Africa APPG- Roundtable with Dr Nabarro, UN Special Envoy on Ebola
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Transcript of 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
3Office of the Special Envoy on Ebola|
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
4Office of the Special Envoy on Ebola|
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
5Office of the Special Envoy on Ebola|
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
6Office of the Special Envoy on Ebola|
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?
7Office of the Special Envoy on Ebola|
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
8Office of the Special Envoy on Ebola|
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
9Office of the Special Envoy on Ebola|
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
10Office of the Special Envoy on Ebola|
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
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4 : The last mile
12Office of the Special Envoy on Ebola|
Ebola by Chiefdom/Ward, last 21 days
Admin 3 Map
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Importance of the role of communities
14Office of the Special Envoy on Ebola|
Search of at-risk villages
15Office of the Special Envoy on Ebola|
Forward operations bases
Tamene, DUBREKA
Kamsar, BOKE
16Office of the Special Envoy on Ebola|
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
17Office of the Special Envoy on Ebola|
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
18Office of the Special Envoy on Ebola|
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.
19Office of the Special Envoy on Ebola|
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.
20Office of the Special Envoy on Ebola|
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