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April 2017

Responding to the Ebola Outbreak in Liberia

When Ebola first appeared in West Africa in late 2013, Guinea, Sierra Leone, and Liberia, the three most affected countries, had few defenses. A new series of ISS case studies profiles key public management challenges governments, NGOs, and international organizations confronted as they tried to contain the infectious disease outbreak. It highlights important innovations and the continuing need for new approaches.   

The five cases in this release focus on national coordination, social mobilization, disease surveillance, supply chain management, and filling skill gaps. An additional profile of the US interagency disaster response will follow.


UNICEF conducted a "mop up" campaign in the Tewor district of Liberia to help communities wipe-out Ebola,
 including door-to-door active case searching and social mobilization. Photo by Martine Perret, UNMEER.

Chasing an Epidemic: Coordinating Liberia's Response to Ebola

In mid 2014, Liberia's fragile health-care system, damaged by a 14-year civil war, could not respond to the demands posed by the largest-ever outbreak of Ebola. The rate of new infections rose, and schools and health facilities closed. Collaborating with international partners, the Liberian government created a dedicated Incident Management System (IMS) to coordinate the country's fight against the disease. The IMS team created a clear decision-making framework, facilitated coordination, and set up a coherent procedure for communicating with an anxious public.

Everybody's Business: Mobilizing Citizen's During Liberia's Ebola Outbreak

Liberia had few defenses when Ebola entered the country. Lacking an effective vaccine, containment efforts focused on restricting contact with those who were infected and anything they had touched. That advice countermanded basic human instincts to comfort a sick child or shake hands with a friend. After top-down tactics to win citizens' cooperation failed to stem the rate of infection, officials recruited community residents to go door-to-door, explain how people could protect themselves, and answer questions---helping to stem the spread of the disease and saving countless lives.


International Organization for Migration Ebola treatment unit in Sinje, Grand Cape Mount, Liberia. 
Photo by Martine Perret, UNMEER.

The Hunt for Ebola: Building A Disease Surveillance System

When Ebola appeared in Liberia, a critical first step was to identify those who had contracted the virus. However, Liberia's post-civil war disease surveillance capacity remained feeble, and citizens' distrust of the government posed a challenge for public health teams tasked with surveillance. To overcome these challenges, the government and its international partners engaged local leaders and community health workers in hunting the disease and developed data management practices to more effectively track and analyze the evolution of the epidemic. By year-end, most new Ebola infections involved Liberians who were already under observation. 

Offering a Lifeline: Delivering Supplies to Ebola-Affected Communities

When Ebola began to spill over national borders in West Africa, halting the epidemic depended as much on logistics as on addressing the medical challenge the virus posed. Without chlorine, protective gear, and other critical items, doctors and nurses could not work safely. But responders faced obstacles at every level of the supply chain. After initial disarray, the government, international organizations, nonprofit groups, and private companies developed a more centralized and integrated system. The volume, speed, and responsiveness of delivery increased across Liberia just as the epidemic began to wane. The challenges triggered a search for innovations that could address similar constraints during future infectious-disease outbreaks.

Filling Skills Gaps: Mobilizing Human Resources in the Ebola Fight 

Mobilizing and coordinating the assistance needed to respond to the Ebola outbreak challenged the Liberian government and international responders alike. Without adequate facilities and equipment, fear slowed recruitment, a problem made worse by constrained medical evacuation services and reduced airline access. Responding organizations owed a duty of care to their employees, and they worked to assemble the "space, supplies, and systems" that could reduce risk. They also sought to promote equity between Liberian and international responders and resilience in Liberia's health system. Gradually governments, international organizations, and voluntary groups were able to deploy thousands of health workers to help contain the epidemic. Lessons drawn from the experience prompted changes in policy and practice.  

ISS Featured Interview

In a 2015 interview with ISS, Dr. Mosoka P. Fallah discusses the evolution of the Ebola response in Liberia, highlighting the failure of the initial top-down approach in city districts and describing the process of developing a bottom-up approach which engaged local leaders in finding cases and building knowledge about the disease. The founding director of the newly established National Public Health Institute of Liberia, Fallah also provides insight on how a lack of resources and coordination among various supporting NGOs and government teams led to a prolonged epidemic in Liberia.

Upcoming Event: Innovations in Property Rights and Land Administration (link is external)

May 31-June 1, 2017
Washington, D.C.
Marking the launch of our new series of case studies about innovative practices and technologies in the land sector, we're hosting a two-day workshop to highlight key lessons and provoke thinking about implications for tenure security around the world. Co-sponsored by the Omidyar Network and New America Foundation, the event will feature insights from reform leaders, critical discussion with experts, and sessions focused on property rights case development and teaching. Sign up here to receive more details.

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Innovations for Successful Societies (ISS) is a joint program of Princeton University's
Woodrow Wilson School of Public and International Affairs 
and the Bobst Center for Peace & Justice.

ISS Monthly Newsletter Archive

March 2017: Land Administration

February 2017: Brazil Anti Corruption

January 2017: Property Rights & Land Administration

December 2016: Reconciling the Impossible: South Africa's Government of Unity

November 2016: The Ongoing Drive for Sustainable Cattle Ranching in Brazil

October 2016: Managing Tense Elections

September 2016: Indonesia's 2014 Presidential Transition

August 2016: Reforming Brazil's Military

July 2016: Graduates to Government: The President's Young Professionals Program In Liberia

June 2016: Delivering on Presidential Goals in the Dominican Republic

May 2016: Pockets of Effectiveness in Senegal and Indonesia

April 2016: Evaluation in Benin & Croatia Defense Reform

March 2016: Powersharing in Tunisia and Kenya

February 2016: Morocco Water, Tunisia Microfinance

January 2016: Mexico Veracruz and Ghana Presidential Transition

December 2015: Peru and Kenya Judiciaries

November 2015: Protecting Forests, Mitigating Climate Change

October 2015: Open Government Partnership

September 2015: Mexico's Presidential Transition

August 2015 Indonesia Military

July 2015: Kenya 2030 Strategy

June 2015: Calderon's Prexidency in Mexico, Anti Corruption in Luthuania

 May 2015: Bihar India Modernizing Systems to Improve Service Delivery

 April 2015: Two New Case Studies on the Philippines

 March 2015: Monitoring Kosovo's Courts 

 February 2015: Pakistan's Citizen Feedback Monitoring Program

 January 2015: ISS Announces a New Online Course

 January 2015: Reducing Deforestation in the Brazilian Amazon 

December 2014: Lagos State and Vietnam: Promoting Reform at the Local Level 

November 2014: Political Transitions in Chile

October 2014: Tunisian Elections

 September 2014: Strategy Development in Serbia and Estonia

 August 2014: Strategy Development in Malayasia

 July 2014: Effective Reforms in Brazil

June 2014: Public Sector Innovation in Mexico

May 2014: Short-Route Accountability in Afghanistan

April 2014: Elections in India

March 2014: Transforming Citizen Services

February 2014: Short-Route Accountability in Indonesia & the Philippines

January 2014: Anti-Corruption Agencies

December 2013: South Africa's Transition to a Non-Racial Democracy

November 2013: Reform Leaders on Effective and Accountable Civil Service

October 2013: Improving Policy Management and Service Delivery

September 2013: Combatting Corruption and Mediating Election Conflict

 August 2013: Improving Service Delivery and Reducing Election Violence 

July 2013: Increasing Accountability and Efficiency in Civil Service

June 2013: Government Delivery Units

May 2013: Anti-Corruption Commissions

April 2013: Election Reforms in Zambia and other Countries

March 2013: Civil Service Reforms in Brazil

February 2013: Infrastructure Projects, Government Investments and Obstacles

 January 2013: Anti-Corruption Efforts in the Baltics and Nigerian Elections

December 2012: Reforming City Management in Palmero and Johannesburg

November 2012: ISS Marks 100 Case Studies

October 2012: Kenya Open Data and the Rapid Results Approach

September 2012: Cabinet Reform and Anti-Corruption Agencies

August 2012: City Management in Bangalore and Rapid Results in Madagascar

July 2012: Indonesian and Georgian Reforms

June 2012: Revenue Collection in Liberia

May 2012: Center of Government in the Batics

April 2012: Indonesian Accountability and Nigerian Electoral Reform

March 2012: Improving Government Accountability, Leading Reform

Spring 2012 Newsletter

Summer 2012 Newsletter