1. This high-level event, “From Ebola to more resilient health systems,” provided an opportunity for the Ministers of Health from Guinea, Liberia and Sierra Leone to present and discuss their health sector recovery plans with Development Partners and other stakeholders, with the aim of accelerating support for ending the Ebola Virus Disease (EVD) epidemic and strengthening health systems within, and across, the affected countries.
2. The meeting participants noted their support to the Ebola-impacted countries in their efforts to reach and sustain zero EVD cases, while concurrently restarting essential health services and strengthening public health capacities.
3. The meeting highlighted the fundamental interconnectedness of response, recovery, and resilience in order to mitigate inevitable future shocks to the health system—including new potential EVD emergencies.
4. Participants commended countries for their efforts to ensure that national investment plans are strategic, prioritized, and appropriately costed. It was recognized that these plans are evolving and constitute a reasonable basis for further refinement in scope, priorities, and costing.
5. The draft Ministry of Health plans estimate the amounts needed to implement the strategies, with US$ 1.3 billion needed for Guinea over the next 3 years, $457 million for Liberia over the next 2 years, and $360 million for Sierra Leone over the next 3 years.
6. As the next phase of prioritizing, costing, and financing gets underway, emphasis was placed on the need to align proposals for increased resource allocations with absorptive capacity of the system. This would include the development of comprehensive monitoring and accountability mechanisms with a focus on systems, service delivery, and resource tracking indicators.
7. Increased development assistance for health must also be aligned to medium-term financing strategies for health that emphasize domestic resource mobilization and increased efficiency and equity in the use of available resources.
8. Development Partners committed aligning their support around agreed country plans and priorities under the leadership of national Governments, based on IHP+ principles with concrete mechanisms for coordination at the country level.
9. Key points emphasized with respect to getting to zero/restarting essential health services included:
- Emphasizing the immediate importance of “getting to zero” to facilitate the early recovery before the rainy season
- Establishing a set of cross cutting priorities including infection prevention and control (IPC) in all facilities, surveillance and integrated data management and communications systems
- Re-establishing essential services, especially services that facilitate the response such as maternal and child health/family planning, routine immunization and HIV/TB/Malaria services
- Creating an ongoing research agenda to address new and emerging risks in Ebola
10. The following key points were emphasized with respect to opportunities and priorities for a more resilient health system:
- Resilience of the health systems depends crucially on increasing the availability and strengthening pre-service and in-service training, deployment and safety of front-line health workers (particularly in rural areas), as well as investing in reforms that expand the role of community health workers
- Recognition that the health sector is a significant opportunity for formal employment (especially for women)
- Results measurement and accountability mechanisms, including innovative real-time informatics
- Supply chain management
- Community-owned and trusted health services, particularly in under-served communities.
11. Key points emphasized with respect to improving regional disease surveillance included:
- The importance of ensuring strong public health capacities and synergies in cross-border interventions, including regional integrated disease surveillance
- The importance of building into disease surveillance capacities an ability to understand the human-animal-ecosystem interface given the spread of infectious diseases of animal origin
- Enabling multi-sectoral and cross-border information sharing and collaboration
- Strengthening and linking national surveillance systems to enable a networked approach across the region and contributing to an African CDC network
12. New financial commitments shared during the meeting included:
- The World Bank Group (WBG) announced today that it would provide at least US$650 million during the next 12 to 18 months to help Guinea, Liberia, and Sierra Leone recover from the impact of the Ebola crisis and advance their longer-term development needs. The priority areas of this new funding will be strengthening health systems and frontline care; agriculture; education; cash transfers and other social protection programs; and lifesaving infrastructure such as electricity water, sanitation, and roads. The funds also will be used to develop a regional disease surveillance system across West Africa that will help prevent or contain future pandemics. The new WBG pledge brings the organization’s total financing for Ebola response and recovery efforts to US$1.62 billion.
- Some other commitments announced today include $300 million from the African Development Bank, $80 million from GAVI, and $387 million from the Global Fund (through 2017).
- This is in addition to previously committed funding to the EVD response and recovery efforts from the United States, United Kingdom, and many other Development Partners, which represents a substantial investment/down payment in support of the national plans.
- Development Partners will have an opportunity to make additional financial commitments before and during the July 2015 "pledging" event at the UN. It would be critical that the outcomes of this meeting are used as a foundation for this July event.