On 10th November 2015, Annie Wilkinson, IDS Post-Doctoral Researcher and member of the IDS Future Health Systems team gave evidence to the International Development Select Committee inquiry into what DFID and the international community is doing to improve the international response for future disease outbreaks following the Ebola outbreak in West Africa.
Annie, who has been working in Sierra Leone since 2009 on Lassa fever and also works on the DFID and Wellcome Trust funded Ebola Anthropology Response Platform, was in the country, including the eastern Kenema district, on a number of occasions during the Ebola outbreak. When asked about the reasons for the delay in the international response to the Ebola outbreak, she said communication was a major challenge. There was “…a big communication gap with Freetown and also between the country and regional offices of Government agencies and NGOs, and headquarters back in Geneva or London”. Part of the reason for this gap was because “…it goes against the interests of nations and sometimes particular people or political parties to admit things are out of control, so there are communication problems and there is also a vested interest in saying that things are fine. We saw a lot of denial of the scale of the problem and that was damaging”.
Another important dimension that impacted on the effectiveness of the Ebola response was the delay in community engagement. Even after the response started in earnest, local concerns were not addressed in a sensitive and flexible way. Annie argued that this was damaging, as it “…prevented meaningful and early engagement of local institutions and organisations, which could have made a more positive effort to the control by helping to develop more locally appropriate control measures”. Annie suggested that future “epidemic responses should be designed to be inclusive, flexible and adaptive from the start”, and that more fundamentally, DFID and other international actors should work in partnership with Sierra Leone and other countries to support sustained long-term efforts to address the underlying causes of such epidemics, including entrenched inequality and the mistrust of institutions.
Read the oral evidence or listen to the discussion in the audio file below.