All Hands on Deck: The US Response to West Africa’s Ebola Crisis, 2014-2015

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Abstract 

In 2014, an unprecedented outbreak of Ebola virus disease in Liberia, Sierra Leone, and Guinea shined a harsh spotlight on global capacity to deal effectively with a fast-moving epidemic that crossed international borders.  By the end of July, the outbreak had started to overwhelm health care systems in all three affected countries. In Liberia, health centers began to close, and President Ellen Sirleaf appealed for help from the United States. President Barack Obama tasked USAID’s Office of US Foreign Disaster Assistance (OFDA) to lead an interagency response. From early August 2014 to January 2016, an OFDA Disaster Assistance Response Team, or DART, deployed to Liberia to help coordinate efforts to stop the spread of infection. The DART was the first to involve a large-scale partnership with the US Centers for Disease Control and Prevention (CDC) to combat an infectious disease outbreak. Although the deployment, which scaled up earlier assistance, took place five months after the first reported cases and required extensive adaptation of standard practices, it succeeded in helping bring the epidemic under control: the total number of people infected—28,616—was well below the potential levels predicted by the CDC’s models. This US–focused case study highlights the challenges of making an interagency process work in the context of an infectious disease outbreak in areas where health systems are weak.

Jennifer Widner drafted this case study based on interviews from August 2016 to August 2017. The case is part of a series about the Liberian response to the 2014 Ebola outbreak, available through the Innovations for Successful Societies website. Case published June 2018. IBM’s Center for The Business of Government helped finance this case study.

Keywords 
emergency response
disease outbreak
epidemiological modeling
pandemics
quarantine
infection control
incident management system
data management
coordination
epidemics
interagency process
Focus Area(s): 
Ebola Response
Critical Tasks: 
Action plans
Consensus building
Coordination
Donor coordination
Follow-up & monitoring
Goal setting
Inter-ministerial coordination
Monitoring
Organization and staffing
Priority setting
Public outreach
Scenario building
Training
Country of Reform: 
United States
Type: 
Case Studies
Author: 
Jennifer Widner