14
0 EBOLA SITUATION REPORT Compiled by Songhai Advisory LLP with input from BCA In-Country Directors ABSTRACT This briefing updates members of the Business Council for Africa (BCA) on the on- going Ebola outbreak and its implications for the affected countries.

Ebola 29 Sept 2014

Embed Size (px)

DESCRIPTION

EbolaHealthWest Africa

Citation preview

Page 1: Ebola 29 Sept 2014

0

EBOLA

SITUATION

REPORT Compiled by Songhai Advisory LLP with

input from BCA In-Country Directors

ABSTRACT This briefing updates members of the

Business Council for Africa (BCA) on the on-

going Ebola outbreak and its implications for

the affected countries.

Page 2: Ebola 29 Sept 2014

1

© Songhai Advisory LLP 2014. All Rights Reserved

Contents BRIEF OVERVIEW ............................................................................................................ 2

GUINEA ........................................................................................................................... 4

LIBERIA ............................................................................................................................ 4

SIERRA LEONE ................................................................................................................. 8

NIGERIA ........................................................................................................................ 10

SENEGAL ....................................................................................................................... 13

METHODOLOGY

The Situation Report draws on information gathered from open source government,

media and international actors such as the World Health Organisation. Importantly, it

also incorporates the on-the-ground experiences of the BCA In-Country Directors in

Guinea, Liberia, Sierra Leone, Nigeria and Senegal. A special thanks goes out to them

for sharing their invaluable insights at this time.

Page 3: Ebola 29 Sept 2014

2

© Songhai Advisory LLP 2014. All Rights Reserved

BRIEF OVERVIEW

Ebola in Numbers

The World Health Organisation (WHO) has confirmed that there have been 3091 reported deaths owing to the Ebola virus, at the time of writing.

4507 confirmed and probable cases were reported to the WHO between December 30, 2013, and September 14, 2014 — a 37-week period.

718 confirmed and probable cases and 289 deaths were reported in the week of September 8 through September 14 alone.

By September 23, a total 211 deaths had been reported among health care workers.

According to the WHO, 90% of reported Ebola cases have been recorded in 14 of 63 districts spread across Guinea, Liberia and Sierra Leone. The concentration of cases in these 14 districts can be explained in part by the inter-connectivity of these border areas, through trade and free movement of persons in densely populated areas coupled with ineffective control measures.

The US Centre for Disease Control (CDC) estimates that “if trends continue without scale-up of effective interventions, by September 30 2014, Sierra Leone and Liberia will have a total of approximately 8000 Ebola cases. A potential under-reporting correction factor of 2.5 was also calculated. Using this correction factor, “…approximately 21,000 total cases will have occurred in Liberia and Sierra Leone by September 30th 2014”.

Similarly, the WHO has stated that up to 20,000 risk infection in the next six weeks. Months ahead of earlier projections. WHO Director General warned “we should expect things to get worse before they get better”.

International Interventions

US to send up to 3000 troops to build 17 treatment centres and train thousands of healthcare workers. But camp hospital will have only 25 beds according to UNDP head in Liberia. The Pentagon to build a field hospital and treatment unit in Liberia, Guinea, and Sierra Leone – along with the establishment of a United Nations emergency mission to respond to the Ebola outbreak – as positive steps.

UK is boosting its first military and humanitarian mission it said, on 23 Sept. 164 staffers from UK National Health Service volunteered to work in West Af

Cuba, China, Uganda, France will also send medics.

United Nations: UN Secretary General, Ban Ki Moon: states that the UN should consider creating a corps of health workers, a standby-force, deployed to countries in emergencies.

World Bank: It will double its funding to fight the disease, to US$400 million to assist worst affected countries. 230 emergency response 170 for medium and long term projects.

WHO: Coordinating global outbreak response.

Medecins Sans Frontiers: It is calling for a centralized system, which can be used each time an aid worker falls sick. Desperate need for isolation centres for those infected.

African Union (AU): The AU has formed its AU Support to Ebola Outbreak in West Africa (ASEOWA) drawing 30 volunteers from Uganda, Rwanda, Democratic Republic of Congo, Nigeria and Ethiopia.

It should be noted that the WHO considers these figures to be an approximation only and that the actual number is far higher because of unreported cases.

Page 4: Ebola 29 Sept 2014

3

© Songhai Advisory LLP 2014. All Rights Reserved

Control Measures: where Ebola is suspected i.e. “Illness in any person, alive or dead, who has (or

had) sudden onset of high fever and had contact with a person with a suspected, probable, or

confirmed Ebola case or with a dead or sick animal; any person with sudden onset of high fever and

at least three of the following symptoms: headache, vomiting, anorexia or loss of appetite, diarrhea,

lethargy, stomach pain, aching muscles or joints, difficulty swallowing, breathing difficulties, or

hiccupping; or any person who had unexplained bleeding or who died suddenly from an unexplained

cause” the below control measures are employed

o Tracing all the people with whom an infected person has come into contact o Isolation of infected persons o Improved clinical management o Supervised and safer burials o Community engagement o International support from partners

Page 5: Ebola 29 Sept 2014

4

LIBERIA

Recent Developments

Norway to Donate US$150 million: Norway is to donate US$150 million over the coming six

years to Liberia for the purpose of helping the government to halt illegal logging. It is

considered by some scientists that illegal deforestation is the cause of the latest Ebola

outbreak, by ridding the fruit-bats- carriers of the disease- of their natural habitats.

Liberian Diaspora Mobilising Funds: Liberian Association of Metro Atlanta is an association of

the Liberian Diaspora community in Atlanta, Georgia, home to an estimated 25% of the

80,000 Liberians resident in the US. It is a not for profit organization designed to “promote

peace, unity, progress and social awareness among citizens of the Republic of Liberia

residing within Metropolitan Atlanta” which has reportedly been mobilizing its members to

channel money back home to help in stemming the onslaught of the virus.

The WHO records four new deaths in the south-western Grand Kru district

Impact on Economy/ Business Activity:

Liberia was forecast to grow above regional averages this year on the back of iron production and

associated foreign direct investment. The present Ebola crisis looks set to retard activity across

services, agriculture and industrial sector activity alike this year. Market closures make it difficult for

market traders-some goods prices have risen by 10% since the crisis began according to local

traders. Sime Darby, one of the largest palm oil producers, has slowed output in Liberia.

ArcelorMittal, the world’s biggest steelmaker, has put plans for expansion on hold as contractors

transfer staffers outside of country. Dangote, the largest cement producer in Africa, has evacuated

some staffers out of Liberia and estimates growth levels will be reduced by one percentage point as

a result of the Ebola virus.

Population: 4 million approx.

GDP: USD2 billion approx.

Healthcare:

- Physicians per 1000 population:

0.014

- Total expenditure on health as

%GDP: 19.45

- Total cases: 3280, according to

CDC

- Deaths: 1677, according to CDC

- Reported cases in Liberia are

doubling every 15-20 days,

according to CDC.

-

Page 6: Ebola 29 Sept 2014

5

© Songhai Advisory LLP 2014. All Rights Reserved

View from The Ground: Interview with BCA In Country Director, David Frankfurt

How has the Ebola crisis impacted upon your daily life in Liberia? A big new stress being careful, limited contact with people, very limited socializing

How would you describe the effects on the economy?

Severe - arrival of health workers, USA forces will be a "band-aid" for the time they are here - mainly in areas of hotels, food.

Do you have confidence in the domestic and international community response where you

are and why?

This stage of the epidemic is more than the majority if not all the world can handle -

coordination of supplies, having qualified personnel in health care and so many other areas,

and working with NGOs, worldwide organisations that have specific remits - is in itself

overwhelming

We re trying to maintain a certain level of normality [at work], just to keep the

offices going, because this is going to end soon, it won’t be forever. Some of [the

mining companies] have scaled down but some of them are still there, maintaining

some level of skeleton staff.

Mining Sector Executive

Page 7: Ebola 29 Sept 2014

6

GUINEA

Recent Developments:

Abduction & Killing of Journalists/Health Workers: Last week (16th September) eight health workers and journalists were killed in the village Wome, South Eastern Guinea. This week, a Red Cross team faced attack when collecting bodies believed to have been infected by Ebola. One worker is reportedly convalescing in Forecariah. The perpetrators were reportedly family members of the deceased who reportedly threw rocks, vandalised cars and attacked the regional health office.

The virus spreads for the first time to the mineral rich Kindia district, 80 km from Conakry. Impact on Economy/ Business Activity:

Guinea is replete with iron ore and bauxite and as such, a number of international firms exploit its

resources in the mineral rich regions, some of whom are still operating in the country in spite of the

outbreak. London-listed gold miner Avocet Mining operates the Tri-K project in eastern Guinea,

close to the country’s second-largest city of Kankan. Although there have been reported deaths

resulting from Ebola in Kankan, the mining company says that it has not experienced the effects of

the disease on its operations. Anglogold Ashanti operates a gold mine in Siguiri, in the northeast of

the country, also in the Kankan region. The miner also says that its operations are unaffected

although it notes that there have been reported cases some 25km away from the mine. Its

preventive measures include restricting the movement of its employees and creating more

awareness campaigns on hygiene. For Brazilian firm Vale which has been involved in a legal battle

with the Guinean government over rights to the northern half of the much-coveted Simandou iron

ore mine, it recalled its six international staffers from Guinea back in April of this year. It has also had

to put its local staffers on leave. Rio Tinto, which has a stake in the southern half of the Simandou

iron ore deposit, donated US$100,000 to the WHO in the tackling of the Ebola crisis. France, UK and

the US have all advised against travel for their citizens. Saudi Arabia has said that it will not grant

visas for passengers coming from Guinea Conakry and other affected countries.

Population: 11 million approx.

GDP: USD3 billion approx.

Healthcare:

- Physicians per 1000

population: 0.18

- Total expenditure on health

as % GDP: 5.96

- Although the system

remains week, gains in

health outcomes have been

made in recent years e.g.

halving of infant mortality to

100 per 1,000 live births

- Total cases:1022 - Total deaths: 635

Page 8: Ebola 29 Sept 2014

7

© Songhai Advisory LLP 2014. All Rights Reserved

View from The Ground: Interview with BCA In Country Director, Biro Diallo

How has the Ebola crisis impacted upon your daily life in Guinea? In general, the awareness level is high, hence a strong belief in reducing shaking hands and cleaning them on a regular basis with appropriate disinfectant solutions. However it is important to note that the population has different levels of awareness and some are still in denial. Either way it has an impact on people’s day to day.

How has it affected your business/ your industry in general?

The industry has seen a great reduction in activities, this is mainly caused by the restrictions imposed in some areas of the country. My industry is spread across the country, hence affected by Ebola.

How would you describe the effects on the economy?

The economical impact is slowly coming to surface; most businesses are running slowly or have stopped. If this continues for too long it may have other consequences such as shortage of food and bear necessities.

What has been the impact on the political situation in the country?

Politically, the pressure is on the Government to show better control of the situation. [Government] is reactive to these pressures.

What has been the impact on the security situation in the country?

In my view not much visible impact on the security, some isolated cases of insecure events from the populations.

Do you have confidence in the domestic and international community response where you are

and why?

The government may have good intentions towards fighting Ebola in Guinea, but not sufficient capacity at local level where it matters. I do not think there is total control over the people who have been in contact with infected persons.

What do you think the outlook is for the ebola situation?

The situation will linger around for while in my view, and if not controlled on time with strict

measures could be devastating, and worse if mixed with the political machine could result in

chaos.

Page 9: Ebola 29 Sept 2014

8

SIERRA LEONE

Recent Developments:

Three-day Lock Down Hailed a Success: A three- day lock-down which took place Port Loko, Bombali and Moyamba. was hailed as a success by the authorities. It was a means for the country to assess the scale of the problem as 30,000 volunteers went door to door to sensitize the population and to ascertain the number of those infected.

President’s Plea: Joining the UN conference via videoconference, President Ernest Bai Koroma called for the bans on flights by airlines to be lifted although Sierra Leone has sealed off its borders to Liberia and Guinea (in spite of AU pledge to lift restrictions).

Impact on Economy/Business Activity:

Sierra Leone was set to perform well economically also, reaching 20% per annum between 2011 and

2013. The IMF was forecasting around 15% for 2014, however the outlook is significantly damaged

by the ongoing crisis. The ban on public gatherings precludes normal market/trading as well as

traditional modes of agriculture which include group farming. One of the main exports of Kailahun,

one of the hardest-hit areas, is coffee and cocoa. But the absence of safe crop seeds will severely

affect output. The ban on fairs and public gatherings has prevented farmers from planting and

harvesting. Average inflation was 10% in 2013. Currently, some newspaper reports describe a 30% or

more increase in the price of basic foodstuffs since the outbreak began. Major foreign companies

such as African Minerals have announced the transfer of some personnel abroad and reportedly put

expansion plans on hold.

A View from the Ground, In Country Director, Sheka Forna

How as the Ebola situation affected your daily life? One voluntarily restricts one’s movements and actively discourages unnecessary visits - not always easy in the African context. More care is taken of hygiene (hand washing) and physical contact limited (no handshaking or hugging). Schools are closed, with those who can afford to sending their families abroad. Restrictions on bars, cinemas and night-clubs will no doubt be affecting the younger generation. Otherwise it’s life as normal.

Population: 6 million approx.

GDP: USD5 billion approx.

Healthcare:

- Physicians per 1000 population:

0.2

- Total expenditure on health as %

GDP: 15.1

Total cases: 1940, according to CDC.

Total Deaths: 597, according to CDC

Reported cases are doubling every

30-40 days, according to CDC

Page 10: Ebola 29 Sept 2014

9

© Songhai Advisory LLP 2014. All Rights Reserved

How has it affected your business/ your industry in general? Two of my clients have suspended operations. Others are less active.

How would you describe the effects on the economy? Business generally is slow. The slow down is referenced in almost all conversations. The economy is driven primarily by the activities of the mining companies, most of which are operating under virtual lock-down conditions. The tourism and entertainment sectors are hard hit. Agriculture is reportedly affected. Discretional businesses have closed shop or cut back. The Minister of Finance has revised growth forecasts.

What has been the impact on the political situation in the country? GoSL has taken a good deal of criticism for their handling of the crisis, particularly from opposition supporters, but increasingly from the middle classes. Although some newspapers are openly critical, outright criticism in-country is rare, with social media the preferred medium. The stirring of middle class voices is interesting as they are normally loath to enter political debate, which appears to be of concern to GoSL with some reporting threats to them or their families by government sympathisers.

What has been the impact on the security situation in the country? There have been reports of instances of unrest in Kailahun, the epicentre of the outbreak, with isolated cases elsewhere. Generally the situation appears calm and the populace unconcerned with regard to possible unrest.

Do you have confidence in the domestic and international community response where you are and why? The domestic response seems confused, with a continuing flow of mixed messages, while recent reports by CDC and WHO do not inspire confidence. However there has been a noticeable step up in efforts by all parties at home and abroad.

What do you think the outlook is for the Ebola situation? Contact tracing and the altering of traditional practices seem to hold the key to stemming the outbreak. There is no reason otherwise for the continuing rate of infection. Unless the various agencies engaged in containing the virus can address these two areas the predictions of the CDC and WHO may prove to be accurate.

Page 11: Ebola 29 Sept 2014

10

© Songhai Advisory LLP 2014. All Rights Reserved

NIGERIA

Latest Developments

President Goodluck Jonathan Declares Nigeria ‘Ebola Free’: Addressing the UN General Assembly

in New York this week, Jonathan said “We can confidently say that today Nigeria is Ebola-free”.

While Nigeria appears to have contained the virus, as noted by the WHO, the emergency centre

for Ebola in Lagos says that in order for the outbreak to be officially declared ‘over’, there cannot

be any cases within a 42 day period. No new cases have been recorded by the WHO since 8

September.

View from The Ground: Interview with BCA In Country Director, Peter Crabbe

How has the Ebola crisis impacted upon your daily life in Nigeria? Initially, at least in Lagos, there was certainly a reduction in social intercourse, with many people refusing to shake hands with anybody, even their own family and friends. Indeed one Christian church suggested that the traditional “peace sign/action” be dropped from Sunday services. Once it became clear that EVD was not spreading quickly, old courtesies quickly returned.

All hospitals and the bigger companies quickly insisted that staff and visitors should use hand

sanitizers before entering their premises and this is still in place. Once they became available,

many companies now also apply body temperature checks to staff and visitors. Many social

clubs and private houses also now voluntarily have hand sanitisers available.

The fact that the Federal Government stopped all schools from resuming after the long vacation,

had a major effect on family life. The public schools were only allowed to resume last week but in

some states, Lagos especially, this has been deferred to October 8th, to allow additional washing

facilities to be provided in schools and to give training to staff in recognizing the EVD symptoms.

Private schools in Lagos were allowed to resume on September 22nd provided that their staff had

adequate training and that a qualified nurse would always be available on-site. Even so,

Population: 168 million approx.

GDP: USD510 billion

Healthcare:

- Physicians per 1000 population:

0.4

- Total expenditure on health as

%GDP: 6.1

Total cases: 20, according to CDC

Total Deaths: 8, according to CDC

Page 12: Ebola 29 Sept 2014

11

© Songhai Advisory LLP 2014. All Rights Reserved

everybody entering is still subject to temperature checks, although these will probably be slowly

and quietly dropped.

One beneficial effect of the schools being closed, is of course that morning traffic flow has

improved.

There has been little disruption to international flight arrivals and departures. Body temperature

checks are being undertaken on arrivals but whilst they are in the immigration queue, so there

has not been any further delay. The airport health authority staff havs been polite and efficient

and nobody has complained.

One long term benefit flowing from the EVD crisis could be that schools and people generally are

much more aware of the need for personal hygiene and more hand washing facilities are being

made available in schools.

A number of expatriate families with children have deferred their return to Nigeria, because of the closure of schools because of the EVD. This is particularly true for the American International School which was due to resume in mid August, some weeks before the other schools. A number of these families have put their children into new schools overseas, rather than have them sitting at home for 2 months; it remains to be seen whether they will now return to Lagos.

What has been the Effect on business/industry/economy/security in general? Apart from the additional sanitization procedures referred to above, which are not unduly time consuming, there has not been any appreciable impact on business life. Clearly there has been some disruption to family life with working mothers having to make alternative arrangements for looking after the children at home during the day but this does not seem to have been a serious issue.

There is evidence that several regular business visitors to Nigeria have deferred trips planned for September; they should now be preparing to come out in October.

What has been the impact on the political situation in the country? With national elections looming in 2015, the Nigerian political scene is very active at present but

the presence of EVD, proven in only 2 states, has not had any effect on the political planning and

scheming. There has been some ‘mud-slinging’ in that the considerable sums, estimates of which

vary greatly, made available by the Federal Government for the purchase and distribution of EVD

test kits and educational materials have not, it is alleged, reached the States’ Ministries of

Health, so there are the usual allegations.

Do you have confidence in the domestic and international community response where you are and why? Generally the Government is perceived as having responded surprisingly well to the crisis.

In the very first instance, the initial EVD case was taken to a private hospital for treatment,

rather than to a public facility as the public hospitals were largely inactive, due to a strike by

public service doctors. That private hospital did not pick up the possibility of EVD for 24 hours, as

they were not told that the patient had originated his journey in Sierra Leone. Once EVD was

recognized the hospital was put into quarantine, and indeed it still is. Very sadly the lady doctor

who first treated the initial case caught the disease and subsequently passed-away.

Page 13: Ebola 29 Sept 2014

12

© Songhai Advisory LLP 2014. All Rights Reserved

There has been some criticism in the less well informed press that no vaccines were made

available and that none of the experimental drugs were sent to Nigeria, but that apart the

international response is perceived as being helpful and supportive. The fact that the WHO has

been publically active in advising the various levels of Government is acknowledged.

What is the Outlook for Ebola in Nigeria?

EVD is seen very much as an “imported disease” and it is important that checks on arriving

passengers from west African countries continue to be vigorously undertaken. One concern is of

course that with air travel to affected countries virtually shut down, there could be a greater use

of land transport, given the propensity for Africans generally to move about and to trade. The

land borders are impossible to police effectively and it has to be hoped that the disease is not

brought in again, say by a long distance truck/bus driver.

Page 14: Ebola 29 Sept 2014

13

© Songhai Advisory LLP 2014. All Rights Reserved

SENEGAL

Latest Developments

WHO declares Ebola to be contained in Senegal: The UN health agency announced this week that it has not recorded a new case of Ebola since 29 August and that along with Nigeria, ‘the outbreaks… are pretty much contained”.

A View from The Ground, BCA In Country Director, Landing Goudiaby.

How has the Ebola crisis impacted upon your daily life in Senegal? Regarding Ebola in Senegal, the only case which existed in the country came from a young Guinean who had gone through the Guinean-Senegalese border. There is no more fear because the young patient (a student) was admitted and was treated at a University Hospital in Fann. The doctors here declared that he had been treated, at which point, he returned back to Guinea.

Also, the Ministry of Health in Senegal placed the people who had been in contact with him into quarantine. In the end, none of these people showed signs of Ebola. Thus the Minister of Health, Awa Marie Colle Seck confirmed that there is not a single case of Ebola in the country. The campaign for the prevention of the disease is intensifying because even the private companies have come together, even companies like Orange is giving away hygiene kits and is offering money to support the government through the Ministry of Health. Furthermore, preventive and detective measures are in place at the International l'Aéroport and at the port of Dakar. In terms of communication, one continues to see messages being circulated around to sensitize the population about the fever and the sanitation practices to adopt in order to detect and prevent the illness.

Population: 13 million

GDP: USD15.5 billion

Healthcare:

- Physicians per 1000 population:

- Total expenditure on health as

%GDP:

Total reported cases: 1

Deaths: 0