Management Sciences for Health (MSH), a Massachusetts-based global health nonprofit organization, today announced it is mobilizing its expertise and resources at the epicenter of the Ebola epidemic in Liberia to help the Ministry of Health develop community care centers for Ebola separate from the health facilities; restore essential health services for non-Ebola patients; and, improve the detection and containment of active Ebola cases in Liberian communities.
"Emergency response is what happens when preparedness has failed," said Dr. Jonathan Quick, President and CEO of MSH and the former director of Essential Drugs and Medicines Policy at the World Health Organization. "MSH has been helping build locally led and locally run health systems in the world's poorest regions for over 40 years. Our immediate priorities are to work with government and community leaders to stop a health system collapse in Liberia, to prevent the epidemic from spreading to nearby nations, and to restore Liberians' trust in their health system."
The MSH response team arrived in Liberia on Monday and is working with the Liberian government and local partners to identify gaps and unmet needs. The MSH team includes Ian Sliney, senior director for health systems strengthening; Dr. Floride Niyuhire, senior technical advisor; Kwabena Larbi, malaria control advisor; and Christophe Maupas, a supply chain management expert. They were met by Arthur Loryoun, MSH technical advisor and pharmacist based in Liberia.
Dr. Fred Hartman, MSH's pandemic preparedness and infectious diseases expert, is departing today for Liberia, where new cases of Ebola are doubling every two weeks. MSH experts are also on the ground in the neighboring countries of Cote d'Ivoire, Democratic Republic of the Congo, Nigeria and Gabon.
"It is likely that we will see more deaths from non-Ebola diseases and conditions than from Ebola itself if we don't get the health system back up and functioning," said Dr. Hartman. "At the moment, most Ebola patients have nowhere to go for effective treatment. The health system has been overwhelmed by the outbreak and many essential health services have stopped. Health workers have stayed at home for fear of direct contact with Ebola patients, and patients have lost confidence in health facilities for much the same reason, so they are not using them."
MSH currently manages projects in 29 African nations and has 28 offices in the region. MSH, which has nearly 1,500 staff in sub-Saharan Africa and has trained 26,000 health workers in the region, implemented its rapid response plan in Liberia following a meeting last week between MSH and the United Nations.
In Liberia, MSH is planning to work with local authorities to move suspected Ebola patients into community care centers to improve the quality of care and limit the spread of the disease. MSH has trained a network of nearly 1,000 private drug sellers or medicines shops in Liberia that are providing public Ebola prevention information, participating in supporting community-based care options for Ebola patients, and working to restore trust in the health system for non-Ebola patients. MSH hopes to train another 700 more medicine shops and obtain additional funding to expand the training to the rest of the country.
In addition, MSH is partnering with the Harvard Humanitarian Initiative (HHI) to bring special technology to the field to collect, aggregate, analyze and map data on Liberia's health needs. The KoBo Toolbox (http://www.kobotoolbox.org/), developed by HHI, is an open source suite of tools for data collection, surveillance and analysis in humanitarian emergencies. MSH will work with NGO partners, trained drug sellers and community volunteers to determine how this technology could be used to capture and track new suspected cases of Ebola.
"Quickly collecting reliable information in a humanitarian crisis is the critical link to saving the lives of the most vulnerable," said HHI Director Dr. Michael Van Rooyen. "By focusing on shoring up health systems, MSH is taking exactly the right approach and we are pleased to have the opportunity to help their team gather and analyze the crucial information they need."
MSH is also drawing on the lessons learned during the avian and pandemic influenza outbreaks during 2007-2010. MSH has developed a Framework for Ebola Response and Recovery at the Local Level, based on a Pandemic Prepared and Response Manual developed with USAID funds during those health crises. These materials will be made available to government, UN, NGO, and other partners in epidemic and at-risk countries.
In addition to Liberia, MSH is pursuing preparedness strategies in four adjacent countries:
- Cote d'Ivoire -- MSH medical personnel are members of the National Ebola Committee and will assist the Ivory Coast Ministry of Health in assessing whether the national supply chain for HIV & AIDS medicines can be used for the distribution of pandemic preparedness supplies.
- Democratic Republic of the Congo (DRC) -- MSH will work with the Ministry of Health to determine whether its existing community health network can manage the Ebola outbreak in 23 affected villages.
- Gabon -- MSH is in active discussions with the nation's leadership on the best method to implement of Ebola pandemic preparedness measures.
- Nigeria -- MSH is seeking donor support to roll-out of a revised version for Ebola of its Pandemic Preparedness Tool.
"The hard truth is that an early investment in nations like Liberia to strengthen the health system, including epidemic preparedness, would have been far more effective and less costly than today's international response," said Dr. Quick. "New outbreaks of Ebola and similar epidemic illnesses are inevitable. But their scale and impact should be dramatically reduced by seizing this moment to accelerate long-term prevention and preparedness, while vigorously tackling the current crisis."
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