Preparing for Ebola Virus Disease in West African countries not yet affected: perspectives from Ghanaian health professionals

Abstract

Background: The current Ebola Virus Disease (EVD) epidemic has ravaged the social fabric of three West Africancountries and affected people worldwide. We report key themes from an agenda-setting, multi-disciplinary roundtableconvened to examine experiences and implications for health systems in Ghana, a nation without cases but where risk for spread is high and the economic, social and political impact of the impending threat is already felt. Discussion: Participants ’ personal stories and the broader debates to define fundamental issues and opportunities forpreparedness focused on three inter-related themes. First, the dangers of the fear response itself were highlighted asa threat to the integrity and continuity of quality care. Second, healthcare workers ’ fears were compounded by ademonstrable lack of societal and personal protections for infection prevention and control in communities andhealthcare facilities, as evidenced by an ongoing cholera epidemic affecting over 20,000 patients in the capital Accraalone since June 2014. Third, a lack of coherent messaging and direction from leadership seems to have limitedcoordination and reinforced a level of mistrust in the government ’ s ability and commitment to mobilize an adequateresponse. Initial recommendations include urgent investment in the needed supplies and infrastructure for basic,routine infection control in communities and healthcare facilities, provision of assurances with securities for frontlinehealthcare workers, establishment of a multi-sector, “ all-hazards ” outbreak surveillance system, and engaging directlywith key community groups to co-produce contextually relevant educational messages that will help decrease stigma,fear, and the demoralizing perception that the disease defies remedy or control. Summary: The EVD epidemic provides an unprecedented opportunity for West African countries not yet affected byEVD cases to make progress on tackling long-standing health systems weaknesses. This roundtable discussionemphasized the urgent need to strengthen capacity for infection control, occupational health and safety, andleadership coordination. Significant commitment is needed to raise standards of hygiene in communities and healthfacilities, build mechanisms for collaboration across sectors, and engage community stakeholders in creating theneeded solutions. It would be both devastating and irresponsible to waste the opportunity.