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What the West Can Learn From Africa’s Ebola Response
A poor country succeeded in fighting off Ebola. Wealthier countries should replicate Liberia’s strategy in combating the coronavirus.
Exactly six years ago, in mid-March 2014, Liberians woke up to texts, calls, and screenshots that all suggested the same thing: Trouble was coming. It wasn’t the sort of trouble we were used to—namely, war—but it was the kind of trouble that could be spread through the simplest of affectionate gestures or through the dutiful expression of one’s faith. No one had yet heard of the thousands of people who had died of unknown causes in Gueckedou, Guinea, just a few hours east of Liberia’s border town of Foya. And no one knew that the virus causing these deaths had spread rapidly across Guinea in the months before.
What we did know on that morning was that samples sent two months before to Lyon, France, had finally yielded results. It was the Ebola virus disease. The more than 60 percent of Liberia’s population under the age of 35 hardly remembered the Ebola outbreak in the Democratic Republic of the Congo in the mid-1990s. Even if they had been born then, they would have been busy dodging bullets.
Panic peaked that morning. A woman said to be carrying the virus had crossed the Guinean border into Liberia’s Foya district. She was making a beeline for Kakata, an hour’s drive outside of Monrovia, and the authorities were hard-pressed to intercept her. That panic dissipated as life went on. Weeks went by without news. Those in Monrovia—nearly a third of the country’s population—and those in neighboring cities saw no cause for alarm. They thought it was a hoax. Among such a youthful, optimistic, and largely undereducated population, one case of Ebola can become ten thousand.
Those first days of the 2014 Ebola outbreak and Liberia’s response from that point on can offer important lessons to European and North American governments in light of the World Health Organization’s announcement that the new coronavirus is now a pandemic—and the evidence in rising caseloads from Madrid to London to New York. The Liberian government’s reaction to the crisis and the approach we took in Liberia could serve as a model for how Western countries, many of which are underprepared for a crisis of this magnitude, can respond.
[Mapping the Coronavirus Outbreak: Get daily updates on the pandemic and learn how it’s affecting countries around the world.]
First and foremost, leaders must communicate with citizens effectively. The success of the response in Liberia, a deeply religious country, hinged on our ability to resolve a confrontation between faith and science that was extremely fraught. People had flocked for refuge to their places of prayer and come out infected. Our Islamic communities had been hit hardest: Ebola had spread through the performance of burial rites for the dead, which mandate washing the body and burying it within 24 hours—a pillar of Islam. As a government, we stood no chance of addressing the crisis if we could not engage effectively with the Inter-Religious Council of Liberia and its diverse interfaith clerical figures to make the case for caution.
But educating the public in general was just as vital. Our communication had to be forceful but engaging to our young population. Then-President Ellen Johnson Sirleaf’s administration, with our development partners, engaged pop stars to compose jingles and songs. “Ebola Is Real” and other songs became some of the most-played songs on the radio. Vietnam and other countries have already effectively adopted this method in response to the coronavirus outbreak.
But the truth itself is the easiest thing around which to craft a unified message from any government to any public—especially in a crisis. Not only does it limit confusion, but it also facilitates the pooling of human and other resources to contain the epidemic and prevent its resurgence. Telling the truth is especially important because, when lives are at stake, misinformation is sure to spread.
In a political and economic context in which a large section of the public distrusts their government because of real or perceived failures, the onset of a crisis renders those anxieties more acute. Pretending we had the whole situation under control and could do it all ourselves would not have instilled calm in Liberia. We had to ask for help. And, when we did, the world answered.
Sirleaf swallowed the nation’s pride. She published an op-ed asking for the world’s assistance to fight Ebola, beseeching global leaders to come together to address the crisis. And help flooded in—from the United States, from Europe, from Asia, from Latin America. And, of course, our fellow Africans did not fail us. Sirleaf led daily meetings and ensured that her government spoke with one voice. There was no confusion and no contradictions.
That unity of command made it easier for me, as minister of finance, to move a core team from my office to work daily from the Ministry of Health. We ensured that the health ministry had the resources it needed, in record time, to function in emergency mode.
But that was not enough. Liberians are vivacious, enterprising, and fun-loving people—and that made it incredibly difficult to contain Ebola’s spread. By July 2014, the economy had ground to a screeching halt, our neighbor Ivory Coast had closed its border, and the major airlines had suspended all flights indefinitely. And yet Liberians still gathered for big events and packed nightclubs. We knew we had to impose a curfew.
To begin, the government imposed a 9 p.m. to 6 a.m. restriction, which curbed evening movements. Then we had to clear daytime traffic. We cleared the offices of the country’s largest employer, the government, by allowing only essential staff to return to work. Our municipalities took a hit to major sources of revenue when we prohibited the rental of public venues for events.
The country’s bustling lifestyle flatlined. Open-air marketplaces emptied. The usually lively, sunny Christmas season was as dead as it had been since the end of the Liberian civil war. But a dead Christmas season was preferable to dead Liberians. This was the cost of saving lives. China has already heeded this lesson to reduce its coronavirus crisis, and countries such as South Korea and Italy have imposed similarly draconian—but essential—measures in the past few weeks.
The unfortunate fact is that even in circumstances like these, many people keep travel promises to their children, check off their bucket-list commitments, or simply go about their daily lives wearing recklessness as a badge of courage. Some dismiss the possibility of their infection on the grounds that the echelons of power and class in which they move are impervious to such scourges. The spread of the coronavirus at the Conservative Political Action Conference last month debunked that theory, sending a U.S. senator into self-isolation. Since then, Canada’s prime minister has done the same after his wife tested positive, and an Australian cabinet official has been hospitalized with coronavirus.
In times like these, Murphy’s Law gleefully asserts itself. While a rapidly spreading virus feasts on an insufficiently vigilant populace, an economic crisis looms. The only question is this: What will hurt us first, the economic crisis or the pandemic?
For Liberia, it was economic. The global prices of rubber and iron ore, our major exports, sunk to lows in 2014 from which they have yet to recover. The loss of revenue from these sources put heavy strain on our growth and development projections. Then came Ebola to sink the economy altogether, sending all foreign direct investors fleeing with their capital and invoking force majeure clauses as they abandoned their commercial pursuits.
The global economy today faces a challenge in the reverse order. But it is no less devastating, if not for whole countries then for working-class citizens who do things like drive buses, load cargo, and take care of toddlers; they lack the luxury of working from home. Layoffs have already begun in the sectors hardest-hit by the coronavirus, and the fall in oil prices has only made matters worse.
At Liberia’s Ministry of Finance, we rode two elephants with one foot on each back. We mobilized domestic and external resources for the fight in front of us, while crafting and communicating ambitious plans for the recovery. We began developing a post-Ebola recovery plan midcrisis. As a result of that forward planning, we raised funding for economic recovery not only in Liberia, but also in the other affected countries such as Guinea and Sierra Leone. At a time when some had little faith in the international system, it was refreshing to find that the multilateral institutions led by the World Bank, IMF, and African Development Bank were very useful; they delivered.
In spite of this, we and our neighbors struggled throughout the crisis to communicate effectively. Something as simple as a phone call from one health minister to another was a difficult experience in 2014, before the transmission and distribution of fiber-optic cable in Monrovia.
This problem is now replicating itself in advanced countries, where technology breaks down barriers. Geopolitical tensions need not hinder communication among trade partners on matters of mutual interest, such as the prevention of a looming pandemic. And adversaries should band together to combat this virus.
The loss of innocent lives is currently lower than the annual mortality rate of influenza, a comparison often misguidedly invoked to trivialize the coronavirus. But, unlike influenza, the coronavirus has a higher mortality rate and no treatment or vaccine. Thousands of deaths are too high a price for a failure to engage due to political rivalry.
WHO Director-General Tedros Adhanom Ghebreyesus has taken pains to distinguish between the countries that have failed to contain the virus due to a lack of political will rather than a lack of resources. The West was Liberia’s first port of call when dealing with a disease far deadlier than this one, and we overcame that outbreak through the resilience of the Liberian people, an abundance of medical equipment, and the financial and human resources that our partners provided.
Much wealthier nations, confronted with a pandemic, must not spare any such effort in defense of their own people. They should build partnerships and deploy both their resources and political will to end this pandemic.