The world breathed a sigh of relief after the release of the World Health Organization’s latest findings on Ebola. It said the number of new cases over the past five months showed its first decline since the start of the epidemic a year ago in the three hardest hit countries: Guinea, Sierra Leone and Liberia.
However, the international emergency response organization, International Rescue Committee, IRC, warned caution should be used when interpreting what the declining numbers really mean.
Emmanuel d’Harcourt, the senior health director for the International Rescue Committee, warned that the story behind declining numbers of new Ebola cases is different for Guinea, Sierra Leone and Liberia.
"Our information and our interpretation of the numbers, based both on field realities and what we hear from other sources, is that the declines are definitely real in Liberia. They’re probably real in Sierra Leone and they’re very uncertain as to their meaning in Guinea," d’Harcourt said.
He attributed the reduction of new Ebola cases in Liberia to communities growing to understand the disease and how it was spreading, and then taking preventative actions.
"And we see that at every level, at the level of the government, but also at the level of local administration and even at the level of villages. We think that a similar dynamic is occurring in Sierra Leone," said the senior health director.
In Guinea, he highlighted, there are questions about the actual numbers.
"The whole epidemic in the three countries really flared up because the international community and WHO, and Doctors Without Borders declared the epidemic over because there were no infections for 21 days. And in fact what was happening was not that there weren’t cases, but that they were being hidden, and the same dynamic that caused that epidemic to burn underground without being reported is still in place,” said d’Harcourt.
He explained people still do not trust the government nor do they trust the international organizations and because of this a lot more confidence in the numbers is needed before we can believe there is actually a reduction of new Ebola cases.
D’Harcourt emphasized one of the biggest lessons learned from the world’s largest outbreak of the Ebola virus is that you cannot separate politics and public health.
“It’s very important for public health professionals to understand that issues such as trust in the system, trust in the government, trust in the public health services, is a vital element of our work,” said d’Harcourt, who added that by just focusing on technical fixes, for example, such as we need to do more training so people can do more surveillance—a key element is missing and that is “do people believe what they are being told on the radio or by government officials?”
“We really need to work on that and obviously we can’t work on it just when there’s an epidemic. We have to be able to view that as part of our work and part of the thing that we measure—which is how much trust there is in the system, and then we have to go do things to build trust in the system,” d’Harcourt emphasized.