The
Challenges
to Ebola
Response
Kim Yi Dionne
Smith College
Challenges
• No recorded previous outbreak (though there
is evidence of previous exposure).
• Outbreak across borders requires coordination
across governments.
Intensity
of
Spread
Challenges
• No recorded previous outbreak (though there
is evidence of previous exposure).
• Outbreak across borders requires coordination
across governments.
• All three of the heavily affected countries have
weak health infrastructure.
Capacity
to
Respond
Challenges
• No recorded previous outbreak (though there
is evidence of previous exposure).
• Outbreak across borders requires coordination
across governments.
• All three of the heavily affected countries have
weak health infrastructure.
• International response was slow and then
reactive/defensive.
Timeline of events
• [Mar 25: CDC announces Guinea outbreak]
• [Mar 30: Liberia reports two cases]
• [May 25: 1st confirmed case in Sierra Leone]
• Aug 8: WHO declares and international health
emergency
• Aug 12: UN special envoy appointed
• Sept 16: President Obama announces $750
million planned response by U.S.
• Sept 18: UNMEER established
Slow and weak international response
• April 10: WHO says $4.8 million is needed for
the response.
• July 31: WHO says $103 million is needed for
the response.
• Sept 18: UN says $1 billion is needed for the
response.
What hasn’t worked?
Photo taken during West Point Quarantine, Monrovia,
Liberia, by John Moore, Getty Images
Photo taken during West Point Quarantine, Monrovia,
Liberia, by Abbas Dulleh, Associated Press
• Quarantine in West
Point neighborhood in
Monrovia, Liberia
• Late June: Liberian
and Sierra Leonean
presidents made
threats of prosecuting
anyone “harboring”
the infected
• Closed borders and
suspended flights
What is working?
A common statement from the West
“We know what works…”
Who is responding?
C-17 Jet in Monrovia, Sept. 18 by Joe Penney
(Reuters)
MSF volunteer preparing CDC doctor to enter Ebola
unit in Liberia (CDC Global)
Who is responding?
Who is responding?
• Locals: the governments of Guinea, Liberia,
and Sierra Leone; health workers; burial
teams; contact tracing teams, and more.
• International agencies: World Health
Organization (WHO); United Nations (esp.
UNICEF); Red Cross; Doctors without Borders
(aka MSF), and more.
• Powerful donors: US, UK, France
• Others: Cuba (doctors); Malaysia (rubber
gloves)
What might work?
• Provide protection for local health workers
• Pay local health workers
• Evacuate all health workers who get sick, not
just the ones from Western countries
• Work with and through local leaders
What new challenges might the
response create?
• Militarization of humanitarian aid
• Focus on potential Westerners who get sick
• Multiple donor countries, still unclear on
coordination