Resumen ejecutivo:

A pesar de su implicación en el apoyo estratégico, material y logístico, así como en el combate, los roles de “soldado” y “víctima” están definidos de manera restringida para las mujeres en los programas posconflicto. La mayoría de programas de desarme, desmovilización y reintegración (DDR) abordan de manera limitada las cuestiones específicas relativas a las mujeres combatientes. El diseño de programas de DDR sensibles al género debe estar unido al proceso de paz en su conjunto, desde las negociaciones de paz hasta el mantenimiento de la paz, y debe continuar con actividades de construcción de paz. Esto incluye cuestiones como identificar a las mujeres y establecer los criterios apropiados para entrar en los procesos de DDR; comprender las cuestiones relativas a la identidad y los obstáculos para la participación política de las mujeres en el posconflicto; dirigirse a las mujeres como unidades más amplias con sus hijos y parejas en vez de como meramente individuos; abordar las necesidades de salud y psicosociales de las mujeres; y sensibilizar sobre las cuestiones particulares de las dimensiones de género de la violencia y las dificultades de la aceptación comunitaria. Este informe destaca lecciones aprendidas sobre enfoques de género en los procesos de DDR y señala que en lo que concierne a la implementación territorial, las comisiones nacionales de DDR deberían ser alentadas a trabajar estrechamente con entidades gubernamentales al cargo de los asuntos de género y de las mujeres, y – especialmente allí donde los gobiernos son responsables total o parcialmente del proceso de DDR – con las redes de mujeres constructoras de paz que pueden servir de puente en la transición a la vida civil y facilitar la reintegración social, política y económica.

By Ibrahim Al-bakri Nyei

Introduction

In late 2013, the Ebola virus was diagnosed in the forest region of Guinea. By mid-2014, it had spread alarmingly in the countries of the Mano River Basin – Liberia, Guinea and Sierra Leone. By the time it was declared a global health emergency by the World Health Organization (WHO) in August 2014, at least 1 711 people were infected and 932 people had died from the virus.

1 The Ebola virus was an alien phenomenon among both healthcare workers and ordinary people, and the affected countries lacked the capacity to respond effectively. The lack of proper response mechanisms at the beginning of the outbreak enabled the virus to spread rapidly, with a 90% fatality rate among the population, leaving citizens – mostly those in densely populated slum communities – in despair and desperation. What became further at risk was the stability of the three countries, two of which – Liberia and Sierra Leone – were still recovering from civil conflicts that had ended a decade earlier. While the crisis was largely health-based, it gravely affected political and security situations, leading observers to predict collapse, violence and a possible return to war.

Under what prevailing socio-economic conditions did the epidemic spread, and how did it pose political and security threats to the affected countries? How did the governments and their international partners respond to the crisis? How did the epidemic and response mechanisms lead to political and social tensions? With evidence from Liberia, this article explores these questions and advances some recommendations for promoting stability, with a focus on human security.

The Mano River Basin: A Region in Perpetual Fragility?

The countries in the Mano River Basin have been governed under mostly autocratic rule since independence. Strongman politics and one-party rule dominated the region and led to political uprisings and, ultimately, violent civil crises in the 1990s. Liberia and Sierra Leone experienced 14 years and 10 years respectively of wars, causing death, destruction of properties and mass displacements.2 In Guinea, strongman politics and military dictatorship led to continuous civil unrests and pockets of insurgencies. With the exit of Liberian president Charles Taylor in 2003, the countries in the region began transitioning from war to peace, with the aid of international organisations. The United Nations (UN) has kept a strong military and civil presence in Liberia and Sierra Leone. Côte d’Ivoire, which borders Liberia and Guinea, experienced instability and intermittent violent conflict during the same period. Both Côte d’Ivoire and Liberia currently have active UN missions facilitating peacebuilding.

At the time of the Ebola outbreak in 2013, all the countries in the Mano River Basin had reached some level of political stability, with no major outbreaks of violence for about 10 years and with democratic elections being held periodically to facilitate constitutional transitions of power. Liberia and Sierra Leone had two successful post-war elections, and Guinea held its first multiparty elections in 2010. The rise of civil society movements and massive international aid to support development programmes provided hope for building a sustainable democratic culture across the region and promoting socio-economic development. However, reports on these countries regarding human development, public integrity, corruption perception and fragility were appalling. In 2013, for example, Liberia, Guinea and Sierra Leone were at the bottom of the UN Development Programme (UNDP) Human Development Index, appearing in the category of Low Human Development. At the same time, Liberia and Sierra Leone were ranked among the countries with the highest poverty headcount percentages, based on the UNDP Multidimensional Poverty Index, at 85% and 77% respectively.3 In the same year, the three countries were declared among the world’s most fragile countries, with Liberia and Sierra Leone being put on alert, and Guinea on high alert.4 The countries in the region were perceived to be very corrupt, as shown by their respective scores in the Corruption Perception Index.5 Table 1 highlights the severity of the political and socio-economic conditions in the three countries at the time of the outbreak of the virus in 2013.

Table 1: Poverty, Corruption and State Fragility

Country | Human Development Index | Corruption Perception Index | Failed States Index

Liberia | 0.388 | 38 | 95.1 (alert)

Guinea | 0.355 | 24 | 101.3 (high alert)

Sierra Leone | 0.359 | 30 | 91.2 (alert)

Massive poverty and weak state institutions – underpinned by official corruption and patronage politics – are symptoms of state fragility, and have been the case for a long time in Liberia, Guinea and Sierra Leone. No wonder, therefore, that the governments in these most-affected countries lacked the capacity to respond adequately to the epidemic and prevent its spread among the already-destitute population. But this lack of response speaks to the larger issue of the absence of state institutions in areas far from the capital city. The overly centralised governance systems in the region have not provided for effective and sustainable service delivery at a local level. It is the prevalence of such governance arrangements – in which local officials have to take orders from the capital city before acting – that rendered local officials and healthcare workers incapable of responding to the Ebola outbreak when it started in the rural areas of Guinea, Liberia and Sierra Leone.

The Human Toll of the Ebola Epidemic

The lack of adequate healthcare systems, particularly at local levels (rural areas), resulted in the Ebola virus spreading from a remote forest community in Guinea to densely populated urban communities in Liberia and Sierra Leone. In Liberia, fear of the virus led to the closure of regular health centres, compelling people mostly to self-treat. This likely led to more deaths from curable diseases such as malaria and typhoid fever, which are also prevalent in the country. Actual figures show that the active transmission of Ebola in the Mano River Basin in 2013–2015 resulted in more infections and deaths than the total death toll across all outbreaks since the virus was first discovered in Democratic Republic of the Congo (then Zaire) in 1976.

7 Liberia alone accounted for nearly half of the total deaths across the three countries. Table 2 shows the human toll of the epidemic in the three countries, as of September 2015.

Table 2: Human Toll of the Ebola Epidemic

Country | Cumulative Cases | Deaths

Liberia | 10 672 | 4 808

**Guinea ** | 3 805 | 2 533

Sierra Leone | 13 911 | 3 955

Total (Mano River Basin)28 38811 296

How did the Governments Respond?

The rapid spread of the Ebola virus and the consequent death and chaos outweighed the capacity of the three governments to respond. By August 2014, the death rate had increased alarmingly and the population was frustrated. Hospitals were flooded with patients, health workers and medicines were in short supply, and health centres in Liberia rejected patients, while in Sierra Leone, strikes among healthcare workers worsened the situation. The population grew weary of the weak and inefficient response and retaliated in frustration – for example, in Guinea, villagers attacked and killed public health workers on allegations of spreading the virus. The governments resorted to security and political methods to contain the outbreak. A state of emergency was declared and all three countries closed their respective borders to prevent the movement of people, in an attempt to contain the Ebola virus. The International Crisis Group (ICG) warned that the spread of the virus and the military response by the three governments threatened stability, and could return the region to chaos.9 This claim was validated by the Liberian government when it declared that it no longer had the capacity to deal with the outbreak, warning further that the epidemic could lead to war in the country.10 Passionate pleas were made to the international community for assistance, which led to the United States (US), France and Britain setting up military hospitals and logistical support units in Liberia, Guinea and Sierra Leone respectively. The military response by the governments in the affected countries exacerbated fear and panic among citizens – but, as the ICG suggested, the governments had more soldiers than doctors, thus they deployed their military strength, even though it was a health crisis. Like the governments in the affected countries, the three foreign powers responded through their militaries, in addition to other channels of support, to end the epidemic.

These responses heightened tensions between the sitting governments and opposition parties in Guinea and Sierra Leone, both of which were preparing for major elections. In Guinea, longstanding differences between the government and the opposition on scheduling local elections intensified when the government announced that it could only organise the presidential election in 2015 and that local elections would be postponed until 2016, due to the outbreak of the Ebola virus.11 In Sierra Leone, the national census – which is significantly linked to elections – was postponed, and opposition parties accused the government of the intent to extend its rule by postponing the general elections, using the Ebola epidemic as a _cause célèbre._12 The Liberian government’s response to the outbreak led to mixed results. The evidence of security threats became even more conspicuous when measures such as night-time curfews and the heavy deployment of security forces at checkpoints were taken by government.

Ultimately, the mobilisation of communities by the government and local non-governmental organisations (NGOs) as key stakeholders in the fight against the virus became the most successful response mechanism to end the human-to-human transmission of the disease.

Political Instability and Insecurity in Liberia

The news of deployment of US military personnel in Liberia heightened fear in the population as rumours of coups and instability spread. Consequently, the Liberian government announced a curfew and restricted movements – including the quarantining of some communities suspected of harbouring Ebola patients. Those measures fell short of containing the spread of the virus effectively and stabilising the growing tensions. The postponement of the senate elections with the linked constitutional challenge, as well as the announcement of extra-emergency powers coupled with resistance in some communities, further exposed the fragile country to internal shocks. The reaction from the government, which led to political tension to the point of threatening stability in Liberia, is the focus of the following subsections.

Emergency Powers and Social and Political Tensions in Liberia

At the beginning of the outbreak of the Ebola virus, many Liberians denied the existence of the virus and accused the government of orchestrating a ploy to attract foreign aid. In their denial, people refused to comply with public health regulations, continued traditional burial rites and resorted to traditional healing methods. This is understandable in a country with a massive illiteracy rate, and with a history of broken trust between the state and its citizens. On 6 August 2014, a state of emergency was declared in Liberia, along with a night-time curfew. This gave the government the authority to enforce extra-constitutional measures. One of the casualties of these emergency powers was press freedom, marked by the arrest of journalists and the lock-down of a newspaper.13 West Point, a densely populated slum in the city of Monrovia, was quarantined when residents ransacked and looted an Ebola Treatment Unit (ETU), accusing the government of not consulting them and threatening their health by the establishment of the ETU. Local residents resisted the quarantine, and they were not allowed to protest due to the state of emergency. The government then enforced the quarantine by deploying armed security personnel and blocking all entries into the slum community. This was met by strong resistance from local residents, leading to clashes during which security forces fired live bullets, killing at least one teenager and wounding several others.

The use of emergency powers during the Ebola crisis was perceived by many as an attempt to suppress dissent from the opposition and civil society, many of whom criticised the government for managing the situation poorly and squandering international aid money intended to fight the epidemic. In October 2014, a request by the president to extend the state of emergency and to curtail certain fundamental rights was condemned by the opposition and the civil society movement, and subsequently rejected by the legislature. In response, the president issued Executive Order Number 65, banning mass movements of people, particularly in relation to the senate elections campaign. According to the government, the objective of the executive order was “to strengthen the efforts of the Government of Liberia to contain the spread of Ebola, protect the security of the State, maintain law and order, and promote peace and stability in the country”.

This brought to the fore important questions on the use of emergency powers in crisis situations in Liberia. The Constitution of Liberia provides in Article 86(b) that “[a] state of emergency may be declared only where there is a threat or outbreak of war or where there is civil unrest affecting the existence, security or well-being of the Republic amounting to a clear and present danger”. The key issues during the contention between the government and the opposition were the curtailment of fundamental rights such as free movement and free expression, and freedom of association and religion. Many thought these were excessive and untenable in relation to the fight against Ebola.

Constitutional Crisis on Senate Elections

Senate elections, set to be held on 14 October 2014 in line with the constitution, could not be held in Liberia due to the state of emergency put in place to contain the spread of the Ebola virus. All election-related activities – including mass rallies and queuing to vote – were against the public health measures needed to stop the human-to-human transmission of the virus. With a marked decrease in the number of Ebola cases by November 2014, stakeholders – including the National Election Commission (NEC), political parties and civil society organisations – held consultations and rescheduled the elections for 16 December 2014. However, some political actors challenged the constitutionality of this move in the Supreme Court, which led to a stay order. Their contention was that since the date set by the constitution for the elections had passed without the elections being held, no institution (not even the government) had the authority to set a date for elections under the constitution; thus, they demanded what they called a “sovereign national conference” of the citizens.15 The Supreme Court subsequently ruled in favour of the NEC, and the senate elections were finally held on 20 December 2014.

Liberia was headed for an unprecedented constitutional crisis if the senate elections were not held before the constitutional tenure of the incumbent senators expired in January 2015. Considering the mounting political and social tensions during the height of the epidemic – occasioned by street protests, excessive use of force by security forces and bickering among politicians – it could easily be predicted that this could have led to prolonged political instability, if not a violent crisis, in Liberia.

Conclusion

The Ebola epidemic of 2013–2015 has been the most devastating tragedy to have hit the three countries of the Mano River Basin since the civil wars in Liberia and Sierra Leone. As mentioned, the disease not only infected and killed people in the Mano River Basin, but had the greater impact of affecting peace and stability in the subregion, as was seen in Liberia. Both the Ebola epidemic and the attendant political crises are symptomatic of continued state fragility and weak capacity in Liberia, Guinea and Sierra Leone. Billions of dollars of aid money have been spent in the name of supporting state-building in the three countries for over a decade. Unfortunately, the Ebola epidemic revealed that the massive investment of international aid money and national expenditures from government budgets have done little to support functional state institutions. With a focus on physical security – police and military – the international community and the national governments paid little attention to human security issues such as investing in healthcare, education and youth empowerment, in the last decade of peacebuilding in the region.

The Liberian experience of the Ebola epidemic is highly illustrative of the inability of the states in the region to deliver on their constitutional promises and to maintain political and social stability while responding to non-military or non-security threats. Post-Ebola recovery measures in the subregion must pay keen attention to key sectors of the state and society. Practical actions are needed beyond the promises of economic growth and development through the much-vaunted models of “trigger-down” economic policies that restrict governments to certain policies.

Liberia, the hardest hit of the three affected countries, has the opportunity to recreate itself through its ongoing constitutional reform exercise. It is important that its current reform focuses on building a democratic and decentralised governance system with emphasis on devolving authorities and resources for local service delivery capacity, particularly in the social service sector: health, education and youth empowerment. While post-Ebola recovery efforts in Liberia need to focus more on improving the ravaged healthcare sector, democratic reforms to ensure political and financial accountability of state actors are critical to strengthen the capacity of the Liberian state in all areas, particularly in delivering basic social services and human security, which has received very little attention over the years of peacebuilding and state-building.

Endnotes

1. Kelland, Kate (2014) ‘WHO Declares Ebola Epidemic as an International Health Emergency’, Available at: <http://www.reuters.com/article/2014/08/08/us-health-ebola-emergency-idUSKBN0G80M620140808> Accessed 21 September 2015.

2. It has been reported that over 250 000 people were killed in Liberia and 70 000 in Sierra Leone. See Report of the Truth and Reconciliation Commission of Liberia (2009), Available at: <http://trcofliberia.org/reports/final-report> Accessed September 2015; See also Kaldor, Mary and Vincent, James (2006) Evaluation of UNDP Assistance to Conflict-affected States; Case Study Sierra Leone. New York: UNDP Evaluation Office.

3. United Nations Development Programme (2013) The Rise of the Global South: Human Development Report 2013. New York: UNDP.

4. Fund for Peace (2013) ‘Failed States Index 2013’, Available at: <http://library.fundforpeace.org/library/cfsir1306-failedstatesindex2013-06l.pdf> Accessed 25 September 2015.

5. Transparency International (2013) ‘Corruption Perception Index 2013’, Available at: <https://www.transparency.org/cpi2013/results> Accessed 25 September 2015.

6. The author assembled this table with data from the Human Development Report 2013 Available at: <http://hdr.undp.org/sites/default/files/reports/14/hdr2013_en_complete.pdf> Accessed 25 September 2015 , Corruption Perceptions Index 2013 Available at: <http://www.ey.com/Publication/vwLUAssets/EY-Transparency-International-Corruption-Perceptions-Index-2013/$FILE/EY-Transparency-International-Corruption-Perceptions-Index-2013.pdf> Accessed 25 September 2015, and Failed States Index 2013 Available at: <http://library.fundforpeace.org/library/cfsir1306-failedstatesindex2013-06l.pdf.> Accessed 25 September 2015.

7. Author unknown (2014) ‘Ebola: Mapping the Outbreak’, BBC News, 14 January, Available at: <http://www.bbc.com/news/world-africa-28755033> Accessed 31 May 2016.

8. The author assembled this table from data from World Health Organization (WHO) (2015) ‘Ebola Data and Statistics: Situation Summary, Data Published on 30 September’, Available at: <http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20150930?lang=en> Accessed 20 September 2015.

9. International Crisis Group (2014) ‘Statement on Ebola and Conflict in West Africa’, Available at: <http://www.crisisgroup.org/en/publication-type/media-releases/2014/africa/statement-on-ebola-and-conflict-in-west-africa.aspx> Accessed 21 September 2015.

10. Author unknown (2014) ‘Liberia Fears Ebola Crisis will Spark War’, Al Jazeera News, 24 September, Available at: <http://www.aljazeera.com/news/africa/2014/09/ebola-liberia-war-201492485447852773.html> Accessed 27 September 2015.

11. Camara, Karim (2015) ‘Political Tensions in Guinea Heating Up’, Voice of America, 22 April, Available at: <http://www.voanews.com/content/political-tensions-in-guinea-heat-up/2730184.html> Accessed 1 October 2015.

12. Author unknown (2015) ‘Sierra Leone News: SLPP Insists on Elections to be Held as Expected’, Awoko, 26 May, Available at: <http://awoko.org/2015/05/26/sierra-leone-news-slpp-insists-on-elections-to-be-held-as-expected> Accessed 1 October 2015.

13. On 14 August 2014, officers of the Liberia National Police forcibly entered the offices of the National Chronicle newspaper, arrested and detained two journalists and shut down the paper. The publisher resisted arrest. See Center for Media Studies & Peace Building (CEMESP) (2014) ‘Liberia: Offices of Independent Newspaper Shut Down, Staff Arbitrarily Arrested’, Ifex, 18 August, Available at: <https://www.ifex.org/liberia/2014/08/18/shutdown_arrest> Accessed 31 May 2015.

14. Executive Mansion (2014) ‘President Sirleaf Issues Executive Order No. 65; Prohibits Mass Movements of People Including Rallies, Parades and Demonstrations’, Press Release, 4 December, Available at: http://www.emansion.gov.lr/2press.php?news_id=3151&related=7&pg=sp#sthash.9MlrmUbs.dpuf Accessed 3 October 2015.

15. For a deeper analysis of this constitutional crisis, see Nyei, Ibrahim Al-bakri (2014) ‘Election or No Election: Another Hard Test for the Liberian Constitution’, Available at: <http://www.ibrahimnyei.blogspot.com/2014/12/election-or-no-election-another-hard.html> Accessed 4 October 2015.

Aid workers carry out life-saving often in dangerous and difficult circumstances. Over the past 16 years, 427 aid workers were killed, wounded or kidnapped in West and Central Africa. The number of victims follows a worrying upward trend with spikes in attacks recorded in recent years. Countries with the highest number of victims are the Democratic Republic of Congo, the Central African Republic, Nigeria, Chad and Mali. The majority of victims were national staff, who account for the bulk of humanitarian workers and are often the most exposed to risks

Heavy rains expected to further increase risk of flooding in West and East Africa

Africa Weather Hazards

1. The persistence of above-average rainfall continues to increase both short-term and long-term rainfall surpluses and trigger flooding throughout many areas in Sudan, South Sudan and western Ethiopia. Above-average rainfall is forecast to continue over the region, further worsening the potential for flooding over many downstream areas of eastern Sudan during the next week.

2. Although less rainfall is forecast over the region this week, torrential rains in early August led to floods that damaged infrastructure and food stocks and displaced people in the Darfur States of Sudan.

3. Increased locust populations in Yemen are forecast to migrate across the Red Sea into parts of Eritrea, Ethiopia, and Djibouti during August.

4. Heavy and frequent rain over the past several weeks has led to substantial rainfall surpluses and flooding over over many local areas of West Africa. During the next week, above-average rainfall is forecast, which will further increase the risk of flooding.

5. Heavy rainfall in July over parts of Senegal, Mali, and southern Mauritania has led to the potential for increased numbers of locusts, which may negatively impact cropping activities.

International Development Minister Rory Stewart offers thanks to humanitarian workers.

If you combine the number of people affected by conflict, natural disasters, disease and extreme poverty around the world they would form the tenth most populous country on earth.

The UK is a global leader in responding to humanitarian crises and today, on World Humanitarian Day (Friday 19 August), we pay tribute to the brave aid workers who risk their lives to help those caught up in conflict and disaster.

International Development Minister Rory Stewart said:

"Conflict, natural disasters and poverty mean that right now there are over 125 million people in need of life-saving aid - a level of human suffering not seen since the Second World War.

"Many of these terrible problems happen in countries where security is difficult, and where individuals are choosing to risk their lives to save others by delivering water, food, shelter, and medicine to people in need. We offer our sincerest thanks to them on World Humanitarian Day.

"By helping countries better prepare for and deal with long-term crises, we are helping to build a more stable, secure and prosperous world for all.

Of all countries, the UK is the second largest provider of humanitarian assistance after the United States. From leading the fight against Ebola in Sierra Leone and reaching people affected by the earthquakes in Nepal within hours, to providing the opportunity for jobs and education to those caught up in the Syria crisis, support from the Department for International Development is saving lives and tackling problems at source – all in Britain’s national interest.

Earlier this year, the World Humanitarian Summit brought the international community together to commit to action that will better support and protect those worst affected by conflict and extreme poverty. Building on the success of the Supporting Syria Conference in London, the UK played a key role at the summit, demonstrating Britain’s continued leadership in responding to protracted crises around the world.

Key achievements of the UK’s humanitarian work in 2015-16 include:

• The crisis in Syria and the region – the UK has been supporting those affected by the crisis for over 5 years and co-hosted the ‘Supporting Syria and the Region’ conference in London in February 2016 which saw commitments to create an estimated 1.1 million jobs for Syrian refugees and citizens in countries hosting refugees such as Jordan and Lebanon. The international community also pledged to ensure that 1.7 million children affected by the conflict will get a quality education.

• Ebola crisis in Sierra Leone – the Department for International Development led the international response to Ebola in Sierra Leone and played a huge part in helping the country become Ebola-free.

• Nepal earthquake – due to pre-positioned stock, UK aid was reaching hard-hit communities within hours of the devastating earthquakes in Nepal and has continued to reach hundreds of thousands in need of basic supplies.

• El Nino – the 2015-16 El Nino effect was one of the worst weather events on record, affecting 60 million worldwide. The UK has been at the forefront of preventing and preparing for the effects of El Nino in the world’s poorest places, by pre-positioning medicine and food supplies and helping people get an income so they can feed their families.

• Central African Republic – support from the Department for International Development has provided around 800,000 Central Africans and Central African refugees with emergency healthcare, livelihood assistance, protection and food aid.

• South Sudan – UK aid reached at least 600,000 people in need of life-saving assistance.

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816 aid workers reported killed, kidnapped, injured or assaulted between January 2015 and June 2016

In 2015, open sources reported 515 aid workers killed (179), kidnapped (129) and assaulted or injured (207) in 234 severe incidents. During the first six months of 2016, open sources reported 301 aid workers killed (129), kidnapped (75) and assaulted or injured (97) in 122 severe incidents.

Addis Ababa, 19 August 2016– Health ministers from the World Health Organization’s (WHO) African Region have begun a five-day meeting to discuss some key health issues affecting the Region.  Addressing the opening session in Addis Ababa, the President of Federal Democratic Republic of Ethiopia, His Excellency, Dr Mulatu Teshome, observed that in the coming decades non-communicable and communicable diseases, epidemics and Africa’s demographic shifts will pose significant challenges to development. He stressed the importance of strengthening health systems and preparedness to address both current and emerging challenges.

President Teshome underscored the critical role of health in socio-economic development and called on governments to prioritise health. “As good health is a driver of our economic growth and development, as leaders, we need to acknowledge the instrumental and intrinsic value of good health and give it the necessary attention,” he said. 

In her remarks, the Director-General of the World Health Organization, Dr Margaret Chan, reminded delegates that the 2030 Agenda for Sustainable Development and Africa’s Agenda 2063 can shape African development well into the future. She noted that the Region can take guidance from the Africa Health Transformation Programme – a five-year plan to transform the health and well-being of African people focused on universal health coverage. Dr Chan said universal health coverage serves is a strong platform for both fair and inclusive health development and increased global health security. “Africa stands to benefit the most as its implementation will tackle poverty, not superficially through hand-outs, but fundamentally, by addressing its root causes,” she added.

The Director-General noted that the progress in health development over the past decades is testament to what can be achieved even in resource-constrained settings. This is an incentive for further investment of domestic and foreign resources. Dr Chan emphasized that the future of Africa depends on its people and not on commodity prices or oil and mineral reserves, therefore countries should place the development of human resources as the primary focus of sustainable development.

Addressing the meeting, the WHO Regional Director for Africa, Dr Matshidiso Moeti, informed delegates that the region has continued to make strides in health security with particular focus on strengthening preparedness and response to epidemics.  She summed up the Region’s efforts and achievements in this regard by reminding delegates that the transmission of the Ebola Virus disease in West Africa had been interrupted. She informed the meeting that, with the contribution of partners, over 126 international experts have been deployed and about 19 million doses of yellow fever vaccines provided to tackle the yellow fever epidemics in Angola and the Democratic Republic of the Congo.

Dr Moeti noted that in April 2016, all the Member States in the region completed the global switch from tri-valent Oral Polio Vaccine (tOPV) to bi-valent Oral Polio Vaccine (bOPV) on time. The switch eliminates the risk of paralysis from vaccine-derived poliovirus type 2. Referring to malaria and TB, it was noted that malaria cases have declined by 42% and deaths by 66% between 2000 and 2015, and six countries are on track to eliminate malaria by 2020. Dr Moeti observed that although the AIDS epidemic is not over, and remains one of our Region’s biggest public health priority, there has been significant progress in combating the disease in the Region. HIV-related deaths have declined for the past 10 years, and there has been significant scale-up of services for the prevention of mother-to-child transmission, and antiretroviral therapy. “We need to address the underlying human rights issues such as poverty, discrimination and inequality which drive vulnerability. Improving the efficiency of HIV programmes, increasing domestic financing and lowering the cost of treatment will go a long way in meeting the needs of people living with HIV,” she said.

With the number of adolescents predicted to increase in the African Region in the next fifty years, the Regional Director appealed to countries to ensure that every adolescent has the knowledge, skills, and opportunities for a healthy and productive life, and enjoyment of all human rights. “They are our best chance to achieve radical change for a prosperous, healthy, and sustainable region, as recognised in the AU’s Agenda 2063.  We must put adolescents at the centre of the post-2015 framework to improve overall health and development in countries,” urged Dr Moeti.

The 66th session of the WHO Regional Committee for Africa takes place from 19 - 23 August 2016 and will deliberate and pass decisions on a number of key issues for health in the Region.  The meeting is attended by Ministers of Health and heads of delegations from the 47 Member States in the African Region, global and regional development partners.

For more information, please contact:

Dr Ibrahima Soce-Fall, Regional Emergency Director, WHO African Region ,

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, Tel +47-241-39695, +242065104619

Collins Boakye-Agyemang, Regional Communications Adviser; Tel: + 242 06 520 6565; Email:

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Loza Mesfin Tesfaye, Communications Officer, WHO AFRO; Tel: +251 911 144 194; Email:

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Fabienne Aboua, Communications Officer, WHO AFRO; Email:

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Pieter Desloovere, Communications Consultant, WHO AFRO; Email:

deslooverep@who.int

• UNHRD continues to dispatch operational equipment for its Partners, most recently supporting WFP by sending ICT equipment to Freetown in Sierra Leone.

• During the worst of the crisis, UNHRD facilities in Accra and Las Palmas served as regional staging areas and the Accra depot hosted UNMEER headquarters.

• On behalf of WFP, UNHRD procured and dispatched construction material and equipment for remote logistics hubs, Ebola Treatment Units (ETU) and Community Care Centres. In collaboration with WHO, UNHRD also procured and dispatched equipment to establish camps for teams tracing EVD. Members of the Rapid Response Team (RRT) set-up supply hubs, an ambulance decontamination bay and ETUs.

AMOUNT: EUR 170 024 365.84 2

The present Humanitarian Implementation Plan (HIP) was prepared on the basis of financing decision ECHO/WWD/BUD/2016/01000 (Worldwide Decision) and the related General Guidelines for Operational Priorities on Humanitarian Aid (Operational Priorities). The purpose of the HIP and its annex is to serve as a communication tool for ECHO's partners and to assist in the preparation of their proposals. The provisions of the Worldwide Decision and the General Conditions of the Agreement with the European Commission shall take precedence over the provisions in this document.

1. MAJOR CHANGES SINCE PREVIOUS VERSION OF THE HIP

Fourth modification as of 05/08/2016

a) In all four countries affected by Boko Haram violence (Nigeria, Niger, Chad and Cameroon), an increased field presence and some recent improvements in access have enabled the assessment of needs of populations in areas previously not accessed by humanitarian assistance. These assessments have revealed additional emergency situations, prompting key partners to scale up their response to address the massive humanitarian needs of the affected populations.

In addition to the great number of IDPs and refugee populations (IDPs estimated to be 2.6 million in the region, refugees over 176 000) who are highly dependent on humanitarian assistance, the host and local communities are also increasingly affected, impacting their coping capacity. Staple food prices are reported to have increased by an alarming 30 to 50% in the region due to the disruption of regional trade exchanges.

Special assistance to these affected local communities is therefore also urgently needed.
The areas affected by the Boko Haram violence are part of the Sahel belt and suffer from recurrent droughts and long lean seasons. The massive recent displacements have compounded the structural food insecurity and chronical under-nutrition known in these areas, leading to over 6.7 million people requiring emergency food assistance in the four countries.

An amount of EUR 10.5 million is added to this HIP to reinforce the humanitarian response to the consequences of the Boko Haram crisis in Nigeria and Niger.

In the last few months, the humanitarian consequences of the conflict between national armed forces and Boko Haram have intensified in North-East Nigeria and its neighbouring countries around Lake Chad, notably in Niger, resulting in new displacements and the further deterioration of the situation of affected populations, as well as in increased protection needs. Additional needs include NFI, shelter, food, health and nutrition.

L'essentiel:

• Situation alimentaire alarmante chez les personnes déplacées internes à Maiduguri dans l’Etat de Borno – Nigeria.

• Installation progressive et quasi définitive de la campagne agricole 2016-2017.

• Hausse continuelle de l’indice des prix des produits observée depuis cinq mois.

La campagne agricole 2016 a eu un démarrage relativement précoce, notamment dans la zone soudano-sahélienne avec cependant des poches de déficit au Centre-ouest du Sénégal, le littoral du Liberia, la zone centre du Ghana, le sud du Togo et au sud-ouest du Nigeria.

La mise à jour des prévisions saisonnières en juillet indique que les probabilités d’avoir des cumuls pluviométriques supérieurs à la moyenne sur la majeure partie du Sahel central et oriental et inférieurs à la moyenne sur les régions de l’extrême Ouest, demeurent élevées.

Les conditions d’élevage globalement moyennes commencent à s’améliorer avec la régénération des pâturages suite aux bonnes pluies enregistrées.

La situation alimentaire et nutritionnelle dans le bassin du lac Tchad continue d’être précaire surtout chez les personnes déplacées internes (PDIs). A Maiduguri dans l’Etat de Borno - Nigéria, 67,5 pour cent des PDIs sont en insécurité alimentaire et 32 pour cent ont recours à des stratégies d’adaptation d’urgence (mendicité).

Au début du mois de juin 2016, dans le département de Bosso à Diffa (Niger), une série d’attaques ont été perpétrées par Boko Haram, occasionnant des déplacements forcés de la population. Face à cette nouvelle crise, 59 pour cent des ménages ont déclaré avoir été confrontés à des difficultés alimentaires au cours des sept derniers jours (Bulletin mVAM/Niger - Juin 2016).

CaLP in West Africa is launching a new Cash and Ebola project that aims to optimize the use of CTP in future crises by documenting, analyzing and providing recommendations from the use of CTP in the Ebola Crisis.

Project background and CTP in Ebola Outbreak

The economic impact of the Ebola crisis is still to be fully understood, but in April 2015 the World Bank estimated 2.2 billion USD in economic losses due to the Ebola crisis in the three most affected countries (Sierra Leone, Liberia and Guinea), which caused huge economic impact at national, community and household levels. In this context, recovery is a major challenge for Ebola survivors and victims’ families.

Supported by its implementation partners, FFP (The Office of Food for Peace - USAID) was a major actor in the Food Security response to the Ebola outbreak in Sierra Leone and Liberia, with humanitarian contributions summing up to $101.5 million in 2015, embracing the idea of using CTP as a mechanism to support Ebola affected communities.

In order to document, analyze and draw learnings from those CTP projects during the epidemic, the Cash Learning Partnership (CaLP) and FFP are working together on a dedicated project in Sierra-Leone and Liberia, where FFP partners have implemented CTP through a diversity of technical approaches. This provides a unique opportunity for documenting and capitalizing on CTP in epidemic crises.

The role of CaLP in CTP Ebola epidemic response in Sierra Leone and Liberia

Building on its experience with the humanitarian community through capacity building, advocacy, evidence gathering and support to coordination, since 2014 CaLP has been responding to requests from actors involved in the Ebola crisis response in Sierra Leone and Liberia, supporting the creation of Cash Working Groups and sharing tools and/or resources.

CaLP has been charged with leading a learning path including a documentation report. This research piece consists of mapping, comparing and analyzing the diverse CTP strategies employed by FFP partners in Liberia and Sierra Leone in response to the Ebola outbreak from a technical perspective. This technical analysis is focused on key technical questions to provide learnings and recommendations for the broad community of practice, identifying factors of success and best practices to optimize the use of CTP in similar contexts / crises.

CaLP has therefore identified nine organizations, supported by Food for Peace to deliver CTP in Sierra Leone and Liberia, on which to base its documentation work.In the research process, CaLP will also conduct 4 learning events (2 in Sierra Leone and 2 in Liberia) providing space to share experiences collectively, discussing good practices and lessons learnt on CTP in the Ebola response.

A case study will be developed to illustrate notable approaches or dig deeper into specific operational lessons learnt. CaLP will also produce a video giving an overview of appropriateness of CTP in Ebola, illustrating the unique context of implementing CTP for such large scale and unexpected epidemics.

CaLP will ensure that all lessons learnt from the project benefit the global community of practice by organizing webinars and dissemination events to share the findings of the project products.

L'essentiel:

• Situation alimentaire alarmante chez les personnes déplacées internes à Maiduguri dans l’Etat de Borno – Nigeria.

• Installation progressive et quasi définitive de la campagne agricole 2016-2017.

• Hausse continuelle de l’indice des prix des produits observée depuis cinq mois.

La campagne agricole 2016 a eu un démarrage relativement précoce, notamment dans la zone soudano-sahélienne avec cependant des poches de déficit au Centre-ouest du Sénégal, le littoral du Liberia, la zone centre du Ghana, le sud du Togo et au sud-ouest du Nigeria.

La mise à jour des prévisions saisonnières en juillet indique que les probabilités d’avoir des cumuls pluviométriques supérieurs à la moyenne sur la majeure partie du Sahel central et oriental et inférieurs à la moyenne sur les régions de l’extrême Ouest, demeurent élevées.

Les conditions d’élevage globalement moyennes commencent à s’améliorer avec la régénération des pâturages suite aux bonnes pluies enregistrées.

La situation alimentaire et nutritionnelle dans le bassin du lac Tchad continue d’être précaire surtout chez les personnes déplacées internes (PDIs). A Maiduguri dans l’Etat de Borno - Nigéria, 67,5 pour cent des PDIs sont en insécurité alimentaire et 32 pour cent ont recours à des stratégies d’adaptation d’urgence (mendicité).

Au début du mois de juin 2016, dans le département de Bosso à Diffa (Niger), une série d’attaques ont été perpétrées par Boko Haram, occasionnant des déplacements forcés de la population. Face à cette nouvelle crise, 59 pour cent des ménages ont déclaré avoir été confrontés à des difficultés alimentaires au cours des sept derniers jours (Bulletin mVAM/Niger - Juin 2016).

• UNHRD continues to dispatch operational equipment for its Partners, most recently supporting WFP by sending ICT equipment to Freetown in Sierra Leone.

• During the worst of the crisis, UNHRD facilities in Accra and Las Palmas served as regional staging areas and the Accra depot hosted UNMEER headquarters.

• On behalf of WFP, UNHRD procured and dispatched construction material and equipment for remote logistics hubs, Ebola Treatment Units (ETU) and Community Care Centres. In collaboration with WHO, UNHRD also procured and dispatched equipment to establish camps for teams tracing EVD. Members of the Rapid Response Team (RRT) set-up supply hubs, an ambulance decontamination bay and ETUs

The UK government is working with the Ministry of Education and Science and Technology (MEST) and UNICEF to ensure that young girls previously excluded from the system can return to full-time education. Guy Warrington, newly arrived British High Commissioner to Sierra Leone, visited a ground-breaking initiative at the War Wounded Academy in Grafton on 19 August. He was hosted by Mrs Olive Musa from MEST. He saw how UK Aid worked with the government of Sierra Leone (GoSL) to help 1.8 million children back to school by ensuring that there was effective infection prevention control, psychosocial support, and an accelerated curriculum to help teachers and children to make up for lost time.

During the Ebola crisis an entire generation of children missed almost a year of education as schools closed due to the crisis, and thousands were orphaned. The GoSL restricted visibly pregnant girls from attending mainstream schools during pregnancy. To ensure that these girls did not permanently drop out of school, the GoSL created the Bridging the Education Programme which was jointly rolled out by DFID, Irish Aid, UNFPA and UNICEF in October 2015. This programme enabled the girls affected to continue their education and then re-join mainstream school. The programme received an overwhelming response and more than 14,500 girls have since benefitted across 14 districts, 330 learning centres provide continuing education to the affected girls; and out of the 14,500 girls, 5,072 were re-integrated into mainstream school in January 2016. The remainder will re-join mainstream school in September 2016.

The British High Commissioner was shown how learning centres offer classes for upper primary (Primary 5 and 6), junior secondary school (JSS 1-3) and senior secondary school (SSS 1-4). 2,297 teachers were selected and trained by MEST to facilitate and support the Bridging Education Programme. The British High Commissioner said that he was pleased that his first visit to a UK-funded project was in the key area of education for young girls:

Education is a right which should be available to all, none should be marginalised.

UK works with Sierra Leone to provide education for girls forced to leave school during Ebola crisis.

The UK government is working with the Ministry of Education and Science and Technology (MEST) and UNICEF to ensure that young girls previously excluded from the system can return to full-time education. Guy Warrington, newly arrived British High Commissioner to Sierra Leone, visited a ground-breaking initiative at the War Wounded Academy in Grafton on 19 August. He was hosted by Mrs Olive Musa from MEST. He saw how UK Aid worked with the government of Sierra Leone (GoSL) to help 1.8 million children back to school by ensuring that there was effective infection prevention control, psychosocial support, and an accelerated curriculum to help teachers and children to make up for lost time.

During the Ebola crisis an entire generation of children missed almost a year of education as schools closed due to the crisis, and thousands were orphaned. The GoSL restricted visibly pregnant girls from attending mainstream schools during pregnancy. To ensure that these girls did not permanently drop out of school, the GoSL created the Bridging the Education Programme which was jointly rolled out by DFID, Irish Aid, UNFPA and UNICEF in October 2015. This programme enabled the girls affected to continue their education and then re-join mainstream school. The programme received an overwhelming response and more than 14,500 girls have since benefitted across 14 districts, 330 learning centres provide continuing education to the affected girls; and out of the 14,500 girls, 5,072 were re-integrated into mainstream school in January 2016. The remainder will re-join mainstream school in September 2016.

The British High Commissioner was shown how learning centres offer classes for upper primary (Primary 5 and 6), junior secondary school (JSS 1-3) and senior secondary school (SSS 1-4). 2,297 teachers were selected and trained by MEST to facilitate and support the Bridging Education Programme. The British High Commissioner said that he was pleased that his first visit to a UK-funded project was in the key area of education for young girls:

“Education is a right which should be available to all, none should be marginalised.”

Psychosocial support (PSS) has been one of the five pillars of the International Federation of Red Cross and Red Crescent Societies’ (IFRC) response to the Ebola outbreak in West Africa.

As the Ebola operation gradually moves from response to recovery, there are growing experiences in terms of understanding the psychosocial needs of beneficiaries, staff, and volunteers, and in implementing psychosocial support inter-ventions for beneficiaries in the context of Ebola.

In December 2015, the IFRC Ebola virus disease (EVD) operation hosted a two-day lessons learned workshop on psychosocial support in Ebola to document and share the lessons learned from the PSS component of the Ebola operation across the affected countries. The workshop was conducted in Dakar, Senegal with representation from the National Societies of Liberia, Guinea, Sierra Leone, IFRC’s regional EVD operation’s office, and the IFRC Nairobi Africa regional office.

The workshop was facilitated by the IFRC Reference Centre for Psychosocial Support and focused on lessons learned pertaining to two key aspects of PSS in Ebola:

• Care and support for staff and volunteers

• Psychosocial support interventions for beneficiaries

Key reccomendations

The key recommendation arising from the workshop is that psychosocial support should have had a higher priority from the onset and throughout the EVD response, and that concerted advocacy efforts are needed at different levels to ensure that PSS is a strong pillar in future responses.

Furthermore, the recovery phase is seen as an important opportunity to strengthen PSS capacity in the National Societies, and to create strong networks at the regional level to increase knowledge sharing and capacity building.

Additional recommendations for future outbreaks of Ebola and other epidemics are enclosed in the report. The ambition is that these recommendations will be institutionalized in order to improve PSS preparedness for future Ebola outbreaks as well as other epidemics.

Summary: How investment can provide critical growth in countries recently affected by Ebola.

On behalf of the Overseas Private Investment Corporation, the development finance institution of the United States, I recently led a delegation of investors to Liberia and Sierra Leone.

Our aim, in both of these post-Ebola nations, was multifaceted.

We wanted to show our solidarity with those in Liberia and Sierra Leone who have suffered and continue to grieve profound losses. We wanted to hear from local investors, businessmen and government leaders about the business opportunities and challenges to realizing long term investment in these economies. We wanted to bring international private investors to explore opportunities in priority sectors such as infrastructure, power, health care and education. And, we wanted to send a positive signal to the rest of the world that, once again, these nations are open and eager to attract new sources of private capital.

Everywhere, we saw stark contrasts, and we saw the green shoots of progress.

The depth of devastation visited upon Liberia’s economy by the civil war is still very much evident in the power infrastructure. In a country where 84% of Liberians currently live on less than $1.25/day, matters are made worse by only 2% of the population having access to grid power. Altogether, Liberia still has less than 25 MW of electricity in its main grid—roughly one tenth of its capacity before the civil war, and an even smaller fraction of what the population needs. And, take for a second the average tariff of power in Liberia: $.49/kWh. This is one of the highest power prices in the world, with neighbors like Sierra Leone paying significantly less at an average tariff of $.29/kWh.

Despite the energy challenges, we were able to visit the construction site of the Mount Coffee Hydropower Plant, funded in part by the U.S. Millennium Challenge Corporation and supporting the President’s Power Africa initiative to increase energy access on the continent. Once completed, it will be able to provide up to 88 megawatts of additional electricity to Liberians.

In Sierra Leone, the energy challenges are similar: only 13% of Sierra Leone’s citizens have access to the power grid, and only 1% of the rural population have access to electricity. However, meeting with a number of energy entrepreneurs, including those focusing on off-grid energy, proved that the energy future could be bright.

In both nations, we heard from government officials about the tragic and far-reaching extent of the Ebola crisis, and about how its arrival amid the collapse of commodity prices delivered a doubly punishing economic blow.

Yet we also heard firsthand about the resilience of the Liberians and Sierra Leoneans, and their determination to invest for the long term in better, safer and more prosperous lives for themselves, their families and their countries.

Aid will continue to be necessary. Both nations--small, impoverished and loosely integrated--will need help in multiple sectors that are not yet ready for private investment. But there are many sectors that could be attractive for private investors, provided they have appropriate incentives and business-friendly government rules, policies and processes. Private capital partnerships between local and international investors such as those whom we brought on this delegation will be essential to rebuilding, creating employment and spurring economic growth.

Private investors, for example, may be able to build both on-grid and off-grid power sources. They could invest in regional infrastructure investments in roads, rail, airports, bridges and ports. Medical care facilities and agriculture projects could be made attractive to them as well. OPIC’s mission and privilege is to provide finance and insurance to just the kind of top quality, committed private investors that Liberia and Sierra Leone needs to help build a growing, inclusive economy.

For example in the health sector, in Liberia where there is a severe shortage of qualified physicians - there is only one doctor for every 50,000 people - the Liberian people have access to only 1% of the per-capita medical expertise that Americans enjoy. Yet Liberians still need medical care and many that can afford it travel instead to Ghana or Nigeria for crucial care – paying thousands of dollars on flights and travel, alone. The JFK Medical Center in Monrovia can and should be upgraded with private service providers and clinics to keep medical dollars in country.

Working directly or combining our resources with our sister development agencies such as USAID, we are ready to support Sierra Leone and Liberia. USAID is working in both Liberia and Sierra Leone to help build up systems such as health information systems, which will ultimately benefit from expanded access to energy and communications infrastructure. The U.S. Global Development Lab within USAID is also working to bring private sector investors and partners back into West Africa post-Ebola to support economic recovery and strengthen health systems. Private sector partners in this work include: Chevron, Coca Cola, PanAfrican Capital, GlaxoSmithKline, and Merck Sharp & Dohme.

OPIC already provides more than $1 billion in financing each year across Sub-Saharan Africa to help build power plants, affordable housing, telecommunication systems, schools and hospitals. We have seen mere possibilities turn into projects with development impact that markedly improves lives. In the years ahead, we will continue to work with the people of Liberia and Sierra Leone to attract just the kind of investors they so richly deserve.

Elizabeth Littlefield is President and CEO of the Overseas Private Investment Corporation.

• UNHRD continues to dispatch operational equipment for its Partners, most recently supporting WFP by sending ICT equipment to Freetown in Sierra Leone.

• During the worst of the crisis, UNHRD facilities in Accra and Las Palmas served as regional staging areas and the Accra depot hosted UNMEER headquarters.

• On behalf of WFP, UNHRD procured and dispatched construction material and equipment for remote logistics hubs, Ebola Treatment Units (ETU) and Community Care Centres. In collaboration with WHO, UNHRD also procured and dispatched equipment to establish camps for teams tracing EVD. Members of the Rapid Response Team (RRT) set-up supply hubs, an ambulance decontamination bay and ETUs.

2016 budget (in USD): US$ 3.88 million

Implementation period: 1 January 2016 to 31 December 2016

2016 deployments: 188 months of GenCap Adviser gender mainstreaming deployments and 12 months of Regional Gender Based Violence Adviser deployments, for a total of 200 deployment months for the project.

Countries of deployment: Needs-based, according to requests of country teams and weighing criteria related to urgency of need, presence of relevant humanitarian frameworks and architecture and potential impact agreed to by the Steering Committee.

Areas of intervention: Gender mainstreaming of all sectors of humanitarian responses through:

• Strategic advice to Humanitarian Country Teams (HCTs) and Humanitarian Coordinators (HCs)
• Support to clusters (country and global levels)
• Capacity strengthening
• Support to phases of the Humanitarian Programme Cycle (needs assessment, strategic planning, implementation and monitoring)
• Advocacy for gender mainstreaming -Sustainable GBV regional capacity building by regional senior advisers.