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Ebola: UN envoy likens final phase of response to ‘looking for needles in haystacks’

A team of lab technicians handle a sample for Ebola testing in a Laboratory in Sinje, Grand Cape Mount, Liberia.
UNMEER/Martine Perret
A team of lab technicians handle a sample for Ebola testing in a Laboratory in Sinje, Grand Cape Mount, Liberia.

Ebola: UN envoy likens final phase of response to ‘looking for needles in haystacks’

The Secretary-General’s Special Envoy on Ebola, Dr. David Nabarro, told the United Nations General Assembly today that the final phase of “getting to zero” cases may well be the hardest, saying the hunt to track down the virus is “like looking for needles in haystacks.”

Dr. Nabarro told reports that having strong surveillance capabilities on the ground to identify people with Ebola, to confirm diagnosis, to quickly arrangement arrange effective treatment, to identify people that are their contacts and to keep those people under review for 21 days “is a really difficult task,” especially as these tasks must be coordinated through 63 different government structures in an area the size of France.

The message by senior UN officials briefing an informal meeting of the General Assembly at UN Headquarters on the public health crisis emanating from the Ebola virus outbreak was two-fold: the need for resources to immediate response to the disease that has affected some 23,000 people with 9,300 deaths, as well as the need to begin planning for revival and recovery.

“Today, we face a critical turning point,” Secretary-General Ban Ki-moon said in his remarks. “The pattern of the Ebola outbreak has changed. 2015 has seen a significant decline in the number of new Ebola cases in the three affected countries.”

He appealed to the Assembly: “Let us provide the resources needed to get to zero” the number of Ebola cases in the current outbreak.

“We are accelerating our work to reach the targets set by the Presidents of the Mano River Union on 15 February – zero cases in 60 days, by mid-April,” Mr. Ban said.

The UN chief also said that “much important work lies ahead until the affected countries reach zero cases and begin the transition to reconstruction and recovery.”

“I call on all responders to redouble their efforts, and on donors to stay the course,’ he said.

Looking ahead, the Secretary-General said: “Let us ensure that reconstruction and recovery can occur without delay.”

In his remarks, Assembly President Sam Kutesa said that while the international community should feel heartened by the progress that has been made against the virus in the most affected countries – Guinea, Sierra Leone and Liberia – “we cannot yet claim triumph over Ebola.” With the rainy season quickly approaching, efforts must be redoubled in order to ensure a final, successful push for eliminating this epidemic but also, begin to direct attention to the region’s long-term recovery effort.

“The most-affected countries still face serious challenges, particularly with regard to their long-term social-economic recovery. The devastating impact of the Ebola outbreak could seriously compromise their sustainable development efforts,” he continued.

To that end, the Assembly President announced that a high-level international conference on Ebola on 3rd March in Brussels, Belgium, is being organized to focus on the long-term needs of the region.

The members of the Assembly also heard a briefing from the field by Ismail Ould Cheikh Ahmed, the Special Representative and Head of the UN Mission for Ebola Emergency Response (UNMEER).

Speaking via video-link from the Lberian capital, Monrovia, he said that since his briefing to delegates last month, latest developments have led him to believe that the worst of the Ebola outbreak is over. In Liberia, for example, progress has been ‘particularly remarkable’ from several hundred new cases a week several months ago, to about five cases per week for several weeks now. In lieu of this, UNMEER resources and personnel will be deployed to boost progress in Sierra Leone and Guinea.

While recognizing progress made in tackling the virus, ‘we cannot sit on our laurels,’ Mr. Ould Cheikh Ahmed said, warning of the region’s impending rainy season and challenges that may lead to an increase of prevalence of other diseases such as malaria. This can mask suspected cases of Ebola. And road closures due to heavy rain may significantly affect the capacity to access affected Ebola communities. Hence, controlling the epidemic in the next 12 weeks is critical.

UNMEER is redoubling efforts to ensure an intervention in each district and detect new Ebola cases as early as possible. Over the long term, this method can also strengthen health systems in affected countries. Mr. Ould Cheikh Ahmed underscored the role of community engagement in reducing case load and further preventing outbreaks. “If we step up our efforts to mobilize communities through more local approach, we can probably win over the communities, facilitate access, and build resilience.”

Recalling a recent four-day mission to Guinea, the UNMEER chief emphasized the need for major search efforts in communities and support from international partners. The scattering of cases makes it necessary for all districts to be equipped with the vital surveillance tools and sufficient geographic coverage. There are still challenges in accessing hard-to-reach areas.

In the same vein, UNMEER has begun planning for the transition phase when national governments will no longer need its support. This shift must be seamless and tailored to each country and even district. “It is critical to transfer operations carefully through a planned and coordinated transition to consolidate the gains we’ve made and leave no voids behind,” Mr Ould Cheikh Ahmed emphasized.

As UNMEER scales down its operations, UN agencies, funds and programmes will scale up efforts to reach zero Ebola cases and to re-establish essential services and infrastructure. Efforts are already underway to support the safe reopening of health services as well as schools and universities.

“UNMEER’s relevance is in making ourselves irrelevant. As soon as we work ourselves out of a job, the better for the people of West Africa,” the UNMEER chief added.

Meanwhile in Guinea, 58 people have reportedly been convicted over an attack on Ebola workers in January 2015, according to UNMEER. Charges included assault and battery of several government workers and medical staff, destruction of public buildings, public insults or threats, and rebellion. UNMEER reported that community resistance remains widespread particularly in 10 prefectures in Guinea.

On funding, Dr. Nabarro said the UN system and other partners require additional finance to support the work of national governments as they strive to “get to zero” cases. If this intensive effort is to be sustained through 2015, he said, the total cost will be around $1.5 billion and the total funds available at this time are only around $600 million.

One valuable mechanism for financing the response is through the Secretary-General’s Trust Fund, Dr. Nabarro said. So far, since it was set up in September 2014, it has received income from 32 donors and distributed $131 million in strategic support for the response.

Dr. Nabarro announced that this week, the UN will publish a first report of what has been done with all funds contributed and spent to date. “More than 90 per cent of the contributed funds have been distributed,” he said.

Also today, Helen Clark, Administrator of the UN Development Programme (UNDP) is winding up her visit today to the three worst affected countries in West Africa, which focused on Ebola-related recovery efforts.