The Ebola outbreak in West Africa is over. More than 42 days passed since the last case in Liberia, marking the end of the outbreak that killed more than 11,000 people. The World Health Organization made the official announcement today, but it was accompanied by warnings that cases may emerge in the region and the wider lessons learned must be put into action to prevent another health crisis of this magnitude.
“We are now at a critical period in the Ebola epidemic as we move from managing cases and patients to managing the residual risk of new infections,” said Dr. Bruce Aylward, the World Health Organization’s (WHO) special representative for the Ebola response, in the announcement. “The risk of re-introduction of infection is diminishing as the virus gradually clears from the survivor population, but we still anticipate more flare-ups and must be prepared for them. A massive effort is under way to ensure robust prevention, surveillance and response capacity across all three countries by the end of March.”
What began as an infection of a child in Guéckédou, Guinea, became a deadly outbreak that infected more than 28,000 people. It spread across Guinea and into Sierra Leone and Liberia. Single cases were discovered in the U.S. and Nigeria, leading to global concerns that the outbreak could spread beyond West Africa. Doctors Without Borders was among the first international groups that responded to the outbreak. Both they and Samaritan’s Purse increased their operations and made vocal calls for more support. Unfortunately, governments and the U.N. were slow to meet the need at the moment when the spread of the virus was spiraling out of control.
“Throughout the epidemic, I witnessed how communities were ripped apart,” Hilde de Clerck, a Doctors Without Borders epidemiologist who worked in Liberia, Guinea and Sierra Leone, said in a news release. “Initially, the response from the global health community was really paralyzed by fear. It was a horrible experience being left on our own and constantly running behind the wave of the epidemic. But it was very empowering to see how extremely dedicated all the national staff were, and fortunately other international actors eventually got involved. For the next epidemic, the world should stand ready to intervene much faster and more efficiently.”
Reviews of what happened during the outbreak exposed the major problems of the health systems in all three countries, as well as the shortcomings of the international community. The WHO came under some of the most intense criticism for its handling of the crisis from the onset. A road map outlined by an independent group of global health experts focused heavily on the reforms that the WHO needs to undertake in order to better prepare it for the next global health crisis.
And while celebrations are taking place across the world now that the outbreak is over, concerns remain that new cases could emerge. Liberia was declared Ebola-free just a few months ago, before a flare-up reset the clock. There have been 10 such flare-ups at the end of the outbreak, due largely to the persistence of the virus in survivors. It is likely more cases will be found and the rhetoric from leaders indicates that precautions are being taken to ensure the virus does not spread.
With the outbreak behind the countries, they all must now look to the long road of recovery. The outbreak cost roughly $2.2 billion to the economies of the three countries, according to estimates from the World Bank.
“Ebola has exacted an enormous toll on Guinea, Liberia and Sierra Leone. It has not only taken thousands of lives, it has devastated economies, health systems, social structures and families—reversing many years of development gains,” Jim Kim, head of the World Bank, said in a news release. “Ebola’s scars will not soon fade, especially for survivors and their families, and for the heroic health workers who cared for the infected.”
Efforts will now focus on ways to recover the economic losses and build up the woeful health systems that struggled to manage the crisis. The heroic response by health workers and volunteers in the countries showed the resilience inherent in the region. Getting back to normal life will not be easy, particularly for the 17,000 Ebola survivors who face health problems from the Ebola and social stigma.
“Today is a day of celebration and relief that this outbreak is finally over,” Joanne Liu, president of Doctors Without Borders, said in a news release. “We must all learn from this experience to improve how we respond to future epidemics and to neglected diseases. This Ebola response was not limited by lack of international means but by a lack of political will to rapidly deploy assistance to help communities. The needs of patients and affected communities must remain at the heart of any response and outweigh political interests.”