Ebola: Moving from emergency to recovery

As the death toll from Ebola now tops 10,000 in West Africa, donors and aid implementers are figuring out how to best transition from the emergency to the recovery phase of the crisis.

Top EU and U.N. officials, leaders of Ebola-affected nations and representatives from the African Union, nongovernmental organizations, the private sector and the scientific community met in Brussels, Belgium, earlier this month to make progress on this goal. They agreed to embark on the design of a road map to help the economies of Guinea, Sierra Leone and Liberia get back on track, starting with the priority task of rebuilding health systems.

But that, of course, will be no easy feat.

“We are at a really crucial stage of the real fight against Ebola, because this is a turning point when the emergency stage or the emergency response or medical response to Ebola containment is now turning into coordinating and structuring the long-term recovery program,” European Commissioner for International Cooperation and Development Neven Mimica said in an exclusive interview with Devex at the Palais d’Egmont in Brussels.

While the conference did analyze the emergency response in detail, Mimica stressed the talks were more geared toward identifying the priorities for recovery, and how EU aid can best support this process.

Coordination, he noted, is key.

The European Union, one of the top donors to the Ebola response in West Africa, is racing against time to redesign its development assistance package to countries affected by the outbreak, as programs — and their accompanying budgets — were approved before the epidemic was declared.

“Now [it’s] a delicate moment,” Mimica said. “We have to better balance [and] structure our contribution especially to some of the public services, not exclusively but for instance to the health sector, to education, to urban sanitation. Regardless whether they were an important part of the priorities — now they should become priorities.”

Present and future

The Brussels meeting on Ebola resulted in a general sentiment that the development community cannot deal with the present without dealing with the future, and vice versa, according to Oxfam GB chief Mark Goldring.

“I think we have to build on some of the successes of social mobilization, of communities taking control and taking responsibility, of governments respecting and supporting that, not imposing measures,” he told Devex on the sidelines of the event. “All of that will help identify, isolate, support and where possible treat the remaining cases. If we don’t do that we’ll have little pockets of people appearing all over the place at any one time.”

Mimica, on the other hand, is looking further down the road, especially on seeking more and better coordination between programs and development priorities related to the Ebola recovery stage.

“We should be able to do it if all our partner countries, especially those affected by Ebola, really sit down together and go into each and every detail that would actually make the structure of our programs more related to Ebola response,” he said. “If we managed to steer such a way of thinking to such a mindset — a common mindset that would bring us together in shaping the Ebola recovery response — then this will be the best outcome.”

Brussels, Mimica insisted, was no pledging conference. This may come in a few months’ time, he revealed, once stakeholders have pinned down priorities and agreed on them with donors and partners.

For Nigel Chapman, CEO of Plan International, the main message was for aid implementers to “work closely with the communities, get their respect, get alongside them, don’t parachute in at the last minute and expect to get listened to.”

“It’s not just about dealing with Ebola in the short term, and moving the cases down to zero, it’s also about building long-term community sustainability — that’s good quality hospitals, or schools, or food production, or whatever,” he said. “All of those things have been very severely damaged in the last year, and they need to be painstakingly built up again.”

Chapman enumerated the four HELP challenges all anti-Ebola efforts should be focused on right now: health, education, livelihoods and protection.

The post-Ebola ‘unspoken agenda’

When discussing Ebola, all stakeholders agree that more funds should be put into health systems strengthening and improving governance in affected countries. But donors continue to face a perennial problem: What do you do to avoid giving more money to governments of weak nations only for them to make the same mistakes all over again?

That’s what Goldring calls the “unspoken agenda” after Ebola.

“If governments were struggling to deliver clear development plans before, it’s going to be an even greater challenge now,” he said. “How are the governments going to lead this in a way that feels qualitatively different to the way they were working with donors beforehand?”

Goldring explained how one major donor told him they want to help one Ebola-affected nation, but they want to be “absolutely certain” that it’s not going to be like last time, when pouring in aid achieved little.

It’s a little bit like the boy who cried wolf, the Oxfam GB chief said, and his organization is working hard to mediate in some sectors — particularly water and sanitation, education and health — between governments and donors, although on a lesser scale than U.N. agencies like UNICEF.

Goldring revealed that during his last visit to West Africa, Liberian President Ellen Johnson Sirleaf had personally asked him for Oxfam’s help to convene a session to help mediate with donors, in the context of a “struggling relationship” and disagreement on how to get the country’s schools opened safely.

Private sector, social mobilization

In the fight against Ebola — and now even more importantly in providing recovery solutions for countries affected by the epidemic — many are looking toward the private sector to support efforts in West Africa, and “think outside the box” to get the job done.

Chapman agrees, and noted how for-profit companies “often bring innovation and different approaches that we don’t think about” on top of particular skills and methods that are more efficient than those of traditional aid implementers. Goldring, meanwhile, believes businesses can help create an environment that allows profits from the country to stay as much as possible in the country, and thus assist the long-term recovery strategy post-Ebola.

Both warned, however, that private sector involvement should not derail the overall goal of poverty reduction.

Another challenge enunciated by a number of stakeholders in Brussels has been getting donors to recognize that building treatment centers is fine, but more money should be put into initiatives that are equally crucial — but may not be as visible — such as community mobilization drives.

“For a long time, getting donors behind the social mobilization agenda was a real challenge,” Goldring said. “Substantial donors were coming in, everybody wanted to build assessment centers, treatment centers. Oxfam didn’t think that was wrong, but we were much more concerned with are we going to do the social community engagement part of it alongside that.”

There were some donors, he pointed out, that were “quite cynical” about this approach, as well as cash transfers. The latter are “vital,” argued the Oxfam GB chief, so that business can recover now, not only at the speed people will be able to afford. Oxfam is currently in talks with the World Bank and other organizations on elaborating such a program for West Africa, Goldring revealed.

What are your thoughts on how to best transition from the emergency to the recovery phase of the Ebola crisis? Let us know by leaving a comment below.

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