Liberian President Sirleaf: Ebola crisis fueled by weak health systems

Liberian President Ellen Johnson Sirleaf speaks at event celebrating Seattle-based Center for Infectious Disease Research. Credit: Keith Walters

The acclaimed women’s rights advocate, Nobel Peace Prize laureate and Liberian President Ellen Johnson Sirleaf says the massive Ebola outbreak in West Africa can be blamed, in part, on the international community’s tendency to react to crises rather than invest proactively in basic prevention – and to a failure to listen.

“This disease exposed our weak health systems, no doubt,” said Sirleaf, who was interviewed prior to her taking the stage for the keynote speech Saturday evening at a big fund-raising gala held here by the Center for Infectious Disease Research (aka CIDR, formerly Seattle Biomed).

But one reason many lower-income countries like Liberia have weak health systems, she said, is because donors and international development agencies have historically tended to offer help based mostly on their own priorities and agendas.

“We don’t want someone coming in to build a hospital or a clinic way out in some rural area where we have no infrastructure to deal with or provide access,” Sirleaf said. The developing world is littered with empty schools and clinics thanks to such well-intended but misguided initiatives. “We need basic things like primary care … We need our international partners to help us build our health delivery systems.”

Tolbert Nyenswah

Tolbert Nyenswah

“I don’t think the international community has learned (that lesson) yet,” said Tolbert Nyenswah, deputy minister of health for Liberia and the man who led the country’s somewhat more-successful effort to combat the Ebola outbreak in West Africa. Nyenswah accompanied Sirleaf on the Seattle area visit.

The Ebola outbreak killed about 4,800 Liberians, sickening many thousands more. It has largely been contained in the region, though sporadic cases are still being identified in Sierra Leone and Guinea.

Many know that the Ebola crisis devastated Liberia’s ability to provide health care, Nyenswah said, killing health workers, shutting down services and clinics, leaving pregnant women no place to give birth, halting childhood vaccinations and causing malaria deaths to increase, among other things.

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But what many still don’t seem to recognize, he said, is that Liberia didn’t have much of a functioning healthcare system prior to the invasion of this deadly virus. And this is partly due to the West’s approach to global health.

“The virus overran the (health) system because it wasn’t there,” said Nyenswah, noting that Liberia had to deal with this outbreak without a single public health laboratory – a fundamental tool needed to identify and track the spread of disease anywhere – despite years of international aid and Western-funded global health initiatives. “We need to build health systems holistically. I don’t see that happening yet, not really.”

Sirleaf, speaking at CIDR’s Gala for Global Health event at the Bellevue Hyatt Regency, specifically praised the $100 million donation made during the crisis by Microsoft co-founder and billionaire philanthropist Paul Allen to help fund some of the basic system needs such as improved laboratory facilities, training health workers, building up emergency management systems and isolation units. Allen, who made the largest private donation to assist with the Ebola response, was honored at the event as well.

Paul Allen, with help from Seahawks defensive end Michael Bennett, receives Champion for Global Health award at CIDR event. Keith Walters

Paul Allen, with help from Seahawks defensive end Michael Bennett, receives Champion for Global Health award at CIDR event. Keith Walters

“Paul Allen’s contribution was timely and incredibly helpful,” said Sirleaf. She added that CIDR’s mission of pursuing basic research aimed at finding better drugs, vaccines and diagnostic tools against the biggest killers in Liberia – HIV, TB and malaria – is an essential element of building up the basics.

“HIV, TB and malaria kill every day the same number of people who died from this Ebola outbreak,” said Alan Aderem, president and director of CIDR. This is not to diminish the tragedy of the Ebola outbreak – the world’s largest so far killing more than 11,000 since December 2013 – Aderem said. It is to put the tragedy in context.

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The Seattle-based research center, the largest such institute in the U.S. devoted solely to infectious disease, is a leader in the search for effective vaccines, drugs and diagnostics for HIV, TB and malaria.

As a former anti-apartheid activist in South Africa, Aderem agreed with Sirleaf and Nyenswah that our efforts to fight diseases of poverty in the developing world need to be more proactive, comprehensive and done within the broader political, economic and social efforts aimed at reducing global poverty and inequity.

Alan Aderem

Alan Aderem

“One cannot look at these diseases except in the context of the geopolitcal situation,” Aderem said. “There’s a reason these diseases are endemic in resource-poor countries as opposed to wealthy countries.”

We need to continue to do the research needed to find new and better tools to fight disease, he said. Aderem added that Sirleaf was invited to come speak in Seattle because she knows through hard-won experience that none of these tools will be sufficient if we do not make progress as well in improving the basics of health care, education and, of course, women’s empowerment.

“We are now focused on rebuilding,” said Sirleaf, noting that Liberia now has only 218 physicians and about 5,200 nurses to serve 5 million people. “We ask our partnership countries who are with us in this fight to join us as we move from treatment to prevention.”

Editor’s note: Tune in later this week for the Humanosphere podcast and listen to our entire interview with Madame President Sirleaf, in which we discuss in greater depth the lessons she learned from the Ebola crisis – and why empowering girls and women is so fundamental to the fight against poverty and inequity.  

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Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.