Update 15/01/16: This blog was written on 14/01/16. A new case of Ebola has been discovered in Sierra Leone, hours after the WHO declared West Africa free of Ebola transmissions. See here for ONE s response to this development
Today, the World Health Organisation has certified that Liberia and West Africa are officially free of Ebola transmission, marking the close of a two-year, wholly international effort and a significant milestone for the global health community. Today, indeed, is a moment to be celebrated!
But how much suffering has West Africa—and in fact, the world—endured to this point? There were 28,637 cases and 11,315 deaths, 99% of which took place in Liberia, Sierra Leone, and Guinea. Since the first case was detected in March 2014, Ebola has taken an absolutely devastating toll on the West African region, dismantling decades of work to build economies and health systems to improve the lives of some of the world’s poorest.
For that reason, today is also a time to reflect on the reasons why Ebola became the catastrophe that it did and embrace ways to work together to ensure that it’s never repeated. Consider, first, the woeful under-preparedness of health systems in West Africa. Before Ebola’s onset, Sierra Leone, Liberia, and Guinea all lacked the infrastructure to support a sustainable health system or any kind of first-line defense against an aggressive epidemic. Whereas the U.S. has 245 doctors per 100,000 people, for example, Guinea had 10 and Liberia had just fewer than 3 before Ebola hit. Sierra Leone only had 42 ambulances for its entire population of 6.1 million people. Meanwhile, more than 80% of people in Guinea, 97% of people in Sierra Leone, and 90% in Liberia lacked electricity, and two-thirds of Liberia’s population lived below the absolute poverty line.
A synchronised, well-equipped global response would have mitigated the impact of West Africa’s weak health systems. But as we well know, the world’s initial response to the Ebola outbreak was haphazard, sluggish, and desperately lacking leadership and accountability. As featured in the Commission on a Global Health Risk Framework (GHRF)’s recent findings (published yesterday), the WHO lacked the focus, capacity, and funds necessary to coordinate a response, hinder Ebola’s further transmission, and marshal monetary and in-kind commitments from key donors.
Even when donors made big pledges, they often failed to deliver on their commitments or merely diverted funds from other elements of their development assistance portfolios; sometimes, pledges just disappeared into thin air, failing to ever make it from the mouths of leaders to the hands of those in most need. While ONE endeavored to hold leaders accountable to their promises with our online, interactive tracker, we ultimately found it impossible to exhaustively gauge the amounts and types of resources that were pledged, what resources were expended, and what gaps that remained unfilled.
In acknowledging everything that went wrong during the Ebola crisis, it is dually important to laud everything that went right. Today, surely, is also a day to honor the incredible heroism of the countless health workers, community leaders, and volunteers from around the world, 500 of whom sacrificed their lives trying to bring the outbreak to a close. From the beginning, health workers were 20-30 times more likely to be infected with Ebola than the general population. Despite these odds, they heroically put themselves in danger to help their fellow man, even in the face of profound fear and uncertainty.
What got these health workers through it? “Courage in the face of danger,” says Dr. J. Soka Moses, head of Liberia’s Ministry of Defense Ebola Treatment Center, to ONE in January of last year. “Imagine,” he said, “being a medical doctor working in a hospital where people are dying from a disease that no one knows how to cure, [or] where senior doctors are running away from the hospital, fearing their own death. Now imagine that you want to help. The one thing that will keep you there is courage.”
It is this same courage that has inspired countless heroes – named and unnamed – to join the fight over the past two years. Dr. Jerry Brown, medical director at the Eternal Love Winning Africa Hospital in Monrovia and one of TIME Magazine’s People of the Year in 2014 was scared of death. He told TIME, “I always had the fear of myself or one of my staff getting infected, and what would become of me thereafter.” It was with courage, however, that Brown was able to successfully discharge over 230 survivors from his hospital by the end of 2014.
This courage, it should be noted, was not limited the people of West Africa. Katie Meyler, founder of the More than Me campaign, left the comfort of her home in New Jersey to return to Liberia, converting a school she had established in 2009 to an-hoc disaster response center. To date, her team has transported 262 suspected Ebola patients to safe and contained treatment units, identified 133 survivors of Ebola, and provided homes for 145 children who became orphans as a result of Ebola. Although Meyler knew that she could have contracted and potentially died from Ebola, she believes profoundly that it would have been “for something she believed in.” In her words, “being a bystander to suffering was not an option.”
In large part thanks to the courage and determination of health care workers and community leaders on the ground, the world has made great progress toward bringing the crisis to a close. But, as recently brought to light by the GHRF Commission, “far more lives were lost than should have been, and the economic costs were far greater than they could have been.”
Before the memories of Ebola fade, as they inevitably do in our busy, dynamic world, let us always laud and emulate the things the heroes of Ebola did right, and work to aggressively correct those things we as a global community did wrong. Investing in global health security moving forward, to be sure, is not only a public good, but also a necessary step towards granting each and every one of us the health, safety, and happiness to which we all are entitled.