Online Program

Ebola and health systems: What went wrong, and what we can do better next time

Monday, November 2, 2015 : 11:10 a.m. - 11:30 a.m.

Emmanuel d'Harcourt, MD, MPH, International Rescue Committee (IRC), New York, NY
Yolanda Barbera, PharmD, MA, MHSM, International Rescue Committee, New York, NY
Laura Miller, MPH, International Rescue Committee - Sierra Leone, Freetown, Sierra Leone
The 2014-2015 ebola epidemic was unprecedented in its scale and pattern, and prompted widespread reflection on the failure of national and international health systems. The focus was on the international response, on treatment, and on the need to rebuild health systems. Within health systems, most of the attention was on technical issues related to epidemic surveillance and control. The resulting recommendations have been primarily focused on this limited analysis. Three key facts received little consideration. The first was that Liberia in particular had, prior to the epidemic, received extensive funding and technical assistance to build its health system. Why did this assistance not lead to better performance? A second was that the key systems failings before and during the epidemic were related less to technical problems than to failures in governance, including problems with corruption, human resource management, and client trust. A third was that actors on the margin of the health system were arguably the most effective in curbing the epidemic. These realities, largely ignored both in media coverage and in official documentation of the outbreak, can yield specific recommendations to make health systems strengthening more effective than it has been in West Africa, and beyond. Some of these recommendations may be disruptive; but they are more likely to lead to sustained improvements.

Learning Areas:

Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Discuss the Ebola epidemic in West Africa. Explain the impact of the Ebola epidemic on health systems. Discuss lessons learned from the Ebola epidemic. Debate what efforts need to be taken to strengthen the health systems to respond to a future epidemic.

Keyword(s): Epidemiology, Health Systems Transformation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been part of the IRC leadership team for the Ebola response in Sierra Leone, leading the Ebola Response Consortium (ERC), a consortium of 15 NGOs. The topic of Ebola and the Health System is an area that I have unique expertise in, from working in Sierra Leone before and during the Ebola outbreak.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.