1. Engage communities – the key to stopping the spread of disease
Community engagement reduces transmission and resistance to health providers, and instils safe practices of care. In both West Africa in 2014 and DRC in 2018, humanitarian actors got this wrong. Rather than see communities as key to tackling the epidemic in West Africa, they were viewed instead as part of the problem. Local cultural behaviours - such as communal eating and burial practices - were seen as obstacles to prevention and epidemic control efforts; but top-down, medically oriented messaging focused on the extreme risks of Ebola fostered stigma, triggered treatment avoidance and resulted in people seeking support from traditional healers.

2. Manage this as a broad-based humanitarian emergency from the outset
The spread of a dangerous disease requires a broad response that goes beyond medical provision. Treating Ebola predominantly as a health crisis meant that the surge capacity and emergency funding characteristic of a large-scale humanitarian crisis were not triggered. Wider implications - for instance for food security, livelihoods and education - were neglected, and respondent were unclear on how or where to engage. A narrow focus on Ebola also downplayed other health implications, and people with other conditions were left without treatment due to the outbreak.

3. Build on existing leadership and coordination structures
Since Ebola was initially framed as a health emergency in West Africa, the leadership and coordination arrangements typical of a large-scale humanitarian response were not triggered. Instead, the UN Mission for Ebola Emergency Response (UNMEER) was created. As a new mechanism, built in the midst of a crisis, it was not a success. Although imperfect, existing structures such as the cluster system are familiar and can effectively scale-up. The need for urgent action, comprehensive responses and familiar, inclusive structures means that new mechanisms should be avoided.

https://www.istat.it/storage/icas2016/g45-gunjal.pdf

https://reliefweb.int/report/world/how-manage-crisis-lessons-west-africa-ebola-outbreak

https://reliefweb.int/sites/reliefweb.int/files/resources/struggling-scale-ebolas-lessons-next-pandemic.pdf

https://www.odi.org/blogs/16779-covid-19-five-lessons-ebola

http://documents.worldbank.org/curated/en/423511560254844269/pdf/Impact-of-the-West-African-Ebola-Epidemic-on-Agricultural-Production-and-Rural-Welfare-Evidence-from-Liberia.pdf