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Public health in Guinea: the Ebola crisis and Rusal’s public-private partnership

Epidemics put enormous stress on any country’s health infrastructure. When that health infrastructure is already lacking, the challenge is even greater.

When the West African country of Guinea was badly impacted by the Ebola virus in 2014, the situation could have spiralled out of control. Instead, thanks in part to an innovative public-private partnership led by Rusal to help fight the epidemic and promote public health, Guinea managed to gain control of the disease and prevent further loss of life.

Public health system in Guinea ill-equipped to deal with Ebola

Victory against Ebola in Guinea was not a foregone conclusion. Major challenges included the under-resourced and under-developed nature of its healthcare infrastructure and public health measures. During the crisis, Guinea has only 3,435 hospital beds to serve a population of almost 11.5 million. It also had only one doctor for every 100,000 people. Health spending per capita is just $67. While maternal mortality – a key indicator of how advanced a country’s health systems are – is declining, it still has one of the highest rates in the world. In early 2014, 57% of health facilities in the country were rated to be in a poor state.

The country also suffers from poor infrastructure more broadly. A report from the World Bank noted that “similar to other African countries, Guinea is facing a deficit in all modes of transport infrastructure” and that “the road network has progressively deteriorated, traffic is often interrupted and roads impassable during the rainy season.” In the context of the Ebola crisis, this meant aid workers and medics could not easily reach their patients or bring them to health centres for treatment. In addition, Guinea generally is one of the poorest countries in the world. Guinea ranks at 179 out of 187 countries in the United Nations Development Programme (UNDP) Human Development Index.

How Rusal’s public-private partnership helped Guinea tackle apublic health crisis

As was noted by the leaders of the three countries most affected by the Ebola crisis – Liberia, Sierra Leone and Guinea– the international community was slow to react to the Ebola crisis. When dealing with a devastating communicable disease such as Ebola, time is very much of the essence.

Guinea, however, did have at least one overseas friend prepared to act quickly in order to try to halt the devastating spread of Ebola: Rusal.

Rusal, as one of the world’s largest aluminium firms, carries out operations all over the world. In every country where Rusal operates, it takes its responsibilities to its employees and the wider community very seriously. Rusal’spublic-private partnerships help these countries improve in areas such as health, education and public health.

In Guinea, Rusal had already conducted itself in such a way. In 2006, in recognition of the way in which Rusal had fostered social and economic progress in the country, Guinea awarded Rusal the status of Socially Orientated Company. When Ebola hit, and other businesses retreated from West Africa, Rusal instead immediately set about doing something to help: setting up a public-private partnership aimed at leading the fight-back against Ebola. It was the only company globally to set up such an initiative in Guinea.

A model for a public-private partnership in public health

To turn the tide in its Ebola public health crisis, Guinea needed better healthcare facilities. Rusal began to construct a state-of-the-art, dedicated hospital that has become one of the nation’s main anti-Ebola hubs.

The Centre for epidemic and microbiological research and treatment (CEMRT) in Guinea was built at the former Soviet-Guinean Institute Pasteur in Guinea’s Kindia region in just 50 days.

As is often the case with such public-private partnerships, CEMRT’s strength is borne of the fact that private levels of finance and expertise are used are for public benefit. With guidance from the experts at the Russian Federal Service for Surveillance on Consumer Rights Protection and Human wellbeing (Rospotrebnadzor), the centre was furnished with the most up-to-date medical equipment. The total cost for funding this public-private partnership was $10 million, and the anti-Ebola centre opened its doors on the 17 January 2015.

The result is a medical centre that is now amongst the leading centres of its kind in West Africa. Its world-class health facilities include an infection hospital, provisional hospital, mobile laboratory and a blood and plasma transfusion department.

At the height of the Ebola crisis, those treated at the centre enjoyed a 62.5% recovery rate – the best in Guinea. It was a crucial part of Guinea’s fight against Ebola and instrumental in enabling the country to be declared Ebola free by December 2015.

Rusal’s long-term public health contribution to Guinea

The usefulness of the public-private partnership launched by Rusal has not ended with the Ebola crisis. It is, and will continue to be, a pivotal site in modernising and improving public health in Guinea. The CEMRT has been commissioned as a medical institution of the Ministry of Health of the Republic of Guinea,and has been included in the Guinean national healthcare system aimed at preventing the spread of Ebola.

The centre is a hub for research into Ebola and other dangerous communicable diseases, and the site which administers Russian-developed anti-Ebola vaccines. The CEMRT facilitated the development of the vaccine by providing safe access to real virologicalspecimens for aid Russian scientists in their research.

While the Ebola crisis was undoubtedly devastating for Guinea and the other West African countries affected, the CEMRT public-private partnership has provided a useful model for how joint working between big business, government and non-governmental organisations can work together to make a difference. Should a similar crisis hit, this public-private partnership’s public health legacy will undoubtedly make Guinea better prepared.