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Ebola: Sierra Leone

Volume 768: debated on Tuesday 19 January 2016


My Lords, with the leave of the House, I will repeat in the form of a Statement the Answer to an Urgent Question given earlier today in the other place by my right honourable friend the Secretary of State. The Statement is as follows.

“The House will be aware that a new case of Ebola has been confirmed in Sierra Leone. A 22 year-old female student from Tonkolili district sadly died on 12 January. This latest case of Ebola in Sierra Leone demonstrates that we need to stay vigilant. In fact the news came just as the World Health Organization formally declared the Ebola outbreak in west Africa over, following Liberia reaching 42 days without a new case, but it is not unexpected given the context of this unprecedented outbreak.

The new case was identified from a swab taken after death and is currently being investigated. The Government of Sierra Leone have activated their national Ebola response plan, and rapid work is under way to identify and quarantine people who have been in contact with the young woman and to establish her movements in the final days and weeks before her death. Teams in five districts are acting on this information. No other cases have been confirmed to date.

The speed of this process reflects the work that the UK has undertaken with the Government of Sierra Leone to develop their national response plan. As today’s IDC report states, the UK has been at the forefront of the global response to the Ebola outbreak in west Africa from the very start, leading in Sierra Leone and working hand in hand with the Government of that country. We took on this deadly disease at source by rapidly deploying the best of British military personnel and NHS staff, building treatment centres in a matter of weeks and mobilising the international response. We have worked with the Government of Sierra Leone to build up their health systems and strengthen all aspects of society, including civil society, to allow them to be prepared.

We continue to stand by Sierra Leone, because we have always been clear that there is potential for further cases. That is precisely why our response is now focused on assisting Sierra Leone in isolating and treating any new cases of Ebola before they spread”.

My Lords, that concludes the Statement.

My Lords, I have previously acknowledged the Government’s positive response to Ebola on the ground and the significant role of British volunteers, but today our thoughts must of course be with the people of Sierra Leone. Today in the other place, the Secretary of State stressed getting to the point of resilient zero—steady eradication with monitoring and surveillance, working with communities and education. The most important thing is of course a resilient healthcare system. One important element of that involves health education and training. With no postgraduate training, those who want to specialise are forced to leave the country to pursue further education, and many never return. What steps are the Government taking to support Sierra Leone’s health sector recovery plan, especially programmes backed by the royal colleges in this country, to provide continuing professional development for healthcare workers at all levels?

My Lords, the noble Lord raises some very important issues about the recovery plan. The UK has committed to £54 million in support of President Koroma’s nine-month early recovery and transition plan, which will focus on health, education and social protection—and, of course, economic recovery. We will be standing shoulder to shoulder with our friends in Sierra Leone; we think that that is the right thing to do. The noble Lord is absolutely right that we also need to ensure that, as we gear up to help build resilience, we get others on board to give that support.

My Lords, I pay tribute to DfID, NHS staff and others, including Save the Children, for their amazing efforts in Sierra Leone since 2014. As unsafe practices were tackled, one upside was the decline in FGM. How is DfID ensuring that that decline is maintained? What is being done to counter other diseases which are a global threat? I am thinking here, for example, of Lassa fever, which has broken out across Nigeria.

My Lords, as the noble Baroness knows well from the work that she did in her former role as a DfID Minister, part of our wider strategy is to ensure that we build resilience, first and foremost, into the health systems. She touches on a very important issue about FGM: ensuring that those practices do not recur once the recovery is in place. We will work very closely with the president on his plan, but also through the wider work that we are going to do through the community-led organisations on the ground to ensure that the work that we did from the Girl Summit going forward does not get lost in the rebuilding of Sierra Leone. As always, with all these issues, it is really about continuing our dialogue with the Government of Sierra Leone to see how we can help them in strengthening their health systems first of all, but also ensuring that we assist them in tackling issues such as FGM at community level.

My Lords, as I think everyone now recognises, mobilisation of communities, as the Minister recognised in her Statement, was and is the most effective and powerful tool to bring Ebola down to zero and eradicate it. Will she confirm that the Government will continue their commendable level of investment in the excellent work of British civil society organisations, which are working with locals on the ground at the heart of communities? I declare my interest as a patron of Restless Development, which does a lot of work in this area.

My noble friend is absolutely right. Having community organisations on the ground was key in enabling us to try to restrain as much of the disease as we possibly could. I can reassure my noble friend that that commitment remains and we will continue to work on the ground with community groups, on a programme of intensive community engagement that began in October 2014. As my noble friend knows, we were among the first to be on the ground to respond to the crisis.

My Lords, is my noble friend aware of the British Army nurse who travelled to west Africa to treat Ebola patients, contracted the disease herself, was brought back to the United Kingdom and restored to health and has now insisted on returning once more? Does not that demonstrate devotion to duty of a quite extraordinary kind?

My noble friend is absolutely right. We must of course pay tribute to all those people who put themselves at risk on the front line, including our military personnel and staff of the NHS, among many who have gone there and worked on the ground, putting their own lives at risk. We must also pay tribute to the people of Sierra Leone themselves, who were very much instrumental in being able to restrain this outbreak.

My Lords, how was it that a swab was taken only after the poor woman died? Surely, diagnosis should have been done when she became ill. Was she not looked after?

In this case—investigations are ongoing, so we have not yet come to some concluding outcomes—the woman did not demonstrate the usual symptoms of Ebola. The practice of taking swabs is something that we in the UK have encouraged, which is why we were able to pick up that this lady died from Ebola.

My Lords, since the outbreak of Ebola there has been investment flight from Sierra Leone. Sustainable healthcare systems demand locally generated revenue, and DfID is playing an important role in this respect, too. But what more can be done to persuade our partners in the European Union and, indeed, the United States, to add their voice and, importantly, resources, to the important task of regenerating the economy of Sierra Leone, without which there can never be sustainable healthcare?

The noble Lord raises the point about funding for the recovery of Sierra Leone, and Liberia as well. We want to ensure that, as a country, we play our part by pledging and by encouraging our partners. So we will continue to play our part and encourage our partners. We have very much supported the UN Secretary General’s high-level panel also to encourage that we do much more collectively and globally. Just to give the noble Lord some assurance, the World Bank has committed $650 million to make sure that, over the next 18 months or so, the reconstruction of those three countries affected by Ebola takes place.

My Lords, following the question from the noble Lord, Lord Boateng, is it not important to recognise that we must not be diverted from the task of rebuilding and regenerating the economy and the health service in Sierra Leone? Does the Minister agree that all the leading authorities warned that individual sporadic cases would be reported and that, while it is tremendously important to deal effectively with them, we should not allow that to colour the judgment that the situation in west Africa is as it was, sadly, a year ago?

My Lords, there are two main issues. One is being able to deal with the recovery and making sure that there is sufficient funding and support for us to be able to help strengthen the health systems in countries whose growth was very good before the outbreak but whose systems were not as strong as they should have been—those systems need strengthening. We will probably see the occasional case, but we must continue to encourage others to make sure that we rebuild west Africa in such a way that economic growth continues on a much more sustainable pathway. That can be done only if all global partners come together to be very supportive of what the UK has often done. The UK has led by example. Part of that is our commitment to 0.7% to ensure that our aid budget will always be protected.

The Minister spoke about the value of community groups. Is she satisfied that there is proper co-ordination between civil society organisations and government health services? In view of the recent incident, is there perhaps a disconnect between the WHO’s analysis and that of the Government of Sierra Leone?

My Lords, there is not a disconnect. We have managed to deal with an unprecedented outbreak, but we need to make sure that co-ordination is much better. The UK was able to co-ordinate 10 government departments to work closely alongside other organisations in Sierra Leone. I do not think there is a disconnect, but there is always room to improve and to learn lessons when things have not gone so well. On the whole, we demonstrated that once you strengthen co-ordination on the ground and assist the Government of the day to support their systems, things get better.