The EU's response to help fight the Ebola outbreak in West Africa

Met dank overgenomen van , gepubliceerd op woensdag 15 oktober 2014.

Brussels, 15 October 2014

What is the situation on the ground?

The current Ebola outbreak is affecting the West Africa region: Liberia, Sierra Leone and Guinea. Nigeria and Senegal had reported imported cases but their initial outbreaks have been contained , and there have been no new cases in the past few weeks. It is the worst outbreak ever of the epidemic. The World Health Organisation (WHO) has declared it a Public Health Emergency of International Concern, calling for a coordinated international response. The United Nations Security Council declared it a "threat to international peace and security" in its Resolution number 2177 and created the UN Mission for Ebola Emergency (UNMEER) which is starting to be deployed in the affected countries.

Up to 10 October, there have been more than 8399 reported cases, including 4033 deaths from the disease, according to the WHO.

Cases of Ebola from a different strain to the current ongoing epidemic in West Africa have also been reported in the Democratic Republic of Congo (DRC). Fearing a spread to other parts of the continent, the European Commission is monitoring the situation in the country.

What are the challenges and needs?

The Ebola epidemic presents major challenges related to transport, coordination, equipment, availability of trained medical staff and behaviour of the population.

Air transport is extremely important, be it commercial air services, air ambulances, or even military airlift; it is indeed essential to maintain connections between the affected countries and the outside world to tackle the epidemic effectively, notably for the entry and free circulation of health workers, for general ingress and egress, or for medical evacuation. Commercial flight connections are equally important to keep EU diplomatic missions operational in the countries concerned.

However, the fear of spreading the disease and exacerbating the problem has led regional and global airlines to limit or even cancel their scheduled flights which means that transporting supplies and personnel is becoming increasingly challenging. Closure of borders, suspension of flights, absence of traffic rights granted for air ambulances for example, are all hampering efforts to solve the situation. Ensuring quality exit screening of air passengers coming for the affected countries is a priority.

Of course, competence in this area lies with the Member States and the role of the Commission is to encourage cooperation and better understanding of the issues at play. The Commission's services are working with NGOs, airline operators and air ambulance companies for that purpose. We note the WHO advice on the continuation of international trade and travel to the affected area.

Limited access to some areas in the affected countries also complicates the registration and isolation of patients. Lack of medical equipment to isolate patients and protect medical staff presents a further challenge. The disease has already claimed the lives of more than 120 health workers.

The immediate needs include tracing of people in contact with Ebola patients, changing behaviour to at least ensure safe burials, supplying treatment centres and equipment and also secure transport for medical staff and supplies. Additional trained medical staff is needed but this is made more difficult by the transport restrictions.

Additionally, there are large associated needs, such as social mobilisation, basic health care, and response to growing food insecurity, especially in the quarantined areas.

What is the EU doing to help?

The European Union has been active from the very early stages of the crisis and has so far pledged €180 million of humanitarian and development aid to help the countries affected by the Ebola virus (Guinea, Sierra Leone, Liberia, and Nigeria).

Diplomatic outreach is being done via the Delegations of the European Union and other channels in order to facilitate the humanitarian response in the countries concerned, to sensitize governments not to overreact to the crisis with regard to travel restrictions, trade impediments, etc.

The European External Action Service is also focused on the analysis of the current situation as well as its wider implications in order to asses and identify the requirements and actions needed to confront this major challenge for the affected countries.

Furthermore, the EEAS is conducting prudent planning with a view to deliver swiftly any additional actions which may be required to enhance the collective EU response and support the existing efforts by EU Member States.

Humanitarian assistance

The European Commission has reacted to the epidemics from the outset. It is active with humanitarian aid, expertise and international coordination.

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Funds have been provided since the earliest signs of the outbreak. As early as March the European Commission gave €1.9 million to help contain the epidemic and ensure immediate healthcare to the affected populations with additional packages of humanitarian assistance being provided on two occasions, bringing it to €11.9 million.
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On September 25 at the United Nations High Level Meeting on Responding to the Ebola Outbreak the President of the European Commission José Manuel Barroso announced an additional €30 million in humanitarian aid.

This funding provides immediate healthcare to the affected communities and helps contain the spread of the epidemic. It is used for the clinical management of cases, including the isolation of patients and their psychosocial support, the tracing of suspected cases, the training and supply of personal protective equipment, conducting communication outreach on hygiene and disease awareness, as well as providing guidance to national authorities.

On the humanitarian front, the Commission supports organisations most actively engaged in the response: WHO, Médecins Sans Frontières (MSF) and the International Federation of Red Cross and Red Crescent (IFRC).

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Furthermore, humanitarian experts have been deployed by the Commission, including specialists in hazardous diseases, to the affected region, where they are monitoring the situation and liaising with partners and the authorities. Several EMLabs - the mobile laboratories funded by the European Commission - are also operating on the ground.
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In October, the European Union set up a humanitarian air bridge to West Africa: the European Commission's Emergency Response Coordination Centre (ERCC) is facilitating the transportation of relief items to the affected countries. In addition, the EU will fund and coordinate if necessary the evacuation of international staff from Liberia, Guinea and Sierra Leone.
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The EU Civil Protection mechanism has been activated for the provision of in-kind assistance. Several Member States, including France, Austria, Belgium and the United Kingdom - have responded to the call, providing medical equipment, sanitation products and experts.

The European Commission is monitoring the situation 24/7 through the ERCC that also functions as the platform for operational planning and co-ordination of EU assistance. Through regular meetings in the ERCC, the Commission is bringing together Member States, UN and other partners, allowing for information sharing and better coordination of the international and European crises response.

Longer-term Development Assistance

The European Commission has mobilised over €137 million in development assistance for the countries currently affected by the Ebola virus in West Africa: Guinea, Sierra Leone and Liberia. This includes:

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€28 million to strengthen healthcare systems, including in the areas of healthcare provision, food security, water and sanitation through an LRRD (Linking Relief Rehabilitation and Development) approach
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€97.5 million will be spent by front loading Budget Support operations to Liberia and Sierra Leone to reinforce governments' capacity to deliver public services - in particular health care - and maintain macro-economic stability
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€5 million will be provided to the newly established mission of the African Union (AU) "Support to Ebola Outbreak in West-Africa" (ASEOWA). This will support some 100 AU health workers to practice in Sierra Leone and Liberia
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€7.6 million towards providing mobile laboratories for the detection of the virus and training health workers, in Guinea, Nigeria and Liberia.

Apart from this package, the EU has activities in the health sector under ongoing and future development programmes.

In Guinea, health is one of the focal sectors for EU development cooperation which is provided through the European Development Fund (EDF). A large-scale project was launched at the end of last year to support the health sector in Guinea. Amounting to €29.5 million, it includes a €9.5 million contribution from the Agence Française pour le Développement. The project aims to build the capacities of the Ministry of Health, improve access to quality basic health services and ensure the access to essential medicines. Health facilities are supported, among other activities, through the training of health workers (midwives, technicians, state-employed nurses) as well as the construction, expansion and rehabilitation of facilities and equipment. The Forest region has been identified as the main area of intervention.

The budget foreseen for health in the 11th EDF for the period 2014-2020 is €40 million and €84 million for urban sanitation.

Under the 11 th EDF, the EU is also considering a State Building Contract for Guinea in 2015, if the conditions are met. This would also contribute to mitigating the negative economic effects of the crisis, e.g. by helping to reduce budgetary gaps.

The EU is also currently financing (as part of its €1 billion MDG initiative) a programme in Sierra Leone that focuses on maternal health (€24.2 million). This project, implemented by UNICEF, supports the Free Health Care Initiative of the government of Sierra Leone and community institutions to deliver better health services, especially to pregnant and lactating mothers and to children. It helps to provide drugs and medical supplies, as well as trained doctors and health workers, and deliver food products and micronutrients (such as vitamins), for treating malnutrition.

In Liberia there is an ongoing Health Sector Support programme to help the government to deliver under the government’s wider health plan and assist progress towards MDG 5 on maternal health, and since 2012 the EU has supported the Government of Liberia, with payments amounting to €19.8 million from an overall programme of €39.8. The EU plans within the next month to pay the remaining amount to the Government of Liberia.

The EU is also providing support to the governments of Sierra Leone and Liberia to deliver public services and macro-economic stability via general Budget Support.

In Nigeria, €240 million of support to the health, nutrition and resilience sectors is foreseen for the 2014-2020 period (part of the 11th European Development Fund). This support will focus on improving policy and institutional governance to enhance the health and nutrition and strengthen the resilience of Nigeria's most vulnerable households, with a specific focus on the North of the country.

Several European specialist teams of the European Mobile Laboratory (EMLab) project for dangerous infectious diseases have been dispatched to Guinea and Nigeria and Liberia, with three mobile laboratories to support with viral haemorrhagic fever diagnostics, rapid analyses of samples and confirmation of cases. The laboratories have tested over 5,000 samples in Guinea, Nigeria and Liberia, providing quick diagnosis in only 4 hours. Their processing capacity is of 70 samples a day and they have diagnosed over 1,000 cases. Further, a forth mobile laboratory, more robust and self-sustained, will be sent to the region in early 2015 to reinforce diagnosis capacity for the outbreak and train local specialists.

This document was originally published on 5 September and was last updated on 15 October

For more information:

Ebola & Public health in the EU: MEMO/14/588

Factsheet on Ebola:

http://ec.europa.eu/echo/files/aid/countries/factsheets/thematic/wa_ebola_en.pdf

IP/14/1108 : Ebola Crisis: EU organises airlift operation to West Africa

IP/14/1099 : Ebola: EU helps deliver aid to Sierra Leone

IP/14/974 : EU announces €140m package in response to Ebola virus outbreak

Website of the European Commission Health and Consumer DG

http://ec.europa.eu/health/preparedness_response/risk_management/ebola/index_en.htm

Commissioner Georgieva's website:

http://ec.europa.eu/commission_2010-2014/georgieva/index_en.htm