After Ebola

Author:Amanda Glassman

African countries have made some progress in improving health systems, but holes remain


After Ebola Finance & Development, June 2016, Vol. 53, No. 2

Amanda Glassman

African countries have made some progress in improving health systems, but holes remain

Nearly two years after the peak of the Ebola outbreak, affected countries in Africa have made some progress in improving their health systems, and a continent-wide agency designed to prevent, detect, and fight disease outbreaks has been established.

But whether donor funds pledged to combat Ebola have materialized and—if so—how they have been spent is unclear. The affected countries in west Africa will have to keep the pressure on donors to deliver on promises and make a concerted effort to document and evaluate the impact of health systems spending.

The lack of spending accountability and of concrete results in the public domain raise persistent questions regarding the international community’s ability to respond effectively to large-scale outbreaks.

Progress on health systemsRecent Ebola flare-ups in west Africa were quickly identified, and contacts were traced and safely contained. The response to these latest flare-ups demonstrates increased capacity of the region’s health systems. Recent investments in rapid response teams, surveillance, lab diagnostics, risk communication, infection prevention and control measures, and other programs seem to be paying off.

Other routine health system functions are also improving. In Sierra Leone, for example, a mid-2015 measles and polio vaccination campaign reached almost all children under the age of five who had missed out during the Ebola outbreak.

Another bright spot is the creation in 2015 of the African Centres for Disease Control and Prevention (African CDC) with $6.9 million in funding from the African Union Commission and technical support from the U.S. Centers for Disease Control. The African CDC is set to coordinate research throughout Africa on the biggest public health threats, gathering data and reinforcing countries’ capacity to prevent and respond to outbreaks. However, initial funding and staffing is minimal, and leadership has not yet been named.

Still, huge risks remain. At the peak of the outbreak, surveys conducted in Guinea, Liberia, and Sierra Leone found that the number of people seeking health care had dropped by half. Analysts estimate that this forgone care likely resulted in increased mortality from other prevalent infectious diseases, such as malaria, tuberculosis, and HIV/AIDS (Parpia and others, 2016). The...

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