Via The Lancet: Getting pandemic prevention right. Excerpt:
The voices of the countries most affected by Ebola have not been at the forefront of the numerous global commissions convened to review the crisis. The history of the HIV pandemic suggests that nuances of managing such a response need to come from those who managed the response and were most affected by it. One review suggests that the global response to Ebola remains inadequate.
This Correspondence is a regional perspective from west Africa, the community most affected by the Ebola epidemic and by infectious-disease outbreaks in general. Systematic inclusion of the perspective of the most affected people in these epidemics will contribute to the overall success of health-related security efforts worldwide.
WHO has established that 42 (76%) of the 55 outbreaks of diseases reported in Africa during the past decade affected west Africa.2 Compared with other regions, west Africa is also disproportionately affected by malaria, tuberculosis, HIV, and neglected tropical diseases, many of which pose a risk of recrudescence as a result of increasing resistance to drugs and insecticides.
In July, 2016, we convened a ministerial-level consultation in Monrovia, Liberia, to review the multiple commission reports on the Ebola crisis. Before this convening, study groups in Guinea, Liberia, Nigeria, and Sierra Leone had reviewed the reports carefully with the support of the Rockefeller Foundation, Chatham House, the Harvard Global Health Institute, Gates Foundation, and Big Wins Philanthropy.
We identified several priorities for our region (summarised in the Joint Communiqué); however, only some were reflected in the reports and recommendations.
The centrality of country ownership was common to all reports, yet there was little mention of regional initiatives, such as the regional surveillance-enhancement efforts of the West African Health Organisation and WHO, which were supported by the World Bank and affected countries.
Declaration of the Ebola outbreak as a public-health emergency of international concern should have been more timely—implementation of surveillance and alert systems in the affected countries is central to such timeliness. Women and children were disproportionately affected by the disruption of services.
However, discussion of these vulnerable groups and how to address the sequelae was reported only in the UN High-Level Panel report; this absence in other reports was unfortunate. We consider donor coordination an ongoing area of concern and have organised additional activities to bring our collective voices forward on this topic.
Cross-border trade and travel disruption cost our economies greatly and have hampered our ability to respond to the emergency. We look to regional organisations capable of working across sectors, such as the Economic Community of West African States, to work with us to address these important concerns. Each of the six UN agencies has a specialisation— ie, health, labour, food, and agriculture. The Ebola emergency crossed all of these sectors.