africa appg- roundtable with dr nabarro, un special envoy on ebola

Presentation to The Africa All Party Parliamentary Group

2nd July 2015

2Office of the Special Envoy on Ebola|

I. Current status of the Ebola outbreak.

II. Progress of the response.

III. Insights on questions raised by the Africa All Party Parliamentary Group.

1. What lessons can be learnt from the recent Ebola crisis in West Africa regarding the role of communities in response to health crises, and more broadly in relation to health systems at the local level?

2. What, if any, are the barriers to successful and sustainable engagement of communities in health crisis response?

In addition, I consider “What are the priorities from now moving forward”

Outline


Ebola outbreak in West Africa 2014-2015

• Zoonotic disease (It came from an animal source)

• Impact on People, on Societies, on Economies

• Stretching Capacities to Prevent and to Respond

• A context of anxiety and concern

• Focus on the Risks people face & the Realities they face

• Engaging and working with people and their communities

• Powerful role of Responders• We always have to anticipate surprises• Different organizations had critical roles • Importance of preparation, coordination, effective crisis response and a capacity

to adapt


Number of new confirmed infections per week

Decem

ber-1

3

Decem

ber-1

3

Decem

ber-1

3

Janu

ary-

14

Janu

ary-

14

Febr

uary

-14

Mar

ch-1

4

Mar

ch-1

4

Mar

ch-1

4

April-

14

April-

14

May

-14

May

-14

June

-14

June

-14

July-

14

July-

14

Augus

t-14

Augus

t-14

Septe

mbe

r-14

Septe

mbe

r-14

Octobe

r-14

Octobe

r-14

Novem

ber-1

4

Novem

ber-1

4

Decem

ber-1

4

Decem

ber-1

4

Janu

ary-

15

Janu

ary-

15

Febr

uary

-15

Febr

uary

-15

Mar

ch-1

5

Mar

ch-1

5

April-

15

0

100

200

300

400

500

600

700

800

900

1,000

Guinea

Liberia

Sierra Leone

Total

Con

firm

ed n

ew in

fect

ions

per

wee

k


Evolution of the Ebola outbreak and response

Decem

ber-1

3

Decem

ber-1

3

Decem

ber-1

3

Janu

ary-

14

Janu

ary-

14

Febr

uary

-14

Mar

ch-1

4

Mar

ch-1

4

Mar

ch-1

4

April-

14

April-

14

May

-14

May

-14

June

-14

June

-14

July-

14

July-

14

Augus

t-14

Augus

t-14

Septe

mbe

r-14

Septe

mbe

r-14

Octobe

r-14

Octobe

r-14

Novem

ber-1

4

Novem

ber-1

4

Decem

ber-1

4

Decem

ber-1

4

Janu

ary-

15

Janu

ary-

15

Febr

uary

-15

Febr

uary

-15

Mar

ch-1

5

Mar

ch-1

5

April-

15

0

100

200

300

400

500

600

700

800

900

1,000

Guinea

Liberia

Sierra Leone

Total

Con

firm

ed n

ew in

fect

ions

per

wee

k

I II III IV


1 : The Beginning

• Ebola, Cholera or Lassa Fever?

• Did it really disappear end-May

• What are the disincentives to reporting an unusual set of events?

• Do these explain the delay?


0

100

200

300

400

500

600

700

800

900

Number of cases

2 : Bending the epidemic curve PHASE 1

Behaviour changeBurial teamsTreatment Centre Beds

Jan

05

Fe

b 0

2

Ma

r 0

1

Ma

r 3

0

Ap

r 2

7

Ma

y 2

5

Jun

22

Jul 2

0

Au

g 1

7

Se

p 1

4

Oct

12

No

v 0

9

De

c 0

7

Jan

04

Fe

b 0

1

Fe

b 1

5

Reporting weeks

Source: WHO


3 : Getting towards Zero PHASE 2

Community OwnershipCase findingContact tracing

10-Jan 16-Jan 3-Feb 15-Feb9-Feb22-Jan 28-Jan4-Jan

Source: WHO


Communities change attitudes and practices in Sierra Leone

Do not participate in burials involving handling of the body

Believe that spiritual healers can treat Ebola successfully

Believe that bathing with salt and hot water can prevent Ebola

0% 10% 20% 30% 40% 50% 60%

August 2014 October 2014 December 2014

Percentage of respondents


4 Jan 2015

11 Jan 2015

18 Jan 2015

25 Jan 2015

1 Feb 2015

8 Feb 2015

15 Feb 2015

22 Feb 2015

1 Mar 2

015

8 Mar 2

015

15 Mar 2

015

22 Mar 2

015

29 Mar 2

015

5 Apr 2015

12 Apr 2015

19 Apr 2015

26 Apr 2015

3 May 2015

10 May 2015

17 May 2015

24 May 2015

0

50

100

150

200

250

300

350

Num

ber

of p

eopl

e ne

wly

dia

gnos

edPeople Diagnosed with Ebola, West Africa, 2015

Information from the World Health Organization

4: The Last Mile


4 : The last mile


Ebola by Chiefdom/Ward, last 21 days

Admin 3 Map


Importance of the role of communities


Search of at-risk villages


Forward operations bases

Tamene, DUBREKA

Kamsar, BOKE


Where we are on the Ebola Outbreak July 1 2015

• Ending an outbreak is always the hardest part

• This outbreak started with one infected person: that is why this time we must not fail to eliminate Ebola from the human population.

• To achieve this we need to be clear on the risks that people face and to ensure a “whole of society” response

• There is no place for use of force or coercion

• It will continue to be a bumpy road


Looking Forward

Whole of Society Prevention, readiness and preparedness

The One Health Approach is key to future collaboration

It is worth the effort to prepare Coordination, financing, operating platforms, personnel, data systems in advance

Recovery is an integral part of the response

Prevention Preparedness Response Recovery


Whole of Society Readiness

It requires a concerted effort that brings together the experience and resources of different Government Ministries, businesses, civil society, media and the military to sustain essential infrastructure and mitigate impacts on the economy.


Five aspects of a “whole of society” response to Ebola

Communities are at the centre - involves local government, traditional leaders, faith leaders, politicians and civil society.

The highest level of leadership (Presidents) have needed to recognise that the response includes the whole government and civil society with a special role for the health ministry.

It all works best when the health sector is seen, as sees itself, as a critical contributor to a “whole of society” response. Including local-level.

While vital, implementing and coordinating a whole of society response is not easy. Barriers of language, culture, trust, geography etc. are significant.

The health sector is key. It must explain and analyse the situation, design the strategy, and implement the core of the response.


Conclusions The challenge facing us all is to collectively ensure a healthier and safer world.

Undoubtedly new infectious diseases will emerge. But we should put the lessons we learned from previous or current outbreaks to use

We must work together on an "All hazards approach" for prevention, detection, response and management of emerging health threats

The response must be prompt, swift, effective and efficient

We should aim to build back better after outbreaks are over

africa appg- roundtable with dr nabarro, un special envoy on ebola

Health & Medicine

ebola ebola outbreak

ebola communities

special envoy

ebola importance

beginning ebola

ebola evolution

recent ebola crisis

west africa