Mr. Nyenswah shared his experiences helping mobilize Liberia’s response, noting that it was critical to gain the trust of the population in the preventative measures taken by the government to reduce the epidemic’s spread. These included the establishment of community care centers to reduce secondary infections and less culturally familiar measures, such as cremation. Dr. Peters showed a graph that chronologically mapped the reproduction number of the Ebola virus vs. interventions taken. In contrast to the common argument that Ebola was curtailed by the construction of new hospital beds, Peters’ graph showed that a decrease in the reproduction number was correlated with not just new hospital beds, but also with other important interventions like hygiene and community engagement. Ms. Moskov spoke about USAID’s larger role in responding to Ebola at the global level, and described the four-pillar approach taken by USAID:
- Control outbreaks;
- Mitigate second-order impacts;
- Establish coherent leadership and operations;
- Work towards global health security.
Rob Hecht provided a capstone to the discussion by linking the Ebola response to other global efforts in sustainable financing and donor transition, e.g. for HIV/AIDS and immunization. He outlined five key pillars of a successful transition:
- External partners and donors should get involved quickly when necessary, and then reduce their involvement in a way that maximizes the chances for successful domestic ownership of programs.
- The transition from vertical to horizontal programs should be conducted in a manner that maximizes health outcomes and financial sustainability.
- Relationships between local and external actors (e.g. governments and donors respectively) should be codified in agreements and compacts, and well-understood by both parties.
- It is important to clarify the role of the public sector and NGOs.
- It is key to understand the relationship between the public sector on supply side and community responders on the demand side.
