WHO Calls End Of Ebola Transmission In
Liberia A “Monumental Achievement”
Agency Identifies
Success Factors
The World Health Organization declared Liberia free of
Ebola virus transmission in early May after 42 days without a
laboratory confirmed case. In describing the achievement, WHO provided
one of the most vivid accounts of the impact of the outbreak as it
occurred during August and September 2014 when Liberia was reporting
300-400 new cases every week.
Vivid Description
According to WHO, “During
those 2
months, the capital city Monrovia was the setting for
some of the most tragic scenes from West Africa’s outbreak: gates
locked at overflowing treatment centres, patients dying on the
hospital grounds, and bodies that were sometimes not collected for
days...
…Flights were cancelled. Fuel and food ran low.
Schools, businesses, borders, markets, and most health facilities were
closed. Fear and uncertainty about the future, for families,
communities, and the country and its economy, dominated the national
mood…
…Though the capital city was hardest hit, every one of
Liberia’s 15 counties eventually reported cases. At one point,
virtually no treatment beds for Ebola patients were available anywhere
in the country. With infectious cases and corpses remaining in homes
and communities, almost guaranteeing further infections, some
expressed concern that the virus might become endemic in Liberia,
adding another – and especially severe – permanent threat to health…
…It is a tribute to the government and people of
Liberia that determination to defeat Ebola never wavered, courage
never faltered. Doctors and nurses continued to treat patients, even
when supplies of personal protective equipment and training in its
safe use were inadequate. Altogether, 375 health workers were infected
and 189 lost their lives.”
Halting transmission
According to WHO, four key factors explain Liberia’s
success in halting transmission.
1. The president’s leadership which made the response a
priority for multiple branches of government.
2. Health officials and their partners were quick to recognize the
importance of community engagement
3. Generous support from the international community,
including financial, logistical, and human resources.
4. Strong coordination of the international and
national response.
Getting to Zero Cases
In order to get to zero cases in the three most
affected countries of Liberia, Sierra Leone, and Guinea, the WHO
action plan for 2015 is focused on the following elements:
1. Further strengthen district surveillance, risk
assessment and response operations, and ensure that each district has
a flexible plan specific to their epidemiological situation and social
/ anthropological context
2. Active surveillance and contact tracing are to
continue with “zero weekly reporting” of suspected Ebola cases through
integrated disease surveillance at public and private health
facilities as well as community event-based surveillance in areas of
particular risk.
3. Mainstreaming community engagement within service
delivery, for example through the training of frontline staff in trust
building and communication skills, and re-orientating social
mobilization activities to address service uptake must be a priority.
4. Case management capacity, triage and infection
control procedures need to be optimized to increase survival rates as
well as to reduce the number of health workers becoming infected with
the disease. ■
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