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Ebola crisis: How to improve the integrity of responses to public health emergencies?

Transparency International called today on the government of Guinea, donor agencies and humanitarian agencies to be more transparent in their responses to public health emergencies to ensure fair, rapid and corruption-free humanitarian aid.

In a new report focusing on the Ebola crisis in Guinea, the global anti-corruption organisation found that supporting local healthcare capacities and investing in communication with affected communities would strengthen the response of aid providers and its integrity.

The report Collective Resolution to Enhance Accountability and Transparency in Emergencies: Guinea report, developed in partnership with Groupe URD, is based on in-depth interviews with affected communities and stakeholders to identify the corruption risks that affected the humanitarian response to Ebola in Guinea. The report makes recommendations on how to mitigate those risks in the future.

The study shows that most of the goods used in the response were too specialised to be resold and were thus less prone to misappropriation. The stigma attached to the disease also significantly reduced the theft of aid. The main risks identified concerned logistics (misuse of vehicles, fuel and generators) and construction (poor design and process in calls for tenders, weak oversight of building sites), as well as risks in human resources due to the large number of staff needed as the response was quickly scaled up.

Furthermore, the populations’ perception that there was an “Ebola business” – high level flow of funds into the country and significant increase of international aid staff predominantly based at expensive hotels in the capital – was a real hindrance to the response and a danger for staff due to hostile reactions by communities. Lack of understanding and errors of communication and behaviour created an environment of rumours and accusations as well as a lack of confidence that made the delivery and integrity of aid more vulnerable.

One of the main characteristics of the Ebola crisis was the significant involvement of scientific research bodies, private laboratories and pharmaceutical companies alongside the relief operations. Though there were obvious needs in terms of rapid diagnostic tools, drugs and vaccines, the practices of these organisations lacked transparency, and there was an obvious race to find the product that would be a source of significant financial reward, which raised questions in terms of ethics and integrity.

This crisis has brought new challenges in relation to aid integrity compared to classic humanitarian responses. As such, there needs to be a better understanding of the relationship between the type of crisis, the type of response and the context, and based on this solutions can be identified to protect the integrity of aid. In particular, Transparency International makes the following recommendations:

Humanitarian aid agencies should:

  • Improve understanding of and communication about the crisis with affected populations.
  • Establish the right tools for financial management in areas such as procurement, recruitment, and financial transfers.
  • Reinforce collective systems and tools for managing logistics in the field, such as for customs, transport and storage.
  • Promote and participate in national coordination mechanisms.

Donor agencies should:

  • Reinforce national capacities and support national coordination mechanisms.
  • Impose ethical standards and transparency for medical research organisations.
  • Be prepared to finance specialists (in areas such as anthropology, sociology, and communications) to enhance the approach to complex crises.

The Government of Guinea should:

  • Reinforce audit and account verification capacities and optimise coordination at and between regional, national and local levels.
  • Consider the legal and institutional framework required to respond to such a crisis.
  • Strengthen communication with and participation of affected populations.


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Chris Sanders
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Laeticia Klein
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