Call for better resources to deal with Ebola virus outbreak in Sierra Leone

8 July 2014

Researchers working in Sierra Leone  have written a letter to The Lancet calling for improvements in access to diagnostic technologies and health-care resources, as well as improved disease surveillance and health communication for dealing with the Ebola crisis [1].

The Ebola outbreak in Guinea, Sierra Leone and Liberia has infected 750 people and left more than 450 people dead since March 2014, according to the World Health Organization.

At present, there is little incentive for patients to seek professional diagnosis of suspected Ebola, say the authors, with most people with febrile (fever-causing) illnesses in Sierra Leone treated at home, and the true extent of the outbreak therefore very difficult to determine.

Moreover, disease surveillance systems in the region are inadequate, despite research (conducted by the authors and others) suggesting that mobile phones and smartphones can be effectively deployed in routine collection of surveillance data.

The authors also highlight a shortage of medical personnel and access to healthcare facilities for most people in the region, writing that, “The relatively few physicians, nurses, and healthcare providers attending to these underserved populations often have poor access to basic personal protective equipment, and might therefore be understandably unwilling to provide direct care for patients suspected to have Ebola. There is an urgent need to provide reliable and constant access to personal protective equipment in health-care centres across the region.”

Finally, the authors suggest that early disease control policies to restrict border crossings and sales of bushmeat have been ineffective.

 They write that, “What is certain is that these policies (and the ways that they were communicated) raised anxiety and, in some places, fuelled rumours that led to counter-productive behaviours. Improved communication by health officials with the media, community leaders, health professionals, and the general public is necessary to reduce misinformation and improve compliance with prevention and control measures that have been proven effective.”

Emergency ministerial meeting on the crisis

The World Health Organization convened an Emergency Ministerial meeting in Accra, Ghana last week for countries in the region. Health Ministers agreed on a range of priority actions to end the Ebola outbreak. In a Communiqué issued at the end of the two-day meeting, the Ministers agreed that the current situation poses a serious threat to all countries in the region and beyond and called for immediate action. They expressed concern on the adverse social and economic impact of the outbreak and stressed the need for coordinated actions by all stakeholders, national leadership, enhanced cross-border collaboration and community participation in the response.

There was consensus that a number of gaps and challenges remain. These relate to coordination of the outbreak, financing, communication, cross border collaboration, logistics, case management, infection control, surveillance, contact tracing, community participation and research.

The World Health Organization will establish a Sub-Regional Control Center in Guinea to act as a coordinating platform to consolidate and harmonize the technical support to West African countries by all major partners; and assist in resource mobilization. The delegates also underscored the importance of WHO leading an international effort to promote research on Ebola virus disease and other hemorrhagic fevers.

The Ministers adopted a common inter-country strategy which highlights the following key priority actions for the affected countries:

  • Convene national inter-sectoral meetings involving key government ministries, national technical committees and other stakeholders to map out a plan for immediate implementation of the strategy;
  • Mobilise community, religious, political leaders to improve awareness, and the understanding of the disease;
  • Strengthen surveillance, case finding reporting and contact tracing;
  • Deploy additional national human resources with the relevant qualifications to key hot spots;
  • Identify and commit additional domestic financial resources;
  • Organise cross-border consultations to facilitate exchange of information;
  • Work and share experiences with countries that have previously managed Ebola outbreaks in the spirit of south-south cooperation.

The delegates also urged partners to continue providing technical and financial support and work with WHO to effectively coordinate the response. In an effort to promote regional leadership, and highlight the seriousness of the outbreak, the delegates strongly recommended that the forthcoming Economic Community of West African States (ECOWAS) Heads of States summit addresses the issue of EVD outbreak.

Further information

Communiqué issued at the ministerial meeting:


1. Ebola in Sierra Leone: a call for action. Rashid Ansumana, Jesse Bonwitt, David A Stenger, Kathryn H Jacobsen. The Lancet, Published Online July 5, 2014.


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