It has been a few weeks since the 2015 World Economic Forum in Davos, and while very important topics were discussed among a panel and audience of distinguished experts and thought leaders, one topic remained at the forefront — dealing with the aftermath of the deadly Ebola outbreak. The Ebola outbreak is unprecedented in terms of the magnitude of its impact. In the wake of this pandemic, thousands of lives have been lost in affected countries and spread beyond the West African borders, leaving fragile healthcare systems in post conflict countries virtually dilapidated. There is a current decline in the incidence and prevalence of Ebola, but this will certainly not be the last disease outbreak that will affect the continent. So what gains have been made from this? African leaders on the continent share priorities and lessons learned from this significant event.
The preparation of healthcare systems is key Some countries in Africa do not have the same quality of healthcare access and capacity when compared to other nations on the continent or countries in the West. The widespread impact of the pandemic presents a wakeup call to address the current state of the healthcare system. Ebola spread silently in Guinea for up to three months before it was detected. Gaps in the supply of vaccines, drugs and diagnostic testing for the prevention treatment & care for Ebola and other diseases will need to be actively addressed as well. Former United Nations Secretary General, Mr. Kofi Annan expressed his concern about the limited professional response to the outbreak this time around. “We discovered Ebola [in Africa] about forty years ago, and we could have really focused on it and done some research on how to counter it. It’s a bit surprising that forty years later, we [have] come back to it. If we had the foresight, we would have been much further ahead with a cure and treatment that we could have used”. Mr. Annan recommended that as the continent moves forward, there will need to be a coordinated approach in the establishment of regional disease control centers that will serve as frontline responders in the event of another disease outbreak.
Investment in human resource capacity is also necessary. There is a need to develop a cadre of trained public health workers who will be able to detect new cases, perform contact tracing and follow up, as well as further epidemiological activities that will study the pattern and cause of disease conditions.
The need for a more inclusive Africa There has been a commitment to fight the pandemic at the highest levels of political leadership across the continent. One thing is clear; the Ebola outbreak brought a sense of solidarity across the continent. The support of the private sector though remains a key priority, as determined by Mr. Tony Eleumelu, Chairman of Heirs Holdings and founder of the Tony Elumelu Foundation. “The private sector should have been involved much sooner in the response; there is a lot the private sector can do in ensuring that we rehabilitate affected communities as soon as possible, as a deterrent to further outbreaks”, he reiterated. There have been responses by the African Development Bank (AFDB), the African Union (AU) and country governments, but Mr. Elumelu recommended the need for strengthened public-private partnerships that will help pave the way forward in rebuilding the economies of affected countries. “We need to ensure that poverty, which predisposed affected countries to the disease is gradually eradicated, even as communities begin to recover”.
Old habits die hard The response to the pandemic on the continent has clearly shown that it is time for Africa to respond to disease outbreaks with new and innovative methods. According to Guinean President Alpha Condé, this was a critical lesson learned. “Ebola is a different type of fight, and one has to give up old methods and adopt new ones”. The response certainly took longer than it should have; the rapid spread of the virus around the world proves the need for new and more effective ways of responding to severe and sustained disease outbreaks.
Spreading panic is certainly not the way go Unfortunately, international communication on Ebola was nothing short of disastrous, and enabled many to give into fear and hysteria. It was Mr. Annan’s observation of this reaction that forced him to speak out publicly against it. “I was in the United States last fall and I was quite amazed at the fear and scaremongering surrounding the disease, and trying to keep out anyone who has been to West Africa, ignoring the scientific knowledge and the advice given by the Centers for Disease Control and Prevention (CDC)”. In an interconnected world as ours, disease is bound to travel – case in point, SARS. Annan continued, “SARS broke out in Asia, and within twelve hours, it was in Canada. With Ebola, we are in the same boat. The public and international community did not wake up to the crisis until it arrived in the United States and the United Kingdom”.
Early detection and rapid response is crucial If patients are reached early enough, there is a greater chance of recovery. This is a significant part of disease eradication. Mali was another country in West Africa that was affected by Ebola, and while they reported only one case, their response serves as an example to other countries in their approach to swiftly preventing disease transmission. Dr. Samba Sow, the Director General of the Center for Vaccine Development, Mali (CVD Mali) and Mali’s Coordinator of the Emergency Operations Center for the fight against Ebola described Mali’s response to this incidence. “The minute we heard there was an epidemic in Guinea, we had our first emergency meeting at the Ministry of Health office and a rapid response team was set up. We did not wait until we saw the first suspected case in country”. While the ministry tried to set up a rapid response team under very difficult conditions, Dr. Sow and his team began to work with the community, stating that Ebola was not only a ‘ministry of health’ business but a national issue that required participation at all levels. To this effect, Sow’s team approached local and village leaders to help gain the community’s trust and individuals were trained to detect and respond to new cases. Mali’s country example shows that prevention is better than cure, and from a public health perspective, services should be deeply ingrained and available at the community level, with linkages set up across the continuum of care.