I was working for UNDP Liberia when Ebola struck in March 2014. I witnessed the fight to the last case and helped support the national response, all through April 2015 when the epidemic was eradicated, leaving over 4,000 victims in its wake.
Ebola was a complex epidemic which didn’t quite fit into the conventional coordination and response mechanisms of the international community. As a large-scale health emergency, it was too wide in scope and too urgent for a standard development response, yet it was also too sharply focused and technical for a typical humanitarian response.
Another complicating factor was that Ebola affected 3 countries (Liberia, Guinea and Sierra Leone), so designing a clear UN and UNDP engagement strategy that encompassed both the overall response and very distinct needs and approaches at the national and sub-national levels was particularly challenging. The response also had to look beyond the medical and public health issues to encompass poverty, distrust, cross-border dynamics, capacity deficits and overall governance failure.
But, if the massive international response and national coordination mechanisms played a major role in curbing the epidemic in Liberia, the turning point became evident when communities began to internalize that the very foundations of their existence were at stake. And this is how UNDP stepped in, realizing as it did, that communities have to be involved in choosing the solutions that will work for them. They have simply to be at the forefront of responding, and no control measures, including lockdowns, can work without the consent of the people affected.
To engage communities and get the message across, UNDP mobilized over 5,000 youth, deploying an “army” of volunteers to find active case, trace contacts and provide psycho-social support, including helping survivors fight stigma.
The door-to-door campaign was a resounding success, and the young volunteers were celebrated for their courage, resilience and dedication, which not only helped curb the spread of the disease, but also instilled a sense of national pride, accomplishment and unity amongst Liberians.
The rest is history.
From an epidemic to a pandemic
Fast forward to COVID-19. I am now assigned to UNDP in Ethiopia. The country has designed a multi-sectoral response plan with robust mechanisms and structures and is currently hard at work to slow down the spread of the virus. This is all familiar as are the usual challenges of coordination, prioritization, resources and speed.
Of the many lessons learnt from fighting Ebola which are relevant as we confront COVID-19, five stand out:
- weak health systems cannot withstand a runaway virus;
- a high degree of vigilance and a readiness to treat the first (index) case can make a big difference;
- no single intervention is, by itself, sufficiently powerful to bring an Ebola-type epidemic under control;
- community engagement is the foundation of success for all other measures. Most importantly, we learned that fundamental changes in how people behave – whether in relation to public health, law and order enforcement, or other forms of restrictions – can be influenced when communities as a whole have incentives to change and access to trustworthy information.
- UNDP is a vital partner for countries tackling these pandemics, but its presence in over 170 countries and territories means that it is also an employer of thousands of people to whom it has a sacred duty of care. This ranges from ensuring job security at the most insecure of times, to having a robust and flexible contingency plan that can foresee a number of complex scenarios so that its staff continue to be active contributors to the pandemic response.
The power of consistent messaging
The Ebola crisis showed the power of sustained, informed, and cohesive messaging. All COVID-19 responders, including the UN, should review the impact of their advocacy, educational and awareness-raising initiatives, which unfortunately can sometimes lead to unwelcome behaviour. On April 17th , when Ethiopia was well into its awareness creation campaign, Ethiopia’s Minister of Health warned against the stigmatisation of healthcare professionals, hospital staff, people who have undergone quarantine as well as those who have recovered from COVID19. “Physical distancing doesn’t mean we don’t offer kindness. We must continue to support our frontline workers and citizens who recovered,” Dr Lia Tadesse tweeted.
Looking back in hindsight, a number of success factors stand out in our approach to tackling Ebola that we can exploit in our COVID19 response:
- Speed - mobilizing the system, determining UN or UNDP’s role and a key narrative, freeing up programme resources, empowering and fielding staff – these all need to be done quickly and firmly.
- Leadership, including criticality assessments to reallocate country programme resources.
- Expertise - for UNDP, being ready for what it can do best: impact assessment, analysis, stakeholder engagement, innovation, and advocacy for the linkages between the immediate response and development leading the UN system in planning for recovery.
- Country-ownership- above all, ensuring that the response remains country-led and that the UN’s approach is aligned with the government’s.
As we forge ahead with fighting COVID-19, the memories of the fight against Ebola are fresh and give me a sense of hope for a successful fight against this dreaded virus.
#Stay safe, #stay healthy, #stay at home
Note: The author is Deputy Resident Representative/Programme, UNDP Ethiopia. Prior to joining Ethiopia, he worked in Liberia for many years including during the period of Ebola