World Bank must lead efforts to raise $1.7 billion to improve Ebola-hit countries’ health care

The World Bank and international donors must find $1.7 billion to improve dangerously inadequate health systems in Ebola-affected countries and help prevent such a deadly epidemic ever happening again said Oxfam today on the eve of Ebola talks at the Bank’s annual spring meetings in Washington DC.

The money is the minimum needed to make health care freely available to all in Liberia, Sierra Leone, Guinea and neighbouring Guinea-Bissau and would go towards paying for well-equipped facilities, sufficient trained staff and medical supplies and robust health information systems that build upon the stronger community networks now in place. Guinea-Bissau has not yet had any Ebola cases but is particularly at risk from porous borders and poor resources.

The international agency says governments and donors must reverse years of neglect with a ten-year investment plan in free universal health care to ensure the countries are able to cope with future outbreaks. A long-term view is essential to do the job. Oxfam estimates it would cost $420 million to train the 9,020 doctors and 37,059 nurses and midwives required to meet the World Health Organization’s minimum standards of care and $297 million annually to pay their salaries.

Oxfam International’s Executive Director Winnie Byanyima said. “Communities pulling together has been vital to cutting Ebola infection rates. After a slow start, Oxfam recognized that and targeted its approach accordingly. But in order to be effective these networks need to work within a strong national healthcare service that is freely available to all people.

“This is where the major donors must now step in,” she said. “Solid commitments are desperately needed now to address public health failures that have contributed to more than 10,000 deaths and to prevent another deadly epidemic.”

Winning communities’ support has been critical in overcoming people’s misunderstanding and fear about the disease. Oxfam trained community volunteers to make house visits with information about symptom awareness, good hygiene and changing risky behaviour.

“One positive outcome of Ebola has been the rise of stronger new community networks that offer greater space for local people to be involved in decision-making,” Byanyima added. “But so far they have been excluded from the recovery planning. This must change. Donors should insist that community engagement is put at the heart of recovery plans. Community networks are also vital in helping to hold governments to account that the money is being well-spent.”

The aid agency is calling for the international community to support the countries to rebuild stronger public services, particularly in health and sanitation, and to help people in Ebola-affected countries to recover from immediate psychological, social and economic impacts.

In Sierra Leone Ebola has created around 12,000 orphans and 180,000 people have lost their jobs. In Liberia half of all heads of household are out of work and 73% of people in three counties told Oxfam researchers in December 2014 that their incomes have plummeted.

Oxfam has so far reached 1.3 million people in West Africa working with communities to help prevent infection, supporting clinics, schools and people in quarantine with water and sanitation and helping communities to be better prepared for potential outbreaks.

Notes to editors

Photos and case studies of clinics, community health workers and people affected by Ebola and poor health care in Liberia and Sierra Leone.

Health care costs are from new Oxfam briefing Never Again – building resilient health systems and learning from the Ebola crisis’

The cost of $1.7bn to close the funding gap is based on raising spending to the recommended $86 per capita to achieve the minimum package of essential services: $419,108,763 for Sierra Leone, $278,663,928 for Liberia, $881,748,021 for Guinea and $131,753,794 for Guinea Bissau = $1,711,274,506 total). Using the WHO standard of a minimum 2.3 doctors, nurses and midwives per 10,000 people, Oxfam has calculated the health workforce gaps in these countries and the costs of training the missing clinical staff and of paying their salaries over 10 years.

International donors, the UN Secretary General and finance ministers will meet Presidents of Ebola-affected countries on Friday 17 April at a high-level roundtable meeting in Washington organised by the World Bank, to discuss their plans and funding needs to end the outbreak, recover from the crisis and strengthen essential systems to prevent another epidemic. Oxfam International’s Executive Director Winnie Byanyima will speak at the ‘Ebola – Road to Recovery’ meeting.

The World Bank published reports on unemployment in Liberia and Sierra Leone in January 2015.

Street Child’s March 2015 report estimated there were more than 12,000 Ebola orphans in Sierra Leone. 

Oxfam's research on incomes in Liberia was carried out in a face-to-face survey during December 2014 in three counties: Montserrado (614 people in 3 communities), Nimba (564 people in 25 towns) and Grand Gedeh (470 people in 10 towns). 1,648 people in separate households were interviewed: 69% head of household, 23% spouse, 8% family member, combined with 19 focus group discussions including youth and women's groups, local leaders and Ebola task force members.

Contact information

Oxfam has a team of spokespeople at the Spring meetings. These include Oxfam International’s Executive Director Winnie Byanyima, Oxfam America’s President Ray Offenheiser, Oxfam’s Head of the Washington DC office Nicolas Mombrial, Shannon Scribner, Oxfam America’s Ebola Campaigner.

To arrange interviews, briefings or to find out more contact Lucy Brinicombe (in Washington) on lbrinicombe@oxfam.org.uk / +44 (0)7786 110054, @lucybrinicombe.

For updates, please follow @Oxfam.