@article{Africa:267621,
      recid = {267621},
      author = {UNDP Africa},
      title = {TAistlseessing the socio-economic impacts of Ebola Virus  Disease in Guinea, Liberia and Sierra Leone The Road to  Recovery},
      address = {2014-12-01},
      number = {2063-2018-592},
      pages = {72},
      year = {2014},
      abstract = {This report presents the principal findings of three  studies undertaken by UNDP on the impact of the Ebola  epidemic on Guinea, Liberia and Sierra Leone. The main  objectives of these studies were to: review the evolution  of the epidemic; examine the economic and social context,  including the state of health systems; discuss the economic  and social impact of the epidemic; examine the responses by  local communities, governments and donors; and consider the  reorientation of UN programmes that will be necessary to  assist governments in fighting the epidemic. The studies  relied on a range of sources, including secondary data  available on the Internet and from government and  international agencies, and in-country interviews of  representatives of affected communities, public and private  agencies. Information from primary and secondary sources  were complemented by results from the macro-econometric and  computable general equilibrium models. Several important  conclusions emerged from these analyses. Guinea, Liberia  and Sierra Leone have high rates of poverty and are ranked  near the bottom on the UN’s Human Development Index. Prior  to the onset of the epidemic and after civil wars or  political turmoil that had effectively destroyed much of  the existing social and economic infrastructure,  restoration of peace and democracy were supporting economic  recovery and some improvements in social indicators. The  epidemic has essentially robbed these countries of much of  the progress made in the past 5-10 years. The health  systems in Guinea, Liberia, and Sierra Leone were  unprepared for Ebola at the outset of the epidemic. They  lacked sufficient amounts of everything required to contain  the epidemic: drugs, ambulances, facilities, trained health  personnel, and many other items. This is not surprising,  since these countries had few resources and suffered from  many serious health issues that generated competing demands  for resources, even prior to the onset of Ebola.  Tragically, the shortage of protective equipment resulted  in multiple infections and deaths among medical personnel,  further spreading the disease and leading people to avoid  treatment for fear of being infected. Moreover,  impoverished rural areas have much more limited access to  services than relatively well-off urban areas. This  inequitable distribution of human and financial resources  has hampered the response to the epidemic, which originated  in, and continues to heavily affect, many rural areas.  Human resources are inequitably distributed. Conakry, which  is home to just 15 percent of the population, has 75  percent of the health workers. By contrast, Guinée  Forestière, which has been hardest hit by the Ebola  epidemic and is home to 22 percent of the Guinean  population, has 9 percent of health workers. Contagious  diseases are difficult to control, while some aspects of  Ebola greatly exacerbated the challenge, given these  countries’ contexts. Control measures, for example the  closure of businesses, quarantine and destruction of  property, are costly to the individuals involved and may be  resisted, while in the absence of local community and or  government commitment, these measures may be difficult to  enforce. Sick people who flee infected areas transmit the  virus to new areas while restrictions on travel are only  sporadically effective. The symptoms of Ebola resemble  other endemic diseases in the area, delaying knowledge of  the epidemic until after it had spread considerably is  common practices in the three countries, including personal  care for the sick by relatives and friends (who largely are  unfamiliar with, and in any event do not have, the  equipment necessary to treat Ebola patients without being  infected themselves), the washing and dressing of dead  bodies in preparation for burial, and communal hand washing  tend to spread the virus. Lack of familiarity with the  disease at the initial stages of the epidemic, combined  with distrust of government advice, limited the use of  simple preventative measures by individuals that could have  saved lives. At times, public policy and institutional  arrangements impaired efforts to control the epidemic. The  failure to keep important commitments eroded trust in  government, impeding cooperation in fighting the disease.  Centralized control over health systems failed to engage  local communities, essentially undermining many programmes  at the local level, and tended to be inefficient. In Sierra  Leone, for example, a single institution was designated to  bury all people who died of Ebola. However, this  institution rapidly became overwhelmed by the caseload,  which severely delayed burials and increased the risks of  disease. While governments have established agencies to  coordinate their efforts in fighting against the epidemic,  bureaucratic competition has nevertheless led to  duplication and increased cynicism about government  commitment. Strong government leadership and effective  coordination, however, did get results. Where the  Government supported local community engagement in  programmes involving effective testing, contact tracing,  quarantine, and safe treatment, the virus could be stopped.  For example, in Télimélé, a village in Guinea, an  effective, locally managed programme stopped the infection;  the last confirmed case was in June. Ebola has spread  rapidly, but unevenly. Since the first cases appeared in  December 2013, the number of new infections has varied by  country, by region, and over time. The epidemic appears to  have begun in rural areas along the borders. With the  exception of Monrovia and Freetown, where the virus has  spread due to the influx of victims seeking treatment,  rural areas continue to be the most affected by the  epidemic. The latest data show a decline in new cases in  Liberia, but a continued rise in Guinea and Sierra Leone;  the virus is not under control in any of these countries.  All in all, there had been almost 18,000 cases, and more  than 6,400 deaths, as at 10 December 2014. The epidemic is  reducing growth and its impact will take 5 to 10 years to  overcome. The economic disruptions from increasing  illnesses and deaths have been exacerbated by people’s  efforts and governments’ edicts designed to avoid the  spread of infection. Workers’ fear of engaging in  collective activities has severely reduced agricultural  production and office work. Government restrictions on  travel and public gatherings, together with the closure of  markets and schools, have severely impeded many economic  activities. Production of goods that had formerly been  traded with neighbouring countries, that came from areas  highly affected by the epidemic, or that involved in-person  cooperation experienced the largest declines. External  transactions have plummeted. Exports are falling due to  supply interruptions in areas heavily affected by the  epidemic, declining availability of shipping due to fears  of contracting the disease at ports in countries affected  by the epidemic, and a decline in the international prices  of minerals. Tourism has virtually disappeared. Imports  also are declining with the fall in economic activity and  constraints on trade. Overall, official forecasts for GDP  growth in 2014 have been revised downwards since the onset  of the epidemic, by 3.2 percentage points in Guinea, 4.8  percentage points in Liberia, and 6.4 percentage points in  Sierra Leone. The likely decline in growth is confirmed by  the results of economic modelling exercises. However, the  CGE models’ predictions of the impact of the epidemic on  growth are significantly different from the revisions to  the official forecasts. This is largely because the model  is designed to capture the interactions among economic  variables. For example, a decline in earnings in one sector  will reduce expenditures by workers in that sector, which  will, in turn, reduce earnings in other sectors. All of  these interactions may not be captured in the official  estimates. Further, the revision in the official estimates  reflects the impact on growth of all recent economic  events, while changes between scenarios in the modelling  exercise is designed to reflect only the impact of Ebola.  The devotion of increased expenditures to fighting the  epidemic, coupled with declining revenues as economic  activity fades, are expanding fiscal deficits and reducing  expenditures on activities that are not directly related to  Ebola. Inflation is rising due to supply bottlenecks,  driven by the reduced labour supply, lower trade  domestically and across land borders, and unavailability of  shipping. To date, the rise in fiscal deficits has been  manageable, in part due to increased budgetary support from  the international community, while the uptick in inflation  has been limited.  Nevertheless, a continuation of these  trends will threaten long-term development. The great  uncertainty concerning the ability of these countries to  control the epidemic is sharply reducing private  investment, which is likely to reduce output in future  years, particularly in the mining sector. The decline in  expenditures not related to fighting the epidemic will  further reduce public sector investment and impair the  government’s ability to provide a range of services, which  will continue to be felt even after the epidemic is  controlled. All of this underlines the importance of the  immediate provision of budgetary support to help these  countries through this critical time. The epidemic is also  reducing welfare. Health status is seriously endangered by  cuts in expenditures on non-Ebola related health services  and a dramatic fall in the use of services (health agency  visits, assisted childbirths, antiretroviral therapy drugs,  home visits) owing to fears of infection. As a result, more  people will die from childbirth, malaria and AIDS, as well  diseases that are relatively easy to cure. Children are  seeing their education delayed, which increases the risk of  their dropping out. Perhaps the single positive impact of  the epidemic is the greater attention to hygiene; as a  result, despite conditions favourable to the spread of  cholera, so far the disease has failed to appear. Women are  suffering disproportionately from the epidemic, because  they care for the sick, which makes them more vulnerable to  infection, and they rely on economic activities (for  example market trading and exports of fruits and vegetables  to neighbouring countries) that have been hit hard by the  epidemic. Further, social disruption increases their  vulnerability. Reports of teenage pregnancies are on the  rise, likely because girls are no longer protected by being  in school much of the day. The epidemic is also breaking  down social ties. Longstanding traditions of community  support and care-giving have been disrupted, Ebola victims  are being stigmatized, and social gatherings have been  cancelled. People have come to fear contact with strangers,  and sometimes even with their own family. The findings help  to chart a pathway to recovery. Improved coordination  between non-governmental organizations (NGOs) and local  officials, and among government agencies is critical to  effective programmes. Governments should step up their  communications activities to combat ignorance that  stigmatizes victims and impedes efforts at prevention. It’s  high time to start thinking about how governments and  private sectors can cooperate in launching the recovery.  Efforts should focus on restarting activities that were  abandoned during the epidemic, for example through  strengthening social protection mechanisms including cash  transfers, concession-based credit facilities, the  provision of inputs necessary for the next planting season,  and support for re-opening local markets. Strengthening the  health management system must be a priority. Meeting the  African Union’s goal of spending 15 percent of the total  budget on health, and WHO’s goal of $34 health expenditure  per capita, is key. Effective decentralization of health  governance is also important to managing the health crisis.  Institutionalizing monitoring and health surveillance is  another. International donors and development partners can  help. These countries desperately need money and technical  support to cope with the virus. Donors are redirecting  their programmes to help control the epidemic, but should  not abandon all their efforts to support long-term  development. The international community should not be  overly engaged with humanitarian and early recovery actions  at the expense of tackling the root causes of EVD. More  debt relief, grants and concessional credits will help  these countries to rapidly recover from the crisis. Better  coordination among donors, and greater emphasis on the  provision of technical experts could improve the  efficiency, effectiveness and coherence of project  assistance. A joint approach between national governments  and development partners to early recovery is the best way  to avoid fragmentation.},
      url = {http://ageconsearch.umn.edu/record/267621},
      doi = {https://doi.org/10.22004/ag.econ.267621},
}