Ebola Has Exposed Pre-Existing Fault Lines in the Health System, Economy and Governance of Sierra Leone

02/10/2014 15:10 | Updated 02 December 2014

The Ebola outbreak in West Africa has exposed deep pre-existing fault lines in Sierra Leone. The donor pledges being made by the international community in London this week at a DFID-sponsored conference, will only help Sierra Leone respond effectively to the crisis and rebuild a more resilient post-Ebola nation if it understands and addresses these fissures. Solutions and remedial action must go beyond simply repairing the weak health care system. A robust economic package must be delivered in parallel with an undertaking from the Sierra Leone Government for major internal policy reforms.

Sierra Leone has made a lot of progress in the 10 years since the end of the country's civil war. It has held regular elections and power has changed hands peacefully but there is still a long way to go. The Government must be encouraged to provide information about its decisions and financial flows, and public servants must be held accountable for failed development programmes. The country's weak public health system is a symptom of a much bigger problem and pouring in aid to fix it will have disappointing results if there is no parallel improvement in accountability and transparency. No post-Ebola support package would be complete without including policy reforms to correct these weaknesses.

Ebola has also exposed the costs associated with low levels of trust in government. Just as initial attempts in the US to educate the gay community about HIV were undermined by a long history of distrust between the authorities and the community, so has distrust of government undermined efforts to educate citizens in Sierra Leone about Ebola. The disease initially took off in an area/region which is the stronghold of the opposition party, it is therefore not surprising that messages from government were not widely embraced in the early days of the disease. Rebuilding trust in government is critical both to solving the short-term crisis and addressing Sierra Leone's long term problems.

Indeed, rebuilding confidence is one of the government's biggest tasks and this spans many areas: confidence that it is worth taking infected love ones to the government clinics because they will receive better care and have a greater hope of recovery than at home; confidence that while bad, the economy is not in free fall and therefore credit can be extended and investments can continue to be made; confidence that health checks at the borders are well implemented and that Sierra Leonean citizens and goods can therefore be accepted into other countries; confidence of foreign investors by ensuring the stable and transparent rule of law, and confidence that the Government of Sierra Leone will learn the lessons of the current crisis and invest donor aid wisely to help build a country that is better and stronger than it was pre-Ebola.

Estimates of the costs of the disease and the economic impact of the crisis vary wildly. This is partly because Sierra Leone is at a critical juncture, where either the external support promised will flow in urgently and stop the spread, or it will arrive late and be insufficient because the magnitude of the problem would have multiplied by then.

In this context, double-counting old commitments by donors as new pledges for repairing the damage to the economy must be avoided and I would cite three reasons: The first is that this practice of artificially inflating the amount of a pledge clouds the extent to which the resource gap is not addressed, rendering planning difficult. The second is that it imposes further stress on the economic management machinery of Governments to access and disentangle the pledge. The third is that the opportunity could be missed to revisit, if not correct the country's growth strategy that depends on its recent minerals boom.

Good quality data is hard to come by. This has severely complicated the response to the crisis. The International Growth Centre (IGC) is therefore working with the Government of Sierra Leone to provide a quick response monitoring system of economic activity and the prices of basic commodities, such as rice, cassava, fish, and palm oil. The data collected will allow a carefully targeted response to areas rendered economically vulnerable by the epidemic.

GDP, Government revenue, and exports are highly dependent on the activities of a few large mining firms. While unexpected one-off shocks to revenue and exports can be compensated for by external support, the signs from the global minerals market are worrying. Iron ore, the chief driver of the country's higher growth rates is under severe stress in the global market. Falling ore prices, compounded by the uncertainty of the Ebola crisis, are exerting enormous pressures on local mining companies. The fallout on employment, when combined with the general slowdown in the economy caused by Ebola containment measures, could trigger a major recession of this already fragile economy. Pledges made in London this Thursday should therefore allow for innovative approaches to address these market failures even though they are largely private sector issues. They must address both the immediate Ebola containment problems and the accompanying economic consequences.