Higher Institute of Human Security

&

International Organization for Migration

Under the Chairmanship of the African Development Bank

Scientific Conference on Ebola Virus Disease in West Africa:

preparedness & response one (01) year after

Terms of Reference

In partnership with the World Health Organization (WHO)

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BACKGROUND AND RATIONALE

West Africa is characterized by a strong tradition of human mobility linked to cultural, social

and commercial vectors. However, in the early twenty-first century, international migration

has been driven by regionalization dynamic which constitutes most of the displacements

(80%) in the region. The most sustained displacements are those around the northern borders

of Côte d'Ivoire and Ghana; the Senegalese borders and between countries in the Gulf of

Guinea. The exchanges are also important between several pair of neighboring countries,

including Liberia and Sierra Leone; Mali and Burkina Faso; Ivory Coast and Burkina Faso;

Guinea-Bissau and Cape Verde; Nigeria and Chad. These dynamics are part of a regional

integration process in terms of migration management: the Economic Community of West

African States (ECOWAS) has set up a range of legal instruments promoting the free

movement of people and goods, the right of residence and establishment; protecting of

migrants rights; and the gender dimension.

Countries can be subject to epidemiological crises and disasters at any time resulting in

human suffering; and large-scale economic and human losses. Populations affected can find

themselves in extremely vulnerable situation if public health systems, cross-border

cooperation and collaboration mechanisms on migration and health are not sufficiently

performing. Anything that would cause significant impacts with regards to States and the sub-

regional area

The outbreak of the Ebola Virus Disease which currently prevails in West Africa shows how

an epidemic can rapidly grow and cause serious problems in the absence of strong health

systems able to respond quickly and in an integrated manner. The outbreak started in Guinea

in December 2013 before spreading quickly in neighboring countries such as Liberia and

Sierra Leone. At the beginning of August 2014, the Ebola virus disease was declared a public

health emergency of international concern by the World Health Organization (WHO).

The Ebola virus was first observed in 1976 upon two simultaneous outbreaks in Sudan

(151 dead) and the Democratic Republic of Congo (280 deaths). The virus was named

"Ebola" the name of a river flowing in the latter country

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In March 2014, a new outbreak of Zaire Ebola virus has been identified in Forest Guinea

and then spread to neighboring countries namely Liberia and Sierra Leone. The virus

was then propagated by air in Nigeria and by road in Senegal and Mali. As of March 2,

2015, WHO reported 23,913 cases of Ebola among which 9,714 deaths reported which

corresponds to a mortality rate varying between 54% and 62% according to countries

(WHO, 2015). Despite these figures being underestimated it is the largest outbreak

known to date.

According to David Evans, chief economist at the World Bank, "With a major epidemic

spread to other countries in the region, children would lose their parents, households lose

income and businesses face a decline in their workforce due to dead, ill or frightened

workers. The agricultural and mining sectors would slow down significantly". The report he

co-authors makes reference to two scenarios on the macro-economic level. In the "low"

scenario the report quantifies the West Africa Gross Domestic Product losses to 2.2 billion $

in 2014 and 1.6 billion $ in 2015. In the "high" scenario these losses would amount to 7.4

billion in 2014 and 25.2 billion in 2015. These two scenarios take into account contagious

effects of other countries. The financial impact of Ebola grows under direct costs effects

(public health expenditures) and indirect costs associated with reduced productivity given the

growing number of workers ill, dying or assisting relatives.

Government revenues from taxes and custom duties from major sectors such as tourism,

agriculture and mining industry are threatened by risk aversion behavior resulting from

restrictions on the free movement of people and goods.1.

Thus, serious challenges remain in the fight against the virus. According the WHO Director-

General, Margaret Chan, deeply held beliefs and cultural practices (contact with mortal

remains during funerals) are a major cause of the virus spread. Also, the Ebola outbreak is

favored by a severe lack of material resources and skilled personnel.

At the beginning of the outbreak, health systems in Guinea, Liberia and Sierra Leone had a

limited capacity. Several functions of the health system generally considered as essential

showed deficiencies preventing the establishment of an appropriate and rapid response to the

soaring outbreak. Health human resources aspect is considered not only as one of the causes 1 UNDP Africa Policy Note, «Ebola Virus Disease Outbreak (EVD) is overstressing the fiscal capacity of Governments in Guinea, Liberia and Sierra Leone», Vol. 1, No. 3, 24 October 2014, [http://www.undp.org/content/dam/undp/library/crisis%20prevention/UNDP_RBA_PolicyNoteonEbolaVol1No3_ENG_31Octo2014.pdf]

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of the Ebola virus disease spread but also as one of the most vulnerable sector with severe

consequences in the response to this crisis. According to the WHO, health workers are one of

the six pillars on which a strong health system must be based. In the case of Ebola, health

workers represent 50-60% of people who died from the virus. Public health system

difficulties to ensure their protection and that of their families in the case of death; risks of

contamination, stigma, low wages, lack of equipment and expertise are among the reasons for

abandonment of post, of their city or country by some medical staff members. Paradoxically,

a reverse migration movement occurred as many doctors, members of the armed forces,

medical personnel, laboratory technician etc. were assigned by their Government in countries

in crisis to actively participate in the response. Anything that enabled capacity building for

the management of tropical infectious diseases with its corollary of contamination of

expatriate medical staff. Several of them were evacuated in countries including the United

States, Spain, France and Germany with recorded deaths. This observation is also valid for

human resources involved in humanitarian emergency operations.

Since the fight against the Ebola virus requires a holistic approach, several organizations

joined together among which healthcare organizations such as researchers, aid teams,

communicators (modern and traditional), etc. At the national level, to contain the epidemic

and stop panic movements among the population, Sierra Leone and Liberia deployed their

army from August 2014.

In Nigeria and Senegal a very effective communication campaign to people and health

professionals as well as the application of a constant precautionary principle helped stop the

spread of the virus. To overcome the spread of the epidemic, Mali placed 577 people under

health surveillance on November 17, 2014.

The development of a treatment against this disease is subject of active research motivated in

particular by risks of the use of the Ebola virus for bioterrorism purposes as raised by the

New York Times following an "assault with a syringe" perpetrated against a US Air Force

federal agent at the Lagos International Airport (September 2014). Avenues for research are

varied and often promising on animal models, but they still remain in the experimental stage

and few of them have reached the clinical trials in human subjects stage as is the case for the

cAd3-EBO vaccine developed by the international company GlaxoSmithKline (GSK) in

November 2014. Two other vaccines namely the ChAd3 and the rVSV-ZEBOV developed

respectively by the GSK company and the American Institute of Allergy and Infectious

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Diseases (NIAID), and the Public Health Agency of Canada were launched in Liberia in

February 2015 with promising results. The major difficulty, in addition to developing

effective treatments and protections without unacceptable side effects, lies on the one hand in

the need to develop molecules that are transportable and storable in epidemic areas; and on

the other hand the availability of volunteers to test vaccines.

This shows the extent to which countries of the West-African sub-region are facing a

multidimensional human security issue regarding health, economy and community resilience

(the ability of affected people to recover from the epidemic). The challenge of these

hemorrhagic fevers in the area concerns both affected countries and not yet affected

countries. To date, the Ebola Virus Disease (EVD) has not been identified in the other

countries of the sub-region namely Burkina Faso, Ghana, Niger and Mauritania. The

appearance of this disease in Burkina Faso would have a devastating effect in the sub

regional area given the geographical position of the country which shares land borders with

six other states. This implies that all national (authorities, health system agents, civil society,

etc.) and international (development partners, laboratories, research centers, etc.) stakeholders

must combined efforts in order to succeed in preventing the appearance of the Ebola Virus

Disease (EVD) in non-affected countries and in eradicating the virus from affected countries.

Therefore, it is imperative to address scientifically the following questions in a framework

involving all stakeholders: What is Ebola? How does the virus spread? What is the socio-

economic impact of this hemorrhagic fever? What are the Health systems response plans?

What assessment of the response plans can be made one (01) year after the outbreak of the

epidemic? What are the prospects of post-Ebola?

From this perspective the Higher Institute of Human Security (ISSH) and the International

Organization for Migration (IOM), in partnership with the World Health Organization

(WHO) are convening the "Scientific Conference on the Ebola Virus Disease in West Africa:

preparedness & response one year later."

This conference is part of the Higher Institute of Human Security (ISSH) and the

International Organization for Migration (IOM) approach in anticipating and preventing the

risk of disasters likely to affect the people in the West African sub-region. It is intended to

strengthen human and institutional capacity to support sustainable human development,

collaboration and cooperation among countries of the sub-region, community resilience in the

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Ebola case and promote a coordinated and respectful management of human migration

Rights.

OBJECTIVES OF THE CONFERENCE

The overall objective of this conference is to capitalize on achievements and lessons learned

on the preparedness and response to the EVD to allow states and people to deal with

outbreaks of the same order.

More specifically, this will involve holding sessions (panels) on the following topics:

1. The Ebola Virus Disease: a health issue;

- Epidemiology of the Ebola Virus Disease(EVD)

- National Health Systems and Response Plans

- Gender and spread of the EVD

- Vaccines, treatment and ongoing research

2. The economic impact of the EVD;

- Economic impact of the EVD in West Africa (affected and unaffected

countries)

- Impacts on Households/Community Resilience and the prospects of post-

Ebola

3. Management of the crisis related to the EVD ;

- Borders management in the spread of the virus in West Africa: the Ebola case

- Humanitarian management of the EVD

- The issue of resource mobilization with regard to the EVD

- Effective responsibility and accountability in the governance of the EVD

preparedness and response programs

4. Socio-cultural profile and practices of West African people in dealing with the EVD

- Cultural, religious, social practices and the spread of the EVD in West Africa:

the role of anthropologists in the care provision,

- What communication strategies to epidemics in West Africa: the EDV

TARGET AUDIENCE:

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This conference is intended for policy makers, regional and international organizations,

medical and scientific sector actors (medical and paramedical staff, economists,

anthropologists, sociologists, etc.); community, traditional and religious leaders.

The expected number of participants is 70

PARTNER INSTITUTIONS:

The partners are the Ministry of Health of Burkina Faso, the African Union, the African

Development Bank (AfDB), the Economic Community of West Africa States (ECOWAS),

the Economic and Monetary Union of West Africa (UEMOA) the UN Mission for Ebola

Emergency Response (UNMEER), the World Health Organization (WHO), the International

Labour Organisation (ILO), the Center for Disease Control (CDC), the West African Health

Organisation (WAHO), the Bioforce Institute, Médecins Sans Frontières (MSF), the Red

Cross of Burkina Faso, the World Young Doctors Organization, the MURAZ Centre

(National Reference Laboratory for virus).

ORGANIZATION

The conference is organized by the Higher Institute of Human Security (ISSH) and the

International Organization for Migration (IOM) country office of Burkina Faso. Facilitation

will be ensured by the scientific coordination of experts from Muraz Centre, WHO, IOM,

World Bank, West African Health Orgsanization, Regional Blood Transfusion Centre, and

the scientific direction of the Institute in collaboration with experts from the scientific and

medical field of institution partners.

The scientific coordination is ensured by a team of experts composed of:

Professor Nicolas MEDAH, Epidemiologist, Director General of the Muraz

Centre,

Professor Issiaka SOMBIE, West African Health Organization

Doctor Chantal KAMBIRÉ, World Health Organization,

Docteur Ousmane Diadie HAIDARA, World Bank,

Doctor Jean-François AGUILERA, regional expert in Migration and Health at the

IOM regional office

Dr. André OUEDRAOGO, International consultant on health issues,

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Dr. Siaka OUATTARA from the Regional Blood Transfusion Centre in Ouagadougou.

Doctor Simeon Anselme SANOU.The Chairman of the Scientific Coordination will be Professor Nicolas MEDAH while the

secretariat will be ensured by Dr. Siaka OUATTARA and Doctor Simeon Anselme SANOU.

CONDITIONS FOR PARTICIPATION

National and sub-regional participants to the conference shall register by email on the website

of the conference dedicated to this purpose: www.conference-ebola.com

PRACTICAL PROCEDURE

The conference will take place over three days from April 7 to 9, 2015 in Ouagadougou.

Work will begin each day at 8:30 am and will end at 17:30. The agenda is presented below.

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PROGRAMME  

D1 D2 D308:30 - 09:00 Reception – Registration

National Health Systems and Response Plans

Effective responsibility and accountability in the governance of the EVD preparedness and response programs

09:00 - 10:15 Opening:- Welcome word- Opening speech

- Inaugural conference on lessons learned from the preparedness and response programmes to the EVD epidemic in West Africa

10:15 - 10:30 Coffee-break Coffee-break Suspension of Work10:30 - 12:30

Epidemiology of the Ebola Virus Disease (EVD)

- Gender and spread of the EVD

- Vaccines, treatment and ongoing research

Final synthesis

Publication of the Conference Proceedings and the next steps

12:30 – 13:30 Lunch Lunch Closing13:30 – 15:00 - Borders management in the spread of the

virus in West Africa: the Ebola case- Economic impact of the hemorrhagic fever in West Africa (affected and unaffected countries)

- Which communication strategies regarding epidemics in west Africa: the Ebola case- Humanitarian management of the EVD

Lunch

15:00-16:30 - Management of financial partners in the EVD epidemic- Cultural, religious, social practices and the spread of the Ebola in West Africa

- Impact on households/ communities resilience and prospects of post-Ebola

16:30-17:00 - Sythesis of the first day Work - Sythesis of the second day Work17:00 Suspension of Work Suspension of Work

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