FREETOWN — Sierra Leone, a West African country bordered by Guinea, Liberia and the Atlantic Ocean, has the lowest life expectancy in the world. A citizen can expect to live just 52.2 years due to a combination of factors: poverty, malnutrition and poor sanitation, to name a few. However, Sierra Leone’s most deadly concern happens to be infectious diseases.
High-Risk Diseases in Sierra Leone
Six of the top 10 causes of death in Sierra Leone are related to infectious illnesses. Therefore, disease prevention and control is a major priority.
- Malaria is the leading cause of death, with an incidence of 304 people infected per 1,000 people at risk (or, about 30 percent).
- Twenty percent of one-year-olds lack measles immunization. Tuberculosis and lower respiratory diseases affect all ages.
- HIV/AIDS remains relatively prevalent, afflicting about 1.7 percent of Sierra Leoneans.
The diversity of high-risk diseases in Sierra Leone indicates that there can be no single solution; rather, a complete overhaul of health care provider training, outbreak response and immunization procedure is necessary to reduce fatalities caused by illness.
Ebola Outbreak and Aftermath
The 2014-2016 Ebola epidemic was the largest in history for that disease, and Sierra Leone sustained the highest number of fatalities. Among other things, the outbreaks represented a major setback in immunization efforts in West Africa. Due to the highly contagious nature of the disease, health care providers advised people to wait to get their children vaccinated—immunization centers, where adults and small children from all over the country might converge and interact, could inadvertently spread the illness and worsen the epidemic. The difficulty was convincing families to resume immunization procedures after the outbreaks were contained.
Columbia University’s ICAP program has been instrumental in reversing the trend following the Ebola epidemic. After receiving funding from the U.S. Centers for Disease Control and Prevention (CDC), ICAP members used a combination of outreach strategies, disease tracking tools, and health care training to encourage families to continue with measles vaccinations.
In June 2019, Sierra Leone’s Ministry of Health and Sanitation announced that a partnership with UNICEF, the WHO and Gavi would allow them to begin nationwide. The week-long campaign is expected to benefit more than 3 million children across the country by providing immunization against these deadly diseases.
Strides in Malaria Prevention
USAID’s support of the President’s Malaria Initiative (PMI) allows for the most effective methods of malaria prevention, including insecticide-treated mosquito nets and indoor residual spraying, to be distributed throughout the country. The Initiative, which previously focused on countries in sub-Saharan Africa, has recently expanded to include Sierra Leone and other malaria-prone countries. In 2016, PMI made the following contributions to preventing malaria in Africa:
- Distributed more than 30 million insecticide-treated nets.
- Procured more than 7 million preventative treatments for pregnant women.
- Supported spraying more than 4 million houses with insecticides.
- Supported training of 51,627 health workers in malaria case management.
Recently, ICAP partnered with Sierra Leone’s National Malaria Control Program (NMCP) and the CDC to pursue the ambitious goal of making Sierra Leone the first country with Intermittent Prevention Treatment in Infants (IPTi) nationwide. The treatment essentially helps infants build up a resistance to the disease in their formative years, putting them at lower risk later in life.
What Else Is Being Done to Fight Disease?
Other initiatives have also been successful in combatting infectious diseases in Sierra Leone. The CDC has supported advancements in laboratory testing so that 10 of the most epidemic-prone diseases—including Ebola, yellow fever and cholera—can now be detected early. The organization also established the Field Epidemiology Training Program (FETP), which provides Sierra Leonean health care providers with the proper training to prevent, detect and respond to disease outbreaks.
Outlook Moving Forward
While it is clear that a handful of organizations are committed to winning the fight against infectious diseases in Sierra Leone, there is still a long way to go. Malaria, Ebola and other potentially deadly illnesses continue to represent the top causes of death in the country. The improvements being made are noteworthy, but a dramatic transformation of the health care system, backed by international funding, is crucial in combatting infectious disease in Sierra Leone.
– Morgan Johnson