $750," Wiah said.
"Later on, it came to as low as 250 US dollars. So, we are saying the $250 is very small, and those that go in the ETUs [Ebola treatment units] $300 is also very small."
Vaccine clinical trials begin
Meanwhile, the Public Health Agency of Canada said Monday that phase one clinical trials for an experimental Ebola vaccine have begun.
It says the vaccine has shown great promise in animal research and will be tested at the Walter Reed Army Institute of Research in the U.S. state of Maryland.
VOA's James Butty contributed to this report.