Ebola: Sierra Leone

Diane Abbott Excerpts

Tuesday 19th January 2016 Commons Chamber

[Justine Greening]

I must say, however, that my hon. and learned Friend achieved amazing value for money in the number of questions asked during the time spoken, for which I commend him.

To respond to the very serious issues that my hon. and learned Friend raises, from the very beginning this has been an unprecedented outbreak. We are seeing that even now, given the length of time that the virus appears to stay in the bodies of survivors after they have fully recovered. That is one reason—as we are still learning, frankly, about the implications of the virus’s persistence in survivors—why part of the work we are doing in Sierra Leone is to mitigate the risks of its being passed on. We are doing so through verifying survivor registers so that we know who should be on the list to be tested; offering safe sex counselling; establishing semen testing; ensuring access to free healthcare; and combating survivor stigma. It is critical to working with the people who may be most at risk of passing on a disease that they have themselves have survived. There is now a national semen-testing programme for male survivors aged 15 and above. Indeed, DFID and Public Health England are working with the Government in Sierra Leone to make sure that it works effectively.

We saw the same in Liberia, a country that also passed its 42-day Ebola-free point, but subsequently had other cases. That is precisely why we have been so vigilant. Indeed, it was the processes, systems and testing that we put in place with the Government in Sierra Leone that have picked up this particular case and enabled us to go through the processes of contact tracing and quarantine. As my hon. and learned Friend pointed out, it is known that this student had travelled extensively, which makes our task all the harder. We are therefore working at district level. One thing we have set up is a mobile field hospital that can rapidly get to a particular district if an outbreak takes place. He asked about the quarantine measures. They are indeed being put in place, and the contact tracing is happening.

My hon. and learned Friend asked about funding in relation to the latest outbreak and about how we are working more broadly to help get to what I call “resilient zero”. Having got past the maximum period of the main outbreak, which was incredibly difficult, we all expected that sporadic cases would continue to appear. We are now in that phase. As he says, getting on top of such cases is the way we will reach “resilient zero”, when we can be more confident that there will not be any future cases. There is funding for the latest outbreak, to cover some of the things I have mentioned and for work in schools to make sure that issues of water and sanitation are understood and that the basic steps that can be taken at community level are put in place to minimise the risk of passing on diseases, including Ebola. The district-level response mechanism that we used so successfully to get over the major outbreak when it was at its peak is still there. The London School of Hygiene and Tropical Medicine estimated that we saved more than 56,000 lives through the work that we put in place with the Government of Sierra Leone to get on top of the outbreak.

My hon. and learned Friend asked about the vaccination process. Prior to the crisis, DFID was involved in the development of early stage vaccines, which can now tackle Ebola. He will know that there are some promising candidates, which give us the prospect of being able more readily to clamp down on future outbreaks.

My hon. and learned Friend spoke about health system strengthening. One of the key messages that came out of the Ebola outbreak was that countries such as Sierra Leone and Liberia that, in the scheme of their histories, were newly emergent from civil war, were less able to cope, simply because their health systems were at an earlier stage of development due to those conflicts. Other countries in the region, such as Nigeria, were better able to clamp down on the outbreak simply because they had stronger health systems, although there is some way for even that country to go.

To reassure the House, it is not a surprise to see these sporadic additional cases, but the people, processes and systems are in place on the ground in Sierra Leone to identify them and respond rapidly.

The final thing that my hon. and learned Friend mentioned was flights. We felt that the decision that we took on direct flights was in the interests of our national security. I think that it was the right decision to take.

Critically, the way in which we got on top of the outbreak in the end was by working with our fantastic Foreign Office as one team to bring the best of British—our military, our doctors and nurses, Public Health England—and working hand in hand in partnership with the Government of Sierra Leone to provide a platform that the rest of the international community could work on to combat the disease. I again put on the record my huge thanks not only to the many DFID staff I am privileged to lead, but to all the other people across Government and all the public sector workers who in many cases put their lives on the line to help Sierra Leone get to grips with this terrible crisis.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I am sure that the whole House will join me in paying tribute not just to the British health workers and military who went to help the people of west Africa in the last Ebola outbreak, but to all the local health workers who bore the brunt of the campaign against Ebola and the brunt of the deaths.

The Secretary of State will be aware that the International Development Committee report says that the Government were too reliant on the World Health Organisation, which eventually declared an emergency in August 2014, and should have listened to other groups, such as Médecins sans Frontières, which had been warning about Ebola months earlier. Does she agree with the Committee’s Chairman that

“The international community relied on WHO to sound the alarm for an international emergency on the scale of Ebola. The organisation’s failure to respond quickly enough is now well documented”?

Does the Secretary of State agree that Ebola cannot be seen in isolation and that we have to look at the general issue of access to healthcare in the region and building a resilient health system?

[Justine Greening]

I am grateful to the hon. Lady for those questions. As she clearly sets out, the key to success in tackling Ebola was, of course, the response of the Sierra Leonean people and their willingness to run towards tackling a disease which, instinctively, many people would have wanted to run away from. Many Red Cross volunteers from across Africa also went into the region to help tackle it. They very much led the effort. The UK’s role was to work hand in hand with them and to ensure that our resources and know-how could be brought to bear to finally get on top of the disease.

Everybody recognises that there are serious lessons to be learned by the international system from the response to the crisis. Indeed, WHO reform is taking place. The Secretary of State for Health and I have talked directly to Margaret Chan about that. It is vital that we learn lessons from the crisis so that we understand how the international system can mobilise far more speedily when a crisis hits. This outbreak spread rapidly, but it started in a part of the world that was one of the least able to respond to it initially.

The UK actioned the Ebola response much earlier than the official declaration of the outbreak by the WHO. As early as June and July, we were supporting MSF, which played a key role alongside many other non-governmental organisations.

There are lessons to be learned. Today’s International Development Committee report goes through the initial response and what happened subsequently in a systematic way. It is important that the WHO be reformed. It must not only look at its processes and how it responds, but ensure that the emergency response fund that it is setting up, which the UK helped to fund initially, is adequately resourced so that it has the means to respond, as well as the strategy.