Responding to the Ebola Epidemic in Liberia and Sierra Leone: Myth and Reality

The current Ebola epidemic in West Africa has been marked, as have past Ebola outbreaks in other parts of Africa, by powerful narratives and images.  One such narrative is that the epidemic’s unprecedented scale is the result of a combination of ignorance, cultural practices, and weak health epidemic surveillance systems.  Another is that stopping the outbreak requires large-scale intervention by foreign medical teams.

Neither of those narratives is supported by the facts of the outbreak and the response in Liberia and Sierra Leone.  The available evidence suggests that lack of trust between communities and the national government, intensified by over a decade of war and a century of poor governance, was the major driver in the spread of the disease.  The evidence also indicates that some communities have been able to curtail the epidemic, with foreign medical teams and other responders playing a supportive role.

These findings have major implications for the international Ebola response.  Restoring trust, and establishing partnerships with communities, rather than massive deployment of foreign medical teams and related logistics, are likely to bring an end to the current epidemic, and prevent future ones.