We will not be defined by epidemics and pandemics – Sierra Leone’s President Bio tells High-Level Africa-CDC Forum

Sierra Leone Telegraph: 19 February 2023:

Speaking in Addis Ababa, Ethiopia yesterday Saturday, President Dr Julius Maada Bio shared Sierra Leone’s experience with Ebola, successes with Covid-19 and efforts at creating public health agencies and using early warning systems.

“The main lesson for us in Sierra Leone is a clear understanding that Pandemic Prevention, Preparedness, and Response are Everybody’s Business. Political leadership, health diplomacy, technical capabilities, active community engagement, flexible funding, and most importantly, speed-of-action, are perhaps the most important success factors for managing an epidemic or pandemic.

“…we are establishing an effective and efficient approach to service delivery that involves strengthening Primary Health Care as well as improving clinical services at the secondary and tertiary levels. We are using the Life-Stages approach to quality client/patient-centred care,” he said.

He added that those efforts will be complemented by the establishment of a new National Public Health Agency, coming on the back of a November 2022 ratification by the Sierra Leone Parliament of the new Public Health Bill.

“The new Public Health Agency will build and strengthen core competencies in surveillance and epidemiology, data and data analytics, laboratory science, and research to answer local and global questions. This would be done while focusing on addressing routine health challenges and honing early warning systems during ‘Quiet’ periods. We will complement those efforts with simulations and exercises to maintain outbreak response competencies,” he said.

President Bio further noted that though tremendous progress had been made over the years, the Ebola outbreak of 2014 to 2016 in West Africa was still raw in their psyche as a nation, with over 14,000 infections and nearly 4,000 deaths.

“Those lessons learned were on full display before, and at every stage of our response to COVID-19 in Sierra Leone. Even before the first case was detected in my country, I assembled a Presidential-Taskforce that I chaired. I took full responsibility and accountability for the response. The Taskforce included representation of key line-Ministries of my government and civil society. We also maintained strong links with international development partners and the private sector,” he said.

He recalled that those outbreaks taught his government and country that epidemics and pandemics were not just health issues, but they have a way of affecting all facets of people’s lives with devastating consequences.

“Distinguished ladies and gentlemen, in Sierra Leone we have had our own share of epidemics and pandemics. As a nation, we refuse to be defined by these health crises. We believe that what hurt us yesterday, makes us wiser, strengthens our resolve, and makes us more determined to not only build back but build back better,” he concluded.

You can read the full statement of the President below: 

Excellencies, Ministers of Government, Distinguished Ladies and Gentlemen. Thank you for asking me to speak at this Inaugural High-Level Ministerial Forum convened by the Africa-CDC and the Government of the Federal Democratic Republic of Ethiopia on the margins of the 36th ordinary session of the AU Assembly of Heads of State and Government. This meeting focuses on strengthening continental and global leadership to achieve agenda 2063.

As we collectively think through global solutions for tackling the evolving phase of the COVID-19 pandemic and future pandemics, the organisers of this event could not have chosen a better time, venue, and forum for these discussions.

Distinguished ladies and gentlemen, in Sierra Leone we have had our own share of epidemics and pandemics. As a nation, we refuse to be defined by these health crises. We believe that what hurt us yesterday, makes us wiser, strengthens our resolve, and makes us more determined to not only build back but build back better.

Though tremendous progress has been made over the years, the Ebola outbreak of 2014/2016 in West Africa is still raw in our psyche as a nation. With over 14,000 infections and nearly 4,000 deaths, this is not something a nation and a people forget easily. The outbreak taught us that these epidemics/pandemics are not just Health Issues. They have a way of affecting all facets of our lives with devastating consequences.

The main lesson for us in Sierra Leone is a clear understanding that Pandemic Prevention, Preparedness, and Response are Everybody’s Business. Political leadership, health diplomacy, technical capabilities, active community engagement, flexible funding, and most importantly, speed-of-action, are perhaps the most important success factors for managing an epidemic or pandemic.

Those lessons learned were on full display before, and at every stage of our response to COVID-19 in Sierra Leone. Even before the first case was detected in my country, I assembled a Presidential-Taskforce that I chaired. I took full responsibility and accountability for the response. The Taskforce included representation of key line-Ministries of my government and civil society. We also maintained strong links with international development partners and the private sector.

With limited international funding initially, we relied entirely on domestic resources and our tried and tested mitigation measures to mount a robust and calibrated response. With a good balance between limited lockdowns, strategic application of restricted movements, and a strong focus on community engagement, hand hygiene, social distancing, and masking, we managed the COVID-19 epidemic extremely well. The results speak for themselves. The cumulative number of cases after four major waves of the pandemic remain at 7,760 with only 125 deaths. This is perhaps one of the best responses in the world.

Our Ebola experience made us ready as a nation for pandemics. While countries were debating the value of mitigating measures such as hand hygiene and social distancing, our communities in Sierra Leone were far ahead in the implementation of those measures. When vaccines became available, because of the trust established between healthcare workers and the communities they serve, vaccine hesitancy was at a minimum.

With a target to vaccinate 70% of eligible candidates with COVID-19 vaccines by December 2022, over 3.6M (73.2%) were fully vaccinated with 87.6% having received at least one dose of the vaccine. Only three other countries in the continent achieved that milestone.

With the success we have seen so far, we know we cannot be complacent about what the future holds. Epidemics and Pandemics are here to stay. It behoves us not to prepare for them. We cannot afford to expend all our energies, talents, and resources to fight an epidemic / pandemic and when we think it is over, we disassemble all of what we had done only to be recalled for the next flare-up. At the same time, we cannot stand up and maintain an emergency posture for a considerable length of time without negatively impacting the people we intend to serve.

In Sierra Leone we are establishing an effective and efficient approach to service delivery that involves strengthening Primary Health Care as well as improving clinical services at the secondary and tertiary levels. We are using the Life-Stages approach to quality client/patient-centred care. We will complement this with the establishment of a National Public Health Agency. Fortunately, in November 2022, the Sierra Leone Parliament ratified a new Public Health Bill that included the establishment of a New Public Health Agency.

The new Public Health Agency will build and strengthen core competencies in surveillance and epidemiology, data and data analytics, laboratory science, and research to answer local and global questions. This would be done while focusing on addressing routine health challenges and honing early warning systems during “Quiet” periods. We will complement those efforts with simulations and exercises to maintain outbreak response competencies.

In the event of an outbreak, the new Public Health Agency will spearhead a national response, surging existing capabilities and capacities, while also coordinating the multiple components of the response. Our experience with outbreaks and pandemics underscores the importance of solidarity between neighbouring countries and the world at large. As these pathogens naturally know no borders and do not need visas to move between countries, Health Diplomacy based on mutual trust and respect for national sovereignty is paramount in securing our collective safety.

Institutions like the Africa-CDC and the World Health Organization are paramount in guaranteeing that safety by setting continent-wide and global standards, while supporting national and regional efforts at prevention, preparedness, and response to outbreaks and pandemics

We should imagine a world in which we actively work to consolidate our gains by Preventing Outbreaks and Pandemics, but when Small Outbreaks do inevitably occur, we are Better Prepared to Respond to them with speed and resolve and prevent them from becoming Pandemics.

I am confident that as we discuss leadership during crisis, political strategy, and health diplomacy in action this morning, and as we continue to define the Africa we want and Africa’s new Public Health order, I sincerely hope that the Sierra Leone experience will help inform that dialogue as we work to secure our common humanity.

I thank you for your kind attention and wish you all fruitful deliberations.

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