As Liberia today celebrates 42 days without any new Ebola infections—effectively marking the end of the Ebola outbreak in West Africa—the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) calls on the global health community to draw on lessons learned during the epidemic to be better prepared for future similar outbreaks.
"Today is a day of celebration and relief that this outbreak is finally over," said Joanne Liu, MSF’s international president. "We must all learn from this experience to improve how we respond to future epidemics and to neglected diseases. This Ebola response was not limited by lack of international means but by a lack of political will to rapidly deploy assistance to help communities. The needs of patients and affected communities must remain at the heart of any response and outweigh political interests."
From the very beginning of the epidemic, MSF responded in the worst affected countries—Guinea, Liberia, and Sierra Leone—by setting up Ebola treatment centers and providing psychological support and conducting health promotion activities, surveillance, and contact tracing. At its peak, MSF employed nearly 4,000 national staff and over 325 international staff to combat the epidemic across the three countries. MSF admitted a total of 10,376 patients to its Ebola treatment centers, of which 5,226 turned out to be confirmed Ebola cases. MSF continues to run support clinics for Ebola survivors in Liberia, Sierra Leone, and Guinea.
"We should congratulate all the people who tirelessly contributed to putting an end to this devastating and unprecedented epidemic, while we should also remember the many health professionals who tragically lost their lives on the Ebola frontline," said Brice de le Vingne, MSF’s director of operations. "This devastating epidemic hit nearly 40 years after the first discovery of Ebola in 1976, yet the lack of research and development on Ebola meant that even today after the medical trials and at the end of the epidemic, there is no effective treatment. There is also a need to obtain licensure for a new vaccine that has been developed."
With such an unpredictable disease, it is crucial that vigilance and the capacity to respond to new cases be maintained in the region as well as a well-functioning surveillance and rapid response system.
Ebola survivors are particularly vulnerable, and they face continuing health challenges such as joint pain, chronic fatigue, and hearing and vision problems. They also suffer from stigma in their communities and need specific and tailored care. MSF has invested in setting up Ebola survivor clinics in Liberia, Sierra Leone, and Guinea, providing a comprehensive care package, including medical and psychosocial care and protection against stigma.
"Throughout the epidemic, I witnessed how communities were ripped apart," said Hilde de Clerck, an MSF epidemiologist who worked in Liberia, Guinea, and Sierra Leone. "Initially, the response from the global health community was really paralyzed by fear. It was a horrible experience being left on our own and constantly running behind the wave of the epidemic. But it was very empowering to see how extremely dedicated all the national staff were, and fortunately other international actors eventually got involved. For the next epidemic, the world should stand ready to intervene much faster and more efficiently."
MSF responded to the Ebola epidemic in the three worst affected countries—Guinea, Sierra Leone and Liberia—and also responded to cases in Nigeria, Senegal, and Mali, as well as a separate epidemic in Democratic Republic of Congo in 2014. In total, the organization has spent over 96 million euros on tackling the epidemic. Already-weak public health systems have been seriously damaged by the epidemic, so MSF has also decided to invest efforts in their recovery. New projects on maternal and child health should open soon in different towns of Sierra Leone (Kabala, Magburaka, Kenema), and a new pediatric hospital has already opened in Monrovia (Liberia). MSF continues to run an HIV project in Conakry, Guinea, in collaboration with health authorities.