March 17, 2019
Challenge The 2014-2016 Ebola outbreak in West Africa was the largest and most complex since the virus was first discovered in 1976. There were more cases and deaths in this outbreak than all others combined. It also spread across countries, starting in Guinea and then crossing land borders to Liberia and Sierra Leone. Faced with this epidemic, the Secretary-General of the United Nations and the Director- General of the World Health Organization (WHO) called for an international response to aid the populations of the three countries affected by the epidemic. Towards a Solution In response to this crisis, the Government of Cuba decided to participate in this global effort, under the coordination of WHO, calling on the governments and ministries of health of all countries to join the fight against this threat. The Cuban medical brigades sent to Africa are part of the Henry Reeve International Contingent of Doctors Specializing in Disasters and Serious Epidemics, created in 2005 and composed of health professionals specializing in combating disasters and major epidemics. These volunteers had over 15 years’ experience and had worked in other countries affected by natural disasters and epidemic outbreaks. The 268 Cuban health workers selected, mainly doctors and nurses, received the standard WHO training on infection control in Cuba before leaving for the affected countries to provide direct patient care. They remained there for six months, working in treatment centres for Ebola virus disease (EVD) patients and community clinics. The Cuban support helped to contain the epidemic, saving hundreds of lives of both infected people and others potentially threatened by the disease in the three affected countries. The Brigade’s main challenges included the need for rapid and timely action, the complexity of the epidemic of an unknown disease that is highly contagious, rapidly disseminated and highly lethal and that occurred in countries with fragile health systems. The intervention required health workers to use individual protective equipment and work at high temperatures, while facing other specific environmental, social, cultural and working conditions. Other countries can replicate Cuba’s approach to organizing response to emergencies and epidemic outbreaks. The key to immediate emergency response is to provide specialized training on direct medical care to selected professionals. Coordination with WHO is a good practice, ensuring that the Cuban health workers were fully integrated in the health services in the recipient countries. Response coordination at the global level and among the different response teams with other countries was also important. In response to this emergency situation, several heads of state of the Americas attended the Summit of the Bolivarian Alliance for the Peoples of Our America- Peoples’ Trade Treaty (ALBA TCP) held in Havana. Participants called for governments’ commitment and support to fight this disease in the region. They also agreed to hold a technical meeting of specialists and managers to address prevention of and response to Ebola virus disease, with 278 specialists and managers from 34 countries of the Americas participating. Subsequently, the International Course for the Prevention and Confrontation of the Ebola Virus was held at the Pedro Kouri Tropical Medicine Institute in Havana, Cuba, for training and preparation in epidemiology, clinic, infection control and personal protection. More than 80 specialists from 18 countries in Latin America and the Caribbean, as well as Mozambique, attended. Cuban experts also conducted several follow-up missions to guide and evaluate response capabilities in the event that of EVD outbreaks in Central American and high-risk African countries. South-South cooperation offered a flexible, agile and innovative framework which enabled this type of support. In recognition of this initiative, at the last World Health Assembly in 2017, WHO awarded the Henry Reeve Brigade the Dr. Lee Jong-Wook Public Health Memorial Award, the most important award granted by this organization. Countries/ territories involved: Cuba, Guinea, Liberia, Sierra Leone Supported by: Cuba’s Ministry of Public Health (MINSAP), PAHO/WHO Implementing entities: Unidad Central de Colaboración Médica (UCCM, Central Unit of Medical Cooperation) of MINSAP; PAHO/WHO Project status: Completed Project period: October 2014-April 2015 URL of the practice: N/A Contact: Name: Country and Subregional Coordination Office, PAHO Email: