Musa Pabai holds his son Oliver for the first time after surviving Ebola at his home in Walakor, Liberia, Feb. 19, 2015. Pabai left an Ebola treatment center in Liberia in November, grateful to have survived a disease that has killed nearly 10,000 people across West Africa. Reuters

The cost of fighting Ebola was three times higher than investing in preventative public health systems in the countries affected by the deadly virus, according to a report released Tuesday by the Save the Children foundation, a relief group based in London. When all expenses were tallied, the international effort to end the outbreak that hit Guinea, Liberia and Sierra Leone last year cost an estimated $4.3 billion. Building up those countries’ health infrastructures in the first place would have cost about $1.58 billion, according to the organization.

Health officials fear that without investment in such safety nets, the disease could make a comeback. “Without trained health workers and a functioning health system in place, it’s more likely that an epidemic could spread across international borders with catastrophic effects,” Carolyn Miles, president and CEO of Save the Children USA, said in a statement. “The world woke up to Ebola but now people need to wake up to the scandal of weak health systems, which not only risk new diseases spreading, but also contribute to the deaths of 17,000 children each day from preventable causes like pneumonia and malaria.”

Save the Children’s report, titled “A Wake Up Call: Lessons from Ebola for the world’s health systems,” looked at 75 countries with the highest child mortality rates in the world. Researchers found that 28 countries around the world were worse off than Sierra Leone in terms of adequate health systems. They include Afghanistan, Chad, Ethiopia, Mali, Nigeria and Somalia. In Chad, the country with the second worst-off health system behind Somalia, there is only one health care worker for every 4,444 people. For comparison, Britain has one health worker per 88 people, according to U.S. News and World Report.

Investment in those countries’ health systems could prevent future outbreaks of Ebola. The minimum amount governments should spend on providing adequate health services to their citizens is $86 per capita, the group said.

The Ebola outbreak that began in March 2014 has killed nearly 10,000 people across several West African countries. Although the number of new cases has diminished greatly since the height of the epidemic last fall, the virus continues to affect certain vulnerable pockets of West Africa.