The solution to prevent ebola and other disease is simple. It’s just not easy.
Over the holidays, I read this Washington Post article looking at how some in the public health field are accusing the International Monetary Fund (IMF) for creating the ebola crisis. Blaming the IMF or the countries, or the donors of the Ebola epidemic does not help to get everyone to contribute to implementing the solution. Yes, the IMF has austerity policies, and yes, the health systems in the affected countries are weak and the infrastructure is also weak. We all knew that even before Ebola. There are no surprises here, except that some cases left the African countries and reached America and other countries. This epidemic was no surprise because the affected African countries have several epidemics and endemic conditions with high maternal and child mortality rates. In fact, preventable and treatable conditions kill more women and children every year than Ebola has killed. All this epidemic did was to give a scary reminder sign that the health systems cannot cope with providing up to standard maternal health care, or prevent measles and malaria, and treat pneumonia and infant diarrhea, and also Ebola. It is easy to imagine what would happen when a disease with high rate of fatalities strikes. It is not that health experts don’t understand the problem or do not know the solution to all the epidemics and endemic conditions in West Africa. We do. In fact, It is simple. It is not easy, though, because it means everyone involved has to change how they work.
Here is the solution: With the epidemic winding down, it is time for all the governments to call in all the donors, foreign assistance organizations and NGOs involved in the epidemic to develop and implement a strengthening strategy of the health systems in the three affected countries making the best of all the existing resources that have been poured in through numerous organizations along with the resources the countries have. Here are steps to follow:
1. Donors that built facilities to treat Ebola cases must develop a plan to effectively and efficiently work with local health providers side by side and prepare for a smooth handover in a 18 to 24 months. It is not right to leave facilities after the emergency and the humanitarian assistance is over without having transferred the expertise to run the facilities and maintain them to the recipient countries;
2. Donors and foreign assistance organizations also need to work with the countries to help them develop a realistic budget that includes the management of these facilities and the upgrading of at least 10% of the countries’ facilities up to international standards each year. In this way, in 10 years, all facilities will be ready to meet any epidemic as well as respond to the health needs of the populations. It is not OK to bring resources to fight Ebola and then withdraw them without a responsible phase out strategy. The lack of which causes deaths to rise after the donor leaves;
3. Donors, NGOS and all involved in training need to transfer all training programs they have taught to the countries’ medical and nursing schools to ensure that future generations of health professionals are prepared to detect and control epidemics;
4. Donors, the World Health Organization (WHO), and foreign assistance organizations need to help the countries strengthen their health surveillance system up to international standards to ensure that the countries finally have the capacity to monitor the status of health of their people, and;
5. The countries’ leadership must be supported and respected. No more parallel systems, no more duplication and lack of coordination. The local MOH staff , usually very short-staffed, must be supported with experts that help them do their job better and account for the progress of the health system strengthening strategies.
The media must continue following the progress and reporting on whether all involved actually followed through and do not fall short of their good intentions. Please do not stop reporting after the excitement over Ebola is replaced by other emergency.
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