Abstract
BackgroundFollowing the West Africa Ebola virus disease (EVD) outbreak (2013–2016), WHO developed a preparedness checklist for its member states. This checklist is currently being applied for the first time on a large and systematic scale to prepare for the cross border importation of the ongoing EVD outbreak in the Democratic Republic of Congo hence the need to document the lessons learnt from this experience. This is more pertinent considering the complex humanitarian context and weak health system under which some of the countries such as the Republic of South Sudan are implementing their EVD preparedness interventions.Main textWe identified four main lessons from the ongoing EVD preparedness efforts in the Republic South Sudan. First, EVD preparedness is possible in complex humanitarian settings such as the Republic of South Sudan by using a longer-term health system strengthening approach. Second, the Republic of South Sudan is at risk of both domestic and cross border transmission of EVD and several other infectious disease outbreaks hence the need for an integrated and sustainable approach to outbreak preparedness in the country. Third, a phased and well-prioritized approach is required for EVD preparedness in complex humanitarian settings given the costs associated with preparedness and the difficulties in the accurate prediction of outbreaks in such settings. Fourth, EVD preparedness in complex humanitarian settings is a massive undertaking that requires effective and decentralized coordination.ConclusionDespite a very challenging context, the Republic of South Sudan made significant progress in its EVD preparedness drive demonstrating that it is possible to rapidly scale up preparedness efforts in complex humanitarian contexts if appropriate and context-specific approaches are used. Further research, systematic reviews and evaluation of the ongoing preparedness efforts are required to ensure comprehensive documentation and application of the lessons learnt for future EVD outbreak preparedness and response efforts.
Highlights
We identified four main lessons from the ongoing Ebola virus disease (EVD) preparedness efforts in the Republic South Sudan
Systematic reviews and evaluation of the ongoing preparedness efforts are required to ensure comprehensive documentation and application of the lessons learnt for future EVD outbreak preparedness and response efforts
Reflections on the lessons learnt from preparing for EVD in Republic of South Sudan (RSS) Against the backdrop of the complex humanitarian setting, achievements and challenges highlighted in Table 1, implementation of the EVD preparedness interventions in RSS revealed several important lessons which we reviewed and synthesized into four main themes which are presented below
Summary
Setting the scene: the humanitarian context and EVD preparedness interventions and challenges in RSS RSS is the World’s newest nation, emerging from an almost 50-year-long civil war with its northern neighbour to attain independence in 2011. IMS Incident Management Systems, NAPHS National Action Plan for Health Security incorporation of strategies aimed at bridging the humanitarian-development nexus into EVD preparedness and planning processes in humanitarian settings right from the onset This will ensure definition, prioritization and implementation of both immediate and long-term health system strengthening interventions for each preparedness and response pillar and phase. A low-cost alternative (less than USD 30 000 per unit) similar to the CUBE (Chambre d’Urgence Biosécurisée, called the Biosecure Emergency Room) which was developed by The Alliance for International Medical Action (ALIMA) [25] came in the form of rapidly deployable Ebola Isolation Units comprising of robust structures that could be stored centrally, distributed and assembled within one day This is an innovative and practical approach that would be cost-effective and appropriate for use in the context of RSS where access remains a major challenge. Regional and national definition of standards in the areas of training, simulations, personal protective equipment and in the design and materials used for EVD isolation units and establishment of a central repository of reference materials and prequalified experts which countries like RSS can draw on is required
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