Ebola, one year later: What have we learned, and where are we going?

Ebola, one year later: What have we learned, and where are we going?


One year ago today, the WHO confirmed the first official cases of the West African Ebola outbreak in Guinea. In the 365 days since, those initial cases spread in unprecedented ways across the West African region, claiming more than 10,000 lives and infecting more than 24,000 people. Although the outbreak remains concentrated in Guinea, Liberia, and Sierra Leone, we saw cases in six other countries around the world—Nigeria, Mali, Senegal, Spain, the United Kingdom, and the United States—reinforcing that this was a truly global crisis.

On the one year anniversary of this tragic outbreak, as we pay tribute to those who lost their lives and reflect on how much has changed, here are six key lessons learned:

1. Infectious diseases love delayed responses

Sadly, very little attention was paid to Ebola in the first few months of the outbreak. And as donors, technical agencies, and media outlets largely turned a blind eye, Ebola flourished. Many experts now say that because we did not take Ebola seriously in the spring and summer of 2014 when it was limited to fewer communities, it was able to spread rapidly and often without tracing or detection, making the job of containment ultimately more difficult and more expensive. It’s a lesson that applies beyond Ebola to many other infectious diseases, such as malaria, too: if we delay or flat-line our global response, the diseases won’t just sit around waiting. History has shown that they’ll rebound, and we’ll lose ground.

2. Massive progress can be made, even in fragile places

Because the world got off to a slow start in tackling Ebola, things initially looked quite grim; early analysis projected that we could see as many as 1.4 million cases by January 2015. Thankfully, a massive uptick in attention and resources by the fall of 2014 allowed the three most affected countries to make dramatic gains against the disease, and those projections never came to fruition. Heroic efforts on the ground by local citizens, governments, NGO partners, and technical agencies were bolstered by financial, medical and military support from the international community. Together, they demonstrated the value of combining local knowledge and leadership with external resources and capacity—and they also showed that rapid progress is possible even in some of the world’s toughest conditions.

3. It’s not over ‘til it’s over

While Liberia has now gone weeks with only one reported new case of Ebola, cases continue to rise in Sierra Leone and Guinea (largely out of the news headlines). In fact, Guinea saw more cases last week than they have had at any point this year. Many have described Ebola as a fire; if we get complacent and leave any embers behind, the blaze could easily and quickly reignite. So until we get to zero across the entire region, we shouldn’t rest or consider our job done. And until the job is done, we must redouble our efforts to keep this issue front of mind for politicians, donors, and the media.

4. Accountability matters

More than 560,000 ONE members have already committed to holding their leaders’ feet to the fire on Ebola, asking them to deliver services as quickly as possible in order to save lives and rebuild for the long-term. Starting in September 2014, we were encourage to see many governments deliver big pledges, but as we know from past crises, securing pledges is only half the battle. We continue to work with partners to clarify those pledges in our interactive tracker, in part because we think it’s equally important to know what resources have actually been disbursed on the ground, which commitments have been additional (rather than “robbing Peter to pay Paul”), and which donors have led the way or lagged behind their global peers.

5. Ebola isn’t just about Ebola

Ebola’s direct health impacts have been clear, but its indirect impacts across the health and development sectors may be even more severe. New UNICEF data shows that in Sierra Leone, for instance, the number of children receiving basic vaccines fell by 21% and the number of children treated for malaria was down 39%. Meanwhile, an estimated 5 million children have been out of school for months, agricultural productivity is down, and food insecurity rates are up. Taken together, the World Bank estimates these secondary impacts will cost the countries more than $1 billion in lost economic growth in 2015. So when we talk about Ebola, we can’t just frame it as a health crisis. Instead, we must understand it as a broader development crisis that merits sustained international focus and dedicated, multi-sector rebuilding efforts.

6. To truly honor those we lost, we must rebuild stronger

The worst outcome of this crisis would be for us to get to zero but then walk away from the region, leaving it just as poorly-prepared to tackle the next outbreak as it was in 2014. In order to rebuild smarter, donors must work in partnership with affected countries to strengthen a wide range of capacities, including disease surveillance, governance, and crisis management. But perhaps above all, we must quickly remedy the drastic health worker shortage and fragile health systems in the three most affected countries. Increasing the health workforce in the Ebola-affected countries is not just the right thing to do — it’s also affordable, and has clear benefits for many other routine health challenges faced by citizens. Ensuring that countries have sustainable plans for retaining more health workers and strengthening the systems around them will be an enormous—but essential—task for the world to undertake, and there is no excuse for delay.

Ask world leaders to make and deliver bold commitments and help end the Ebola epidemic.


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