Andriukaitis: Ebola highlights Africa’s health challenges

Vytenis Andriukaitis [European Commission]

The Ebola: From Emergency to Recovery conference, being held by the European Commission today (3 March), provides an important opportunity to plan for the long term recovery and resilience of affected countries, Health Commissioner Vytenis Andriukaitis told EURACTIV in an exclusive interview.

Vytenis Andriukaitis is a Lithuanian physician, politician, and co-signatory to the 1990 Act of the Re-Establishment of the State of Lithuania.

He spoke to EURACTIV’s Senior Editor Georgi Gotev.

What are your impressions following your recent trip to the Ebola-hit countries in West Africa?

I visited Guinea, Liberia and Sierra Leone with the EU Ebola Coordinator, Commissioner Stylianides, in November. We saw great suffering and enormous needs. These countries needed more medical staff – mobile medical teams including epidemiologists, paramedics, nurses, medical workers – to provide treatment, and to train and work with local personnel, in particular in rural areas.

My first action on my return was to talk to all EU Health Ministers individually, and to the Health Council, to share my findings and encourage them in their efforts to provide additional staff and resources to the affected countries.

Besides Ebola, what are the greatest challenges for addressing health issues in Africa and in the developing countries?

Although the Ebola outbreak in West Africa is currently in the spotlight of the world’s media because of its unprecedented scale and severity – over 22,900 cases and 9,200 deaths to date, there are other serious, long-running health threats affecting this part of the world, notably malaria, Tuberculosis (TB) and HIV/AIDS. Due to insufficiencies in basic services (health, education, water, sanitation) and to economic and governance difficulties, Africa needs the world’s support in addressing these health challenges.

In 2011, 1.4 million people died from TB, with Africa recording the highest per capita death rate. Sub-Saharan Africa is the region most affected by HIV/AIDS and is home to 69% of all people living with HIV worldwide and 91% of all new infections among children. As for malaria, in 2010, 91% of global deaths from this disease were in Africa. These diseases are all preventable, and outcomes significantly improved with timely treatment. The European Commission is a founding member and major financial contributor to the Global Fund to Fight AIDS, Tuberculosis and malaria (GFATM) which invests strategically to prevent and treat these diseases, particularly in developing countries.

Ebola and these other infectious diseases highlight the important challenge Africa faces in developing their health systems. The Ebola: From Emergency to Recovery conference, organised by the European Commission (3 March), provides an important opportunity, not only to improve the emergency response to eradicate the disease, but also to plan for the long term recovery and resilience of affected countries, including the development of their health systems. These countries must rebuild their health systems with better infection control, in line with International Health Regulations (IHR) and improve basic services such as water and sanitation. Last but not least, they should tackle the stigma associated with Ebola and other diseases such as AIDS – so that people come forward for timely treatment.

What is the EU doing at present, except providing funding NGOs to do work on the ground)?

The European Union has been active in the response to the Ebola emergency from the start. It has mobilised all available political, financial and scientific resources to help contain, control, treat and ultimately defeat Ebola. From the onset of the crisis, the EU has been in constant contact with the United Nations, relief agencies on the ground, the governments in the region as well as with regional organizations such as the African Union and ECOWAS. The appointment by the European Council of my colleague, Commissioner Stylianides, as EU Ebola Coordinator, as well as the establishment of an EU Taskforce, aims to ensure that EU institutions and Member States act in a coordinated manner with each other and with international partners.

The EU’s total financial contribution (from Member States and the Commission) to fight the epidemic is over €1.2 billion. Of this, the Commission has given over €414 million to fight the disease, covering emergency measures as well as longer-term support. This covers humanitarian funding (more than €65 million allocated) which is channelled through humanitarian partner organisations, such as Médecins Sans Frontiers (MSF), Save the Children, UNICEF and many others. This EU aid contributes to epidemic surveillance, diagnostics, treatment and medical supplies, deployment of doctors and nurses, training of health workers and awareness raising, e.g. on safe burials.

The Commission is also providing over €210 million in development and early recovery assistance. Most of this money is provided to stabilise the countries, help them recover from the crisis and strengthen important areas like healthcare, eradication, water and sanitation. The Commission is also promptly and strongly supporting urgent Ebola research on potential treatments, vaccines and diagnostic tests, allocating almost €140 million from Horizon 2020, the EU’s research and innovation funding programme.

In addition to funding and coordination, the Commission facilitates the delivery of material support from EU countries and provides expertise for all facets of the emergency. A good example of this is the deployment by the European Centre for Disease Prevention and Control (ECDC) of five teams of epidemiologists to work closely with the WHO in areas of the country affected by Ebola.

The Commission also organises logistical support including multiple airlifting operations. The EU medevac system ensures evacuation to an appropriately equipped hospital in Europe for international healthcare workers of any nationality who have been exposed to or diagnosed with the virus. My services are actively involved in identifying medical facilities available in EU when an evacuation request is made by the WHO. To date, a total of 27 people suffering from Ebola or having had a high risk exposure to the virus, have been medically evacuated to Europe.

With regard to being prepared for the outbreak spreading to the EU, although the risk is low, the Commission and the Member states have been working on preparedness and coordination of risk management in close cooperation with the European Centre for Disease Prevention and Control (ECDC) and the WHO. In the EU, we have established lists of available Ebola capacities which could be shared, including high security laboratories, hospital capacity and medical evacuation equipment and have provided information for travellers in all EU languages, key messages, and reviewed procedures for airports and health authorities on handling possible Ebola cases. Finally, we have launched the ‘Ebola Communication Platform for Clinicians’ – an online platform enabling the rapid exchange of information on the treatment and prevention of Ebola virus disease. The platform brings together EU hospitals and physicians recognised as reference centres for the treatment of Ebola.

What could be done better in the next few years? Are there plans to provide assistance to reform developing countries’ health systems?

The high-level Ebola conference provides a forum to discuss precisely this. The governments of Guinea, Liberia and Sierra Leone are expected to present their assessments and plans for national recovery, which are being prepared in cooperation with the United Nations, the World Bank, the African Development Bank and the European Union at the event. Priority areas for recovery will include resuming basic services – health, education, water, sanitation – and the need to return to economic development.

The main outcome of the conference is expected to be a declaration which will include concrete elements of future actions, such as the need to make pledged funds available and to maintain the international level of support including medical teams, laboratories, epidemiologists and other resources – until there are no more cases of Ebola.

The experience should be used as an opportunity to raise awareness and reduce stigma associated with Ebola and other diseases in Africa. Stigma is a barrier to receiving adequate and timely care and preventing the spread of the virus in the community.

What could be done in the field of training medical personnel? How could well-trained personnel be encouraged to stay in their home countries, instead of choosing immigration?

Health migration is also a big problem within the EU, with healthcare professionals abandoning their home country for higher salaries in other countries. A phenomenon sometimes referred to as the ‘brain drain’. This is a concern all over the world, including in Africa. However, immigration rules in various countries go towards preventing a mass exodus.

At EU-level, we have an Action Plan for the EU Health Workforce which stresses the EU’s commitment to the implementation of the WHO Global Code on international recruitment of health professionals. The European Commission is supporting a European network to improve workforce planning and forecasting, as destination countries in the EU should aim to meet future health workforce needs through medical and nursing education and training and avoiding recruitment from fragile economies.

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