West Africa is facing the largest and most complex Ebola epidemic on record. Guinea, Liberia and Sierra Leone are the most affected countries. Over 22 900 people have been infected, more than 9 200 of whom have died. The European Union has been active in the response to the Ebola emergency from the start. It has mobilised all available political, financial and scientific resources to help contain, control, treat and ultimately defeat Ebola. In October 2014 the European Council appointed Christos Stylianides, EU Commissioner for Humanitarian Aid and Crisis Management, as EU Ebola Coordinator.
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Commissioners Christos Stylianides, Vytenis Andriukaitis and Neven Mimica have visited the affected countries in late 2014 to reaffirm the EU’s support for the fight against the disease and to announce support measures.
On March 3 2015, the European Union is organising a high-level conference on the Ebola epidemic. The purpose is two-fold: first, to take stock of the ongoing emergency response and adapt it to the evolving situation on the ground, leading to eradication of the disease; second, to plan for the long term and support the recovery and resilience of the affected countries, including the development of their health systems. The event is co-chaired by the EU, Guinea, Sierra Leone and Liberia, the United Nations, the African Union, and the Economic Community of West African States (ECOWAS).
Financial assistance
The EU’s total financial contribution to fight the epidemic is over 1.2 billion. This includes funding from the Member States and the European Commission.
The Commission has given over 414 million to fight the disease, covering emergency measures as well as longer-term support.
Humanitarian Aid
Since March 2014, the European Commission has allocated more than 65 million in humanitarian funding to address themost urgent needs. These funds are channelled through humanitarian partner organisations, such as MSF, the International Federation of the Red Cross and Red Crescent societies, IMC, Save the Children, IRC, Alima, WFPs Humanitarian Air Service, UNICEF and WHO. EU aid contributes to epidemic surveillance, diagnostics, treatment and medical supplies; deployment of doctors and nurses and training of health workers; raising awareness among the population and promotion of safe burials.
Development Aid
In addition to the existing EU and bilateral development partnerships, the Commission is providing over 210 million in development and early recovery assistance. Most of this money is provided to stabilise the countries and assist them in recovering from the crisis and beyond.
In addition, the EU was already helping to strengthen health systems in the affected countries before the outbreak, as part of its long term support, and is now redirecting existing programmes towards the Ebola efforts and crisis context.
Budget support is provided to Guinea, Liberia and Sierra Leone to help them deliver urgently needed public services – in particular health care – and also cushion the economic impact of the epidemic.
Development funding is also used to strengthen other important areas like healthcare, education, water and sanitation. The idea is to facilitate a smooth transition from the humanitarian phase to recovery through what is known as a “Linking Relief, Rehabilitation and Development” (LRRD) approach.
Three mobile laboratories, deployed in Guinea and Sierra Leone, help with the detection of the virus and training of health workers. The labs can process up to 70 samples each day, seven days a week. A fourth mobile laboratory, EUWAM-Lab, more robust and self-sustaining, will leave for Guinea in early March.
Furthermore, the EU supports the African Union’s medical mission in West Africa, contributing to paying civil, military and medical staff. This has so far allowed to cover the costs of the first 90 medical professionals and support staff, and to subsequently increase the total number of staff to about 150 people.
The EU is equally working to strengthen preparedness against the epidemic. The EU has supported national plans in six countries for some 10.6 M and has, for example:
– Helped to refurbish and equip an Ebola treatment unit at the central hospital in Ivory Coast
– Helped to provide a water and sanitation programme with hygiene messages on Ebola prevention in Guinea Bissau
– Set up a facility in Burkina Faso to support the national preparedness plan
Medical Research
The European Commission has promptly and strongly supported urgent Ebola research on potential treatments, vaccines and diagnostic tests with almost 140 million from Horizon 2020, the EU’s research and innovation funding programme.
An initial 24.4 million were deployed to fund five projects that look to develop potential vaccines and medication against Ebola and translate their findings into available treatments. Work on these projects started in October 2014, and some have already begun producing results applicable to the current outbreak. Most promisingly, the EU-funded REACTION project recently announced encouraging evidence that favipiravir, an antiviral drug, is an effective treatment against early Ebola disease. More information on EU-funded projects can be found at the EU Research on Ebola website.
Additionally, the European Commission and the European pharmaceutical industry are funding eight research projects on the development of vaccines and rapid diagnostics tests, which are key to overcoming the current Ebola crisis. These projects are run under the new ‘Ebola+’ programme of the Innovative Medicines Initiative (IMI) and funded with a total of 215 million, 114 million of which come from Horizon 2020.
The EU is also supporting clinical research on Ebola through the European Developing Countries Clinical Trials Partnership (EDCTP), a joint effort by European and Sub-Saharan African countries to develop promising treatments for poverty-related diseases like malaria, HIV/AIDS, and tuberculosis. EDCTP recently added Ebola to this list and launched a call to develop new diagnostic tools for these diseases. The Commission has also urged EDCTP to mobilise funding from the Participating States to increase the EDCTP budget for 2014 and 2015 and to coordinate relevant research activities.
The Ebola outbreak demonstrates that ‘rapid reaction’ research and innovation in health crises is needed. In this context, the European Commission and other major funders have recently founded the ‘Global Research Collaboration for Infectious Disease Preparedness’ (GloPID-R) which will facilitate launching a coordinated emergency research response within 48 hours in case of a significant new or re-emerging outbreak.
Emergency supplies and expertise
As part of its coordinated response, the EU has provided emergency supplies and sent experts to the affected countries. The EU Civil Protection Mechanism facilitates the delivery of material support from the Member states. They have provided mobile laboratories, treatment centres, ambulances and field hospitals. The EU has organized logistical support including multiple airlifting operations and supports the deployment of navy ships to transport emergency supplies provided by the Member States, such as food aid, medical kits, clean blankets and chlorine for sanitations. EU humanitarian experts, including specialists in hazardous diseases, have been deployed to the three most affected countries.
Medical Evacuation
International health workers are the backbone of the response to the Ebola epidemic. To support their mobilisation and protection, the EU has established a medical evacuation system. Member States are making capacity available for this.
The medevac system ensuresevacuation to an equipped hospital in Europe for international health workers and other EU nationals diagnosed with the virus. Evacuation requests are made by WHO to the health department of the Commission (DG SANTE) which identifies medical facilities available in EU Member States through communications in the EU’s Early Warning and Response System (EWRS). Transport to Europe is then coordinated by the ERCC. To date, a total of 21 people suffering from Ebola or having had a high risk exposure to the virus, have been medically evacuated to Europe.
Preparedness in the EU
The risk of Ebola to the general public in the EU is very low. Transmission of the virus requires direct contact with a symptomatic patients body fluids. Furthermore, the EU has very high standards of healthcare infrastructures and preventive care. Nevertheless, there is a small possibility of individuals arriving in the EU with potential Ebola virus infection.
Since the outbreak of the Ebola virus disease, the Commission and the Member states have been working on preparedness and coordination of risk management in close cooperation with of the European Centre for Disease Prevention and Control (ECDC) and the WHO.
The EU’s Early Warning and Response System for medical emergencies has been in operation throughout the epidemic to exchange information between Member States. The EU Health Security Committee (HSC), which brings together EU Member States and the Commission, with input from ECDC and WHO has met regularly to coordinate Ebola prevention and readiness. It has carried out activities on Member states’ preparedness and has established lists of available Ebola assets which could be shared, including high security laboratories, hospital capacity and medical evacuation equipment. The HSC has also developed the procedures for organising Medical Evacuation of international health care workers suffering from Ebola to have treatment in Europe; provided information for travellers in all EU languages and reviewed procedures for airports and health authorities on handling possible Ebola cases.
In addition, the Commission has launched the ‘Ebola Communication Platform for Clinicians’ – an online platform enabling the rapid exchange of information on the treatment and prevention of Ebola virus disease. The platform brings together EU hospitals and physicians recognised as reference centres for the treatment of Ebola.
Advocacy, coordination and diplomatic outreach
From the onset of the crisis, the EU has been in constant contact with the United Nations, relief agencies on the ground, the governments in the region as well as with regional organizations such as the African Union and ECOWAS.
The appointment by the European Council of an EU Ebola Coordinator, Commissioner Christos Stylianides, aims to ensure that EU institutions and Member States act in a coordinated manner with each other and with international partners. To this end, an EU Ebola Task Force has been set up and meets three times a week, bringing together the Member States, Commission services, the European External Action Service (EEAS) and representatives of the UN, the Red Cross and NGOs.
