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As health workers, diplomats and U.S. troops fight to contain and defeat the virus in West Africa, there now are cases in six other countries; a second U.S. case has emerged; and the World Health Organization puts the death toll at more than 4,000 and rising. President Barack Obama has led urgent U.S. calls for the world to do more, saying that current efforts aren’t enough to stop a disease that in the jet age is unconstrained by national or even continental borders.

“We live in an extraordinarily interconnected world, and that is why it is so essential that we put full energy into stopping this virus in West Africa,” said Nancy Lindborg, an assistant administrator at the U.S. Agency for International Development who’s leading the aid agency’s Ebola response. “It is essential for the entire world to step forward with the kind of help that can stop this epidemic from spreading further.”

In a 2013 analysis of future threats, U.S. intelligence agencies concluded that a pandemic that incapacitated 1 per cent of the world’s population — about 70 million people today — would be “one of the most disruptive events possible.”

“I have never seen a health event threaten the very survival of societies and governments in already very poor countries,” Margaret Chan, director general of the Geneva-based World Health Organization, said in a statement Monday that called Ebola’s spread “a crisis for international peace and security.”

Obama and other officials cite Ebola as one more sign that an increasingly interdependent world is giving rise to new security threats. A pandemic, whether naturally occurring like Ebola or a synthetically created biological weapon, can paralyze economies, fray societies and destabilize countries.

The U.S. Centers for Disease Control and Prevention in Atlanta estimated in September that in a worst-case scenario, as many as 1.4 million West Africans could be infected by mid- January. A September study by scientists at the WHO and Imperial College London found that cases in Guinea are doubling every two weeks; in Liberia every three weeks; and in Sierra Leone every month.

Ebola already has taken “an extraordinary toll” on West Africa’s economy, said AID’s Lindborg, who traveled to Liberia this month.

That nation is facing a 16 per cent decline in state revenue this year, and the World Bank now projects that GDP for Guinea, Sierra Leone and Liberia will be $90 million less than a pre-crisis estimate, Lindborg said in a telephone interview.

“All economic indicators have dropped; markets have been disrupted; private-sector companies are having trouble keeping operations going; farmers are having trouble getting food to market,” she said.

Lindborg described the social cost of the disease, as people no longer touch each other, schools are closed and the number of orphans rises daily. Public buildings require visitors to wash their hands in a chlorine solution, and temperatures are taken religiously. Visitors are sometimes asked to wear labels showing their temperature readings.

Pandemics do far more than disrupt daily routines. They can shape the course of history, triggering political upheavals, hollowing economies and snuffing out entire civilizations. The Black Death took 75 million to 200 million lives in 14th-Century Europe and killed half the citizens of Paris. Smallpox brought by 16th-Century Spanish conquistadors and other European settlers helped eradicate the Aztecs and Incas and decimate Native American tribes. The influenza epidemic of 1918 to 1919 killed hundreds of millions.

Today, opportunistic viruses can use international aviation and shipping to spread farther and faster than any of the historic pandemics. “The fact that in an interconnected world, infectious disease can be transported across borders is one of the reasons we have to take it seriously,” Obama told state and local health officials on an Oct. 8 conference call.

The intelligence assessment last year helps drive the urgent U.S. calls for a more robust global response. The U.S. has committed more than $400 million to fight Ebola, according to the Agency for International Development, and the Defense Department is ready to commit more than $1 billion to the response effort, building transportation infrastructure and temporary hospitals.

Timor-Leste, a tiny country neighbouring Indonesia, has contributed $2 million to the global effort. That is almost the $2.3 million pledge by China, which has massive investments in Africa, according to the State Department. So far, U.S. Secretary of State John Kerry said on Oct. 8, there are “not enough countries to make the difference to deal with this crisis.”

Donald Lu, the State Department’s deputy coordinator for Ebola response, said in a telephone interview that the UN coalition to fight Ebola includes 35 countries and international organizations.

“You wonder, why is it only 35 countries?” Lu said. “There are 192 countries as defined by the UN. Where is the rest of the global community?”

Some projections are now putting Ebola’s death toll at 20 per cent in the three most affected West African nations, according Mathew Burrows, an author of the 2013 intelligence agency report.

“Multiply by 20 what was said about the 1 per cent,” said Burrows, director of the Strategic Foresight Initiative at the Atlantic Council, a Washington policy group. “That’s absolutely devastating economically, also politically, and these countries are fragile to begin with.”

The WHO’s Chan, who oversaw the response to the SARS outbreak in 2002 and 2003 and the avian flu epidemic in 2009, said in the statement released by her Geneva office that she had “never seen an infectious disease contribute so strongly to potential state failure.”

Sierra Leone, Guinea, and Liberia only recently have emerged from decades of civil war. Sierra Leone now faces a price slump in iron ore, its biggest export earner and 16 per cent of its GDP, reducing the government’s coffers just when it desperately needs resources to respond to the outbreak.

In Liberia, President Ellen Sirleaf-Johnson’s request for greater powers to limit movement and assembly to fight the outbreak has led opposition politicians to warn of a potential police state. Sirleaf-Johnson, whose son heads the National Security Agency, already faces allegations of corruption and nepotism.

Oil-producing Nigeria, which is working to contain cases with help from the U.S. Centers for Disease Control and Prevention, is fighting a long-running Muslim insurgency in the north.

“It’s going to be staggering to cope with the deaths,” Burrows said, “but over the longer run, you could see complete breakdown in the state, certainly fragmentation, and possibly conflict.”

The way countries respond will be key to avoiding instability and fragmentation, he said. “If authorities are not seen as helping, if they’re seen as helping themselves and you have a breakdown in trust, then there’s real loss of credibility,” he said.

Those conditions are ripe for areas to break away from central state control, leaving them more vulnerable or open to insurgents or militants. “That creates the safe havens more than anything else,” Burrows said.

A core of the U.S. and international response is focused on dealing with secondary impacts such as food shortages and market declines that could destabilize the affected countries, Lindborg said. The U.S. and United Nations are supporting salaries for health-care workers and funneling additional money into the World Food Program to ensure that food instability — a potential cause of rioting —doesn’t deepen.

“Without question, this is an unprecedented, historic outbreak,” Lindborg said. “It is imperative that we stop this epidemic in West Africa.” If the global response isn’t adequate, she said, “if you play out the scenarios, they start looking very grim.”