MUST READ REPORT - 'How Nigeria Contained Ebola: Lessons For Institutional Reform'.

Dr. Ameyo Stella Adadevoh 

The largest Ebola Virus Disease (EVD) outbreak to date occurred in the West African sub-region - particularly in Guinea, Sierra Leone and Liberia - with a total of 7,178 reported cases, including 3,338 deaths, as of 1st October 2014. 

A total of 20 Ebola cases (19 laboratory confirmed, one probable) were reported in Nigeria in 2014, with no new cases reported since the 5th of September of the same year. All 20 Ebola cases stemmed from a single importation by a Liberian diplomat, Patrick Sawyer, who was returning to Nigeria from Liberia. 

This book, therefore, chronicles the events leading to the first index case of Ebola in Nigeria, and the response of both the Federal and State Governments, and Development Partners in the country. The book also identifies and describes the systems, activities, resources and timelines at national, state and LGA levels for the pre-outbreak, alert, response and post- outbreak phases required to mitigate and contain any re-introduction of EVD in Nigeria using our national health institute and effective public health measures.

But more importantly, Nigeria’s successful response to the Ebola outbreak provides an opportunity to document the lessons learned, particularly for institutional reform purposes. This book, “How Nigeria Contained Ebola: Lessons For Institutional Reform”, details Nigeria’s successful response to the Ebola epidemic. The lessons learned serve three main purposes. 

Firstly, public health managers faced with similar challenges or outbreaks may use Nigeria’s successful response as a guide. 

Secondly, a reading of this book will reveal that although there were challenges, those challenges were successfully overcome and offer lessons for the future. 

Finally, it provides lessons for institutional reform, particularly in the areas of leadership, teamwork, inter-governmental relations, collective will and national unity.

ACKNOWLEDGEMENTS BY DR. JOE ABAH

Those that follow a particular interpretation of institutional theory will have you believe that countries are slaves to their history and culture, and that the path that a country follows depends on the choices and decisions that it has made in the past. This fatalistic view of the world frequently writes off Africa, given its history of colonialism, civil wars, military dictatorships, high indebtedness and poverty. Tackling epidemics require strong institutions and good governance, which it is claimed are lacking in many African countries.

Putting these two arguments together, the expectation was that in the case of an Ebola outbreak, Nigeria, Africa’s most populous country, would be overrun with catastrophic consequences on a biblical scale.

But it wasn’t! Why? Are the governance institutions in Nigeria stronger than many foreign commentators make out? Or were there other factors at play that ensured that Nigeria’s containment of Ebola became an example of good practice for the rest of the world? Or were a combination of factors at work? That is the subject of this book.
We wish to pay tribute to former President Goodluck Jonathan, Governors Babatunde Fashola and Rotimi Amaechi, and Professor Onyebuchi Chukwu, former Minister of Health, for their leadership. We are also grateful to the doctors and nurses who gave their lives to protect their fellow citizens and the scores of healthcare professionals whose professionalism, dedication and patriotism ensured that Nigeria defeated the virus.

In compiling this book, we wish to thank Mr Oronto Douglas (Special Adviser to the President in Research, Documentation and Strategy), who unfortunately passed away recently, for the primary research he undertook. We are also grateful to the Permanent Secretary, Federal Ministry of Health, Mr Linus Awute, not only for his management of the crisis, but also for his editorial contributions to this work.

I am grateful for the support received from Dr. Ngozi Azodoh, Director, Health Planning Research and Statistics, and her staff member, Dr. Chima Elenwune, both of the Federal Ministry of Health, for their useful contributions. Mr James Nicholls of the DFID FEPAR programme assisted with editing. I am also grateful to, and proud of, Mr S. Inyang Anyang, my technical assistant and a civil servant, who wrote most of this book.

Joe Abah, Ph.D.
Director-General
Bureau of Public Service Reforms 

Click to read the full report.