Sierra Leone and Liberia have made remarkable recoveries since their civil wars. Ban Ki Moon was in Freetown this month to bring an end to the UN Security mission and set the UN presence on a conventional development footing from 1st April 2014. In Liberia there has been a gradual drawdown of the peacekeeping mission which will approximately halve the UN military presence by 2015. However both countries remain fragile with high unemployment and concerns about corruption. The devastating Ebola outbreak in Sierra Leone and Liberia demonstrates the dangers of ignoring the least developed countries in the world. The weak state of the health system in both countries has greatly reduced the effectiveness of the response to Ebola. There is an alarming lack of capacity in the health system, including a shortage of skilled clinicians.The Committee have determined that the scale of the Ebola crisis now unfolding in Sierra Leone and Liberia, may well be connected to declining levels of international support for health system improvements in what remain two of the poorest and least developed countries in the world.

Government response to (HC 247, session 2014-15, ISBN 9780215078209)

Almost ten years on from the official end of wars in Sierra Leone (2002) and Liberia (2003), attention is shifting from post-war peacebuilding to longer-term development. What headway has been made? What challenges lie ahead? And what lessons that can be learnt? This issue of Accord draws on experiences and perspectives from across societies in both countries to explore comparative lessons and examine progress, and argues that peacebuilding policy and practice needs to concentrate more on people: on repairing and building relationships among communities, and between communities and the state; and on developing more participatory politics and society that includes marginalised groups. It suggests that customary practices and mechanisms can help deliver essential services across a range sectors, and that local civil society can facilitate national and international policy engagement with them.

This synthesis report is based on three national studies on the evolution of the Ebola epidemic and its impact on Guinea, Liberia and Sierra Leone. Using computable general equilibrium (CGE) models, this report provides a more comprehensive assessment of the socio-economic impact of the epidemic and offers a more solid base to plan for recovery and medium term development efforts. The epidemic is disrupting the development progress achieved since the restoration of peace and democracy in the three most-affected countries. As of 10 December, almost 18,000 people had been infected and more than 6,400 had already died. Health services in Guinea, Liberia and Sierra Leone were not well equipped to fight the disease and the crisis is now completely outstripping their ability to stem its spread. Some specific features in the three countries have made Ebola particularly difficult to control. Lack of medical personnel and beds in Ebola Treatment Units, the complexity of identifying active cases and contacts, and the slowness of the response have all contributed to the seriousness of this health crisis. Finally, in the midst of the crisis, we must not lose sight of these countries' desperate need to re-set development, but on a more sustainable path. Evidence from this study shows that an increase in quality spending in health and development projects is a critical path to recovery. Governments and donors are understandably eager to devote as many resources as possible to containing the epidemic. But attention must still be given to how these economies can best recover and again achieve improvements in human welfare, once the disease has been contained.

The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.