The campaign to eliminate the Ebola virus marked a significant milestone on Saturday, as the World Health Organization declared that Liberia was free of the disease. The announcement came 42 days after the safe burial of the last confirmed Liberian victim of the Ebola, a period equal to twice the virus’s incubation period.
The news was met with jubilation in Liberia, which along with Sierra Leone and Guinea was the country most affected by the virus. But officials tempered their joy with a note of caution.
“Let us celebrate, but stay mindful and vigilant,” said Ellen Johnson Sirleaf, Liberia’s president.
Since the epidemic began last March, 10,564 people across Liberia contracted Ebola, nearly 250 out of every 100,000 people in the country, and 4,716 died. But the human toll still understates the sheer scope of the damage incurred by Liberia, one of Africa’s most impoverished countries.
Ebola exposed glaring deficiencies in Liberia’s public health system, where there are few qualified doctors and most hospitals lack access to electricity and clean water. In the early stages of the crisis, workers at Liberia’s clinics treated patients without adequate precaution, inadvertently spreading the disease. Private hospitals turned many patients away, and at the height of the outbreak Liberians reported seeing Ebola victims die on the street. Altogether, 189 medical workers in Liberia lost their lives to Ebola.
In a country where the average citizen lives on just $1.25 per day, the Ebola epidemic also had a deleterious effect on Liberia’s economy—estimated at $180 million for 2015 alone. The disease cut the beleaguered country off from the outside world, as airlines like British Airways suspended service to the country, and complicated foreign travel. Liberians traveling to the United States were required to report their temperature to authorities over the first 21 days after their arrival. International fear of the disease grew so acute last December that India canceled a planned summit involving African heads of state due to concern about Ebola’s spread.
Ebola remains active in neighboring Sierra Leone and Guinea, which both reported nine cases of the disease in the last week. The World Health Organization has warned that the Ebola virus can survive in male semen for up to 82 days after infection, and have urged Liberians to refrain from unsafe sex as a precaution. Liberia’s health care system—despite vast improvements in treating Ebola—remains inadequate, and contraction of other diseases has surged. There have been 562 cases of measles in Liberia in 2015, including seven that proved fatal, and over 500 Liberians have contracted whooping cough.
Nevertheless, Liberia’s eradication of Ebola in 14 months was a significant accomplishment in a country just 12 years removed from a devastating civil war that killed 200,000 people. The victory resulted, in part, from the fast reaction of Liberia’s government as well as a sustained international aid effort. But crucial to the eradication effort were the Liberians themselves. Teams of community health workers traveled from door to door in the most dangerous slums of Monrovia, Liberia’s capital, and educated skeptical residents about the dangers of the disease.
"The communities were the heroes in this fight," Hassan Newland, a UNICEF official based in the country last year, told NPR.
But the same issues that have plagued Liberia for generations—poverty, misgovernment, and instability—ensure that the risk of another deadly outbreak has not gone away.
“Now is the time to address factors which contributed to Ebola’s spread, in particular, weak social service delivery, lack of accountability and overly centralized government,” said Karin Landgren, the UN Secretary General’s special envoy to Liberia.