The United Nations and the Global Ebola Response. The UN emergency health mission "UNMEER"

Table of Content

1. Introduction

1.1 Current state of research

1.2 Research relevance

1.3 Structure of the report

1.4 Methods and Limitations

2. Background

2.1 Ebola Virus Disease

2.2 The 2014 Ebola outbreak in West Africa

2.2.1 Historical background of Guinea, Sierra Leone and Liberia

3. Challenges

4. UNMEER

5. Analysis

Introduction to Analysis and Timeline

5.1 Stage 1: March 2014 – July 2014

5.1.1 The onset of the outbreak and first steps in the response

5.1.2 Unprecedented outbreak and lack of acknowledgement

5.1.3 The role of the WHO Regional Office for Africa

5.1.4 Financial assistance versus humanitarian assistance

5.1.5 Increasing awareness

5.1.6 By the end of July

5.2 Stage 2: August 2014

5.2.1 Increased national response

5.2.2 WHO and the declaration of a PHEIC

5.2.3 Increased international response

5.2.4 Acknowledgement at the national level

5.2.5 The UN scale up of response efforts

5.2.6 Private sector engagement

5.2.7 Was the declaration of a PHEIC too late?

5.2.8 The governments of the affected countries

5.2.9 International reaction or inaction

5.2.10 Other challenges

5.2.11 By the end of August

5.3. Stage 3: September 2014

5.3.1 Calls for international action

5.3.2 Increased international response

5.3.3 UN system wide response

5.3.4 The establishment of UNMEER

5.3.5 Responsibility to lead

5.3.6 UNMEER or reinforcing existing systems

5.3.7 UNMEER raised awareness

5.3.8 By the end of September

5.4 Stage 4: October and November 2014

5.4.1 Increased response efforts

5.4.2 UNMEER’s impact on the response

5.4.3 Progress towards the 30-day and the 60-day target

5.4.4 Success stories of Senegal and Nigeria

5.4.5 First Ebola case in Mali

5.4.6 By the end of November

5.5 Stage 5: December 2014

5.5.1 District-by-district approach and “Western Area Surge” in Sierra Leone

5.5.2 Empty Ebola Treatment Units

5.5.3 The African Union deploys health workers

5.5.4 Efforts regarding long-term recovery and system strengthening

5.5.5 Activation of Humanitarian Clusters

5.6 Stage 6: 2015 and what’s next

5.6.1 From Phase 1 to Phase 2 of the response

5.6.2 UNMEER and the situation from January to July 2015

5.6.3 IFRC and MSF

5.6.4 Meetings on Ebola in 2015

5.6.5 What’s next?

6. Conclusion of analysis and evaluation

7. Lessons learned and recommendations for similar future health emergencies

7.1 Reinforcing OCHA instead of creating a new emergency health mission

7.2 Strengthen health systems in resource-weak countries

7.3 Ensure implementation of the obligations under the IHR (2005) through a Global Fund

7.4 Preformed medical teams and emergency contracts with health experts

7.5 Emphasis on community engagement

7.6 Increase partnership with the private sector

8. Final remarks and further reflections

Objectives and Topics

This report investigates the impact of the United Nations Mission for Ebola Emergency Response (UNMEER) on the global response to the 2014 Ebola outbreak in West Africa. The primary research question addresses whether the establishment of this first-ever UN emergency health mission was the correct strategic decision for the UN, given the unprecedented nature of the crisis, the initial response challenges, and the effectiveness of the mission compared to pre-existing international humanitarian mechanisms.

• Critical evaluation of UNMEER’s operational mandate and its coordination role within the wider UN system.
• Assessment of the challenges faced during the Ebola crisis, including community resistance, weak health infrastructure, and the role of historical/socio-cultural factors.
• Analysis of the UN and WHO response strategies, contrasting them with the efforts of international NGOs like MSF and IFRC.
• Strategic recommendations for future health emergencies, including the potential to reinforce existing systems like OCHA instead of creating new ad-hoc missions.

Excerpt from the Book

Summary of Chapters

1. Introduction: Presents the 2014 Ebola outbreak as a modern public health emergency, outlines the research questions, and justifies the focus on UNMEER.

2. Background: Provides foundational knowledge on the Ebola Virus Disease, its history, and the specific socio-political context of Guinea, Liberia, and Sierra Leone.

3. Challenges: Details the primary obstacles to containment, including humanitarian crises, community resistance, and weak national health infrastructures.

4. UNMEER: Explains the mandate, structure, and strategic objectives of the UN Mission for Ebola Emergency Response as the primary operational response mechanism.

5. Analysis: Provides a comprehensive, stage-by-stage timeline analysis (from March 2014 to July 2015) of the outbreak, the international response, and the specific impact of UNMEER’s intervention.

6. Conclusion of analysis and evaluation: Summarizes the key research findings, concluding that while UNMEER provided political and logistical value, it suffered from structural issues and unclear mandates.

7. Lessons learned and recommendations for similar future health emergencies: Offers strategic, non-tactical advice on how the international community can better prepare for future large-scale health crises.

8. Final remarks and further reflections: Provides closing thoughts on the research process and the broader implications for global health governance and the UN’s role in future emergencies.

Keywords

Ebola, UNMEER, United Nations, WHO, Global Health Governance, Humanitarian Response, Crisis Management, Emergency Health Mission, Public Health, Infectious Disease, West Africa, Coordination, Community Engagement, Lessons Learned, International Health Regulations.

Frequently Asked Questions

What is the primary goal of this research?

The research aims to evaluate whether the creation of UNMEER was the correct political and operational decision for the United Nations to manage the 2014 Ebola crisis.

What are the central themes of the work?

The core themes include global health governance, the effectiveness of ad-hoc UN missions, the challenges of humanitarian aid coordination, and the importance of preparedness for future pandemics.

What is the main research question?

The central question is: Was the establishment of the first-ever UN emergency health mission, UNMEER, the right decision to make from the UN side in response to the 2014 Ebola outbreak?

What methodology was applied?

The study utilizes a mix of exploratory and explanatory research methods, primarily based on qualitative primary data from semi-structured interviews with 31 key stakeholders, supplemented by analysis of official reports, secondary data, and academic literature.

What is discussed in the analysis section?

The analysis provides a chronological assessment of the outbreak across six stages, evaluating UNMEER's performance against its specific strategic objectives, such as rapid impact and coordination.

Which keywords best describe this study?

Key terms include Ebola, UNMEER, Global Health Governance, Humanitarian Response, Crisis Management, and Public Health.

Why was the UNMEER headquarters located in Accra?

According to the report, the UN chose Accra due to its proximity to the affected countries and the existence of an "air bridge" from Ghana to the capital of Liberia.

Did UNMEER successfully collaborate with other organizations?

The findings are mixed; while UNMEER improved high-level political networking, it faced significant challenges in achieving on-the-ground coordination with NGOs like MSF, often due to a lack of staff presence and unclear roles.

What is the primary recommendation regarding future missions?

The authors recommend not creating new ad-hoc health missions, but rather reinforcing existing systems under the Office for the Coordination of Humanitarian Affairs (OCHA) and ensuring surge capacity for health emergencies.