Cost of the Ebola Epidemic

Aside from the devastating health effects, the Ebola epidemic also had a pronounced socio-economic impact in Guinea, Liberia, and Sierra Leone. According to 2014 projections from the World Bank³, an estimated $2.2 billion was lost in 2015 in the gross domestic product (GDP)⁴ of the three countries. The disease resulted in lower investment and a substantial loss in private sector growth, declining agricultural production that led to concerns about food security, and a decrease in cross-border trade as restrictions on movement, goods, and services increased.^5,6,7

Healthcare workers caring for patients with Ebola were among those at highest risk for contracting the disease. From the start of the outbreak through November 2015, a total of 881 confirmed health worker infections were reported in Guinea, Liberia, and Sierra Leone, and there were 513 reported deaths.⁸  Liberia lost 8% of its doctors, nurses, and midwives to Ebola; Sierra Leone and Guinea lost 7% and 1% of their healthcare workers, respectively.⁹

In addition to the devastating effects on the healthcare workforce in Guinea, Liberia, and Sierra Leone, the Ebola epidemic severely impacted the provision of healthcare services and caused setbacks in the treatment and control of HIV, tuberculosis, and malaria. Because of reduced access to healthcare services in the three most affected countries, an estimated additional 10,600 lives were lost to HIV, tuberculosis, and malaria during the epidemic based on a the assumption of an approximate 50% reduction in healthcare services in these three countries.¹⁰

Children were greatly affected by the Ebola epidemic. Nearly 20% of all Ebola cases occurred in children under 15 years old. Figures from the Guinea¹¹, Liberia¹², and Sierra Leone¹³ recovery plans estimate that more than 17,300 children have been orphaned because of Ebola. In June 2014, all schools in Guinea, Liberia, and Sierra Leone closed because of the epidemic. By the time the schools reopened in 2015, students had lost approximately 1,848 hours of education due to school closures, ranging from around 33 weeks in Guinea to 39 weeks in Sierra Leone.¹⁴ Children also experienced a gap in vaccination schedules as routine immunizations decreased by 30% when funding and logistics previously dedicated to vaccination campaigns were redirected to fight the epidemic or were postponed to avoid public gatherings.¹⁵

The countries highlighted in the map were the top donators to the international Ebola response, donating more than $3.611 billion (USD) by December 2015.¹⁶ The U.S. government allocated approximately $2.369 billion for Ebola response activities, including $798 million to CDC, $632 million to the Department of Defense, and $939 to the U.S. Agency for International Development. In addition to providing personnel, technical expertise, and resources to the response, these funds established three new emergency operations centers in Guinea, Liberia, and Sierra Leone.

To prevent Ebola from crossing borders, travelers leaving West Africa were screened at airports. More than 339,000 people were screened before leaving Guinea, Liberia and Sierra Leone.¹⁷  Exit screening helped to identify those at risk for Ebola and prevent disease transmission to other countries. The United States also implemented enhanced entry screening for travelers coming from Guinea, Liberia, Sierra Leone, and Mali by routing them to designated airports that were able to assess travelers for risk. More than 38,000 travelers entering the United States were screened for Ebola.¹⁷

During the height of the response, CDC trained 24,655 healthcare workers in West Africa on infection prevention and control practices.¹⁸ In the United States, more than 160 clinical webinars and conference calls were held with professional organization members and more than 6,500 people were trained during live training events throughout the response.¹⁹ In addition, Laboratory capacity was expanded in Guinea, Liberia, and Sierra Leone, with 24 labs able to test for Ebola by the end of 2015.²⁰

1. CDC. 2016. 2014 Ebola Outbreak in West Africa – Case Counts. January 20. Accessed January 22, 2016. https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html.
2. CDC. 2016. Outbreaks Chronology: Ebola Virus Disease. January 20. Accessed January 22, 2016. https://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html.
3. The World Bank. 2014. GDP growth (annual %). Accessed January 20, 2016. http://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG.
4. GDP per capita denotes the gross domestic product/population for year 2014. Values shown in current US dollars (2015).
5. The World Bank. 2015. Summary on the Ebola Recovery Plan: Sierra Leone. April 15. Accessed January 20, 2016. http://www.worldbank.org/en/topic/ebola/brief/summary-on-the-ebola-recovery-plan-sierra-leone.
6. The World Bank. 2015. Summary on the Ebola Recovery Plan: Guinea. April 16. Accessed January 20, 2016. http://www.worldbank.org/en/topic/ebola/brief/summary-on-the-ebola-recovery-plan-guinea.
7. The World Bank. 2015. Summary on the Ebola Recovery Plan: Liberia – Economic Stabilization and Recovery Plan (ESRP). April 15. Accessed January 20, 2016. http://www.worldbank.org/en/topic/ebola/brief/summary-on-the-ebola-recovery-plan-liberia-economic-stabilization-and-recovery-plan-esrp.
8. World Health Organization. 2015. “Ebola Situation Report – 4 November 2015.” Accessed January 20, 2016. http://apps.who.int/iris/bitstream/10665/192654/1/ebolasitrep_4Nov2015_eng.pdf?ua=1.
9. David K Evansa, Markus Goldstein, Anna Popova. 2015. “Health-care worker mortality and the legacy of the Ebola epidemic.” The Lancet Global Health 3 (8): e439–e440. Accessed December 22, 2015. doi:10.1016/S2214-109X(15)00065-0. http://www.sciencedirect.com/science/article/pii/S2214109X15000650.
10. Alyssa S. Parpia, M., Martial L. Ndeffo-Mbah, P., Natasha S. Wenzel, M., & Alison P. Galvani, P. Impact of the 2014-2015 Ebola Outbreak on Malaria, HIV, and Tuberculosis in West Africa. Emerging Infectious Diseases (in press).
11. 2015. “Guinea: Post-Ebola Socio-economic Recovery and Resilience Strategy 2015-2017.” Document of the Government of the Republic of Guinea. Accessed January 20, 2016.
12. 2015. “The Economic Stabilization and Recovery Plan.” Republic of Liberia.
13. 2015. “National Ebola Recovery Strategy for Sierra Leone 2015-2017.” Government of Sierra Leone.
14. United Nations Development Group (UNDG) – Western and Central Africa. 2015. “Socio-Economic Impact of Ebola Virus Disease in West African Countries: A call for national and regional containment, recovery and prevention.” Accessed December 23, 2015. http://www.africa.undp.org/content/dam/rba/docs/Reports/ebola-west-africa.pdf.
15. UNDP. 2014. “Assessing the socio-economic impacts of Ebola Virus Disease in Guinea, Liberia and Sierra Leone: The Road to Recovery.” Accessed December 22, 2015. http://www.africa.undp.org/content/dam/rba/docs/Reports/EVD%20Synthesis%20Report%2023Dec2014.pdf.
16. USAID. 2015. “West Africa – Ebola Outbreak: Fact Sheet #6, Fiscal Year (FY) 2016.” January 21, 2016. Accessed February 18, 2016. https://www.usaid.gov/sites/default/files/documents/1866/west_africa_fs07_01-21-2016.pdf.
17. CDC – Division of Global Migration and Quarantine – International Border Team.
18. CDC – International Infection Control Team.
19. CDC – Division of Healthcare Quality Promotion.
20. 2015. Ebola labs testing in infected African countries. February 20. Accessed January 20, 2016. https://public.tableau.com/profile/jenniferchan.nethope.#!/vizhome/NetHope_HDX_LabTesting_FINAL_DAedit/EbolaLabstestingininfectedafricancountries.