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Article Article May 24th, 2018
Health

Ebola is back – what should happen now?

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@TonyBanbury led the @UN response to the 2014 #Ebola outbreak. With new cases confirmed in the #DRC, he tells us what should happen now...

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#Ebola is more than a health issue, says @TonyBanbury – it is a multi-dimensional crisis requiring a multi-dimensional response

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While hoping for the best, today's @UN leaders need to start preparing *now* for the worst, says @TonyBanbury #Ebola

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30-second summary

  • Tony Banbury spearheaded the UN response to the 2014 Ebola crisis. With new cases confirmed in the Democratic Republic of the Congo, he offers his thoughts on what today's decision-makers should be doing in order to help stop the virus in its tracks. 
  • Time is of the essence in dealing with Ebola. Leaders need to see it as much more than a medical crisis and as something that is multi-dimensional and with political, logistical and social considerations.
  • Identifying key personnel, the possible leadership and the necessary resources, as well as holding initial consultations with relevant governments, are among the actions that UN leaders could be taking now in case the current outbreak takes further root.

Tony, you led the United Nations response to the 2014 Ebola crisis. Based on these experiences - and your 20-year career tackling humanitarian crises around the world - what do you think should be happening now at the UN, in order to help stop the current outbreak from spreading? 

There absolutely are a set of actions which are all the more important since there has been at least one confirmed case in the city of Mbandaka, a city in the Democratic Republic of Congo (DRC), and home to a million people. When this outbreak first became known, it was confined to a small village in a remote part of DRC, but now it is in such a large city that's when the risks become exponentially higher.

What is most important right now, is for the United Nations and governments to realise that this is already more than a health issue. A big error that was made in the world's response to the 2014 Ebola crisis was that responders viewed it as just a health crisis for too long. So you had doctors and nurses figuring out how to respond when it was already a multi-dimensional crisis that needed political, logistical and social considerations.

In order to address the 2014 crisis, we created an Emergency Health Response Mission that brought together a lot of different capabilities that went beyond medical professionals - and this was critical. Now, as far as I can tell, the current outbreak is still primarily being handled by the health responders. They are essential - but they're not sufficient.

Does today's UN possess the institutional memory from 2014 to effectively tackle the current crisis?

There is the necessary expertise, but I just hope there is the required perspective to understand that this is already a multi-dimensional, complex emergency and not just a health crisis. If the perspective is to see it as a health crisis - as was the case before - then even though the expertise exists, then it won't be drawn upon. That, to me, is the real risk.

Has the current crisis gotten lost amidst other international issues such as Iran and North Korea? Is there a lack of urgency in the international community?

I do think that more headlines about it would be helpful. The big question, though, is that we don't know if this is just going to be two or three cases within Mbandaka, or if it is going to spread to ten countries and affect tens of thousands of people.

Unfortunately, as long as it is confined to a few cases, there seems to be a lack of that sense of urgency. To its credit, the World Health Organization (WHO) has learned a lot of lessons from 2014 and they are responding with some energy and significant resources. But again, because this is more than just a health emergency, its response in and of itself is not enough - you need helicopters, you need labs, and you need logistics pipelines that WHO doesn't really do.

So which organisation does have it? Who has that capability?

Well, this is exactly why the UN emergency Ebola Mission was created in 2014 - because there was no platform for that, nor was there any place to bring that strategic approach together. There were different actors doing their thing but they were islands of activity without a central platform to provide the framework for a strategic and operational response.

If it starts to really spread - particularly if it goes beyond a national border - I'm not sure who is going to provide that. In the absence of new systems, structures and processes having been developed since the 2014 crisis, if it were to start really spreading then I think it might well be appropriate to create another central Mission to provide that essential capability.

The 2014 Mission was always meant to be temporary. It's not super-complex - it doesn't require a ton of people - so it would be possible to put it into place in a relatively short period of time. We had to do it super-fast in 2014, which was inefficient, so it would be better to go about it in a slightly more methodical manner. If I was in the secretariat of the UN now, I would certainly be looking very carefully at whether we need to establish this once again.

So, what is your top-line advice to today's key decision-makers at the UN and beyond?

Right now, with two or three cases in one city, you probably don't need this type of emergency Mission but it might be required in very short order.

So I would suggest that they assume that they will need to launch this in four weeks time - so they need to identify the steps they should be taking now in order to do that: identify key personnel, identify leadership, identify the necessary resources, start looking at logistics pipelines, start having initial consultations with relevant governments, look at where the Mission would be placed - in DRC or a neighbouring country that has more developed infrastructure like Uganda.

I  would be going through all these issues which we had to do in 2014 in three or four days. It would be so much better to be able to spend three or four weeks thinking through these issues, gathering information and having good policy discussions with the relevant stakeholders to come up with informed decisions and then be able to launch very quickly if the need arose. Hope the best - but prepare for the worst.

Want to learn more about Tony's 20 years of experiences at the UN and career in the top-tier of the US federal government? Read our profile interview here 

 

FURTHER READING

  • Target zero: the eradication of Ebola. The Ebola epidemic rippled across communities, borders and oceans - and is not yet over. The Africa Governance Initiative's Andy Ratcliffe takes us inside the global response
  • Cleared for take off. For emerging economies. ‘leapfrogging‘ represents the best way to deliver rapid healthcare reform, says Emre Ozcan
  • African dawn. South African campaigner, academic, public servant and business leader has Dr Mamphela Ramphele tells us why good governance is critical to positive public impact
  • Delivering on development: Dr Jim Yong Kim on life in the World Bank hot seat. Ending extreme poverty and shared prosperity are the twin north stars of World Bank President Dr. Jim Yong Kim. We hear about how he is seeking to turn vision into reality
  • Click and learn. Nick Martin explains how technology is shaking up the worlds of international development and higher education
  • Financing the future of development. How is the World Bank helping middle income countries cope with the influx of refugees? Daniel Balke tells us about an innovative financial approach

Written by:

Tony Banbury President and CEO, International Foundation for Electoral Systems
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