Ellen Johnson-Sirleaf, the President of Liberia, is interviewed on the fight against Ebola.
1. What is the current situation with Ebola in your country, Liberia?
From all indications, the Ebola virus disease outbreak is being subdued. We know that because we are not getting as many cases as we did in July, August and September. Instead, we are getting isolated numbers of cases scattered around the country. In simple terms, the trend is flattening. But that said, this is a dangerous phase of the disease, when people could begin to relax preventive measures that resulted in the current decline in cases. Let me add that our ambition is to get to zero new cases by Christmas. The existing trend suggests that this ambitious goal will be achieved, using our Rapid Isolation Treatment for Ebola (RITE) strategy, which involves empowering our country health teams with trained personnel who have adequate assets to investigate cases and stop the transmission. Safe isolation of cases and treatment is or strategy.
2. What are your most pressing needs as you respond to the situation?
Relative to strategy, our most pressing need is to redirect and focus our scarce resources at the country and local levels with the goal of doing purposeful and tactical hunting of cases. Every case that we find, we must list the contact and follow that for 21 days. This means that social mobilization has to be a key feature of our fight against the disease.
3. What mechanisms need to be put in place to ensure a prompt and effective response to international crises in the future?
We need to ensure first that our public health system is fully equipped with the needed surveillance capacity at the local or sub-national level to detect and respond to any outbreak. This means that at a district and community level, we must develop a system for real case hunting. This should involve a process whereby surveillance officers are equipped with training, motorbikes, fuel, scratch cards and other facilities to detect and report cases when an outbreak occurs. We need to decentralize our public healthcare system. In addition, our international and regional partners like the World Health Organization, the Centers for Disease Control and Prevention, and the West Africa Health Organisation need to be swift in responding to outbreaks and not adapt a wait-and-see approach, especially when such diseases have the potential of being transported outside our borders. Lastly, we must develop regional disease surveillance systems to prevent the threat of exporting the disease from one nation to another.
4. Are there lessons to be drawn from the Ebola outbreak that could be applicable to non-medical pan-regional and global crises?
The lesson to be learned from this crisis is that in pre-Ebola era, we took a more curative approach to healthcare delivery and not a preventive one. Our healthcare delivery system did not address disparities in health. There were alarming differences in incidence, prevalence, mortality, burden of diseases, and other adverse health conditions that existed among specific populations (poor slum communities and rural residents). Therefore, when Ebola hit, these low-income and poor slum communities and rural inhabitants were the hardest hit (affected at higher rates and more severely). In simple terms, we failed to address inequitable health outcomes. We must therefore leverage our resources to capture needs at the community level and not throw our resources at large organizations, which sometimes do not funnel their resources to reach the poor and destitute segments of our population.
5. Clearly, the immediate concern is to halt the spread of human tragedy, but Ebola will also leave an economic legacy in the region. What is your assessment of the tools and international assistance that will be needed for a sustainable economic recovery?
We acknowledge that as a consequence of the prolonged Ebola outbreak, revenue and growth have declined precipitously. We were moving to double digits, but we have reached zero, and thus we need to fix the economy. We need to restore our productive sectors and bring back investors who left as a result of the outbreak. We need to reactivate and strengthen our institutions ranging from education to jobs. Government is nearing a point where it might be unable to meet its current wage bill. Indeed, private sector growth is a vital part of our strategy, as is restoring electricity, water, and other public services, including the cash assistance programmes for vulnerable populations.
This interview first appeared in the November Executive Note, a monthly briefing from the World Econonic Forum’s Global Agenda Councils.
Author: Ellen Johnson-Sirleaf is the President of Liberia.
Image: Liberian President Ellen Johnson-Sirleaf speaks to villagers about Ebola virus precautions outside Ganta, Liberia, October 7, 2014. REUTERS/Daniel Flynn