Discussing Community-Level Challenges in the Ebola Response
May 14, 2015
On April 21, 2015, the Paul G. Allen Family Foundation, in partnership with the Skoll Global Threats Fund and the U.S. Agency for International Development (USAID), hosted the Ebola Innovation Summit in San Francisco. The goal of the summit was to crowd-source ideas for its continued investment in the Ebola response and in pandemic preparedness – including how to address communication challenges at the local level. To date, the Foundation has supported a diverse set of projects totaling approximately $60 million and including a $2.5 million grant to the Ebola Medevac Fund; a $12.9 million grant to the CDC Foundation to establish emergency operations centers in Guinea, Liberia, and Sierra Leone; and a $2.2 million grant to PCI Media impact to support the development of educational campaigns.
The summit was structured to encourage new connections and foster collaboration among more than 300 experts from the technology and private sectors, non-profits, government, academia, and philanthropies. Following a morning of panel discussions on lessons learned from the Ebola outbreak in West Africa, participants were split into four challenge groups and led through a problem-solving exercise to spark innovative ideas for:
- Data strengthening and coordination to improve the interoperability of national, regional, and local health data systems;
- Diagnostics to accelerate the development and deployment of tools for Ebola and other diseases;
- Social mobilization to incorporate community perceptions into program design and situational analysis; and
- Emergency infrastructure and logistics to move people and supplies during health emergencies.
In the social mobilization challenge group, in which I participated, we discussed the importance of communities and how cultural beliefs and practices surrounding burials, misinformation around Ebola and its transmission, and deep mistrust of the government contributed to the devastating consequences of the outbreak in West Africa. The objective of this session was to identify new uses of mobile and other low-technology approaches that can enable communities to exchange information in real time and provide data to governments and other organizations so that interventions can be better targeted and lead to improved health outcomes.
There was a palpable sense of excitement in the room and even consensus on numerous points: many saw Guinea’s unusual epidemic curve as the result of community resistance to culturally insensitive public health interventions, and attributed Liberia’s sharp drop in cases to a change at the community level—albeit one that is not yet well understood. Participants stressed that this highlights the importance of taking the time to understand community perceptions and adhering to community rituals—even in the midst of an emergency—and emphasized that this is the quickest and most effective way to achieve behavior change. Some participants noted the importance of finding a way for individuals from the affected communities to join the conversation and be a part of the brainstorming process. They highlighted this point by posting the following notes to the social mobilization challenge board: “Innovation begins and ends in community” and “Empower and encourage Africans to provide solutions for Africa”.
The identification of social mobilization as one of the most pressing challenges in the Ebola response is an encouraging sign of the increasing recognition that communities play a critical role in responding to health threats. If the Foundation is looking to fund innovative means of social mobilization, it should look for ways to include the voices of those from the impacted communities to help ground the conversation in reality, identify local needs and constraints, and share promising ideas. Active community participation is a key ingredient to developing tools and interventions that will more effectively impact the response and outcome of future outbreaks.