Being clever by being simple: the Ebola Private Sector Mobilisation Group story
Posted on 17.06.15 by
The Ebola Private Sector Mobilisation Group – or EPSMG – has received notable recognition for its role in helping West Africa tackle the Ebola outbreak. But what and who was behind the group? What actions did EPSMG take and can it offer any lessons to NGOS, the public and private sectors?
May 15, 2015
By Alan Knight, chairman of the Ebola Private Sector Mobilisation group
This is a personal account. I am the general manager of corporate responsibility at ArcelorMittal, the world’s largest steel and mining company, which has an iron ore mining and shipping operation in Liberia. ArcelorMittal initiated EPSMG and I was privileged to chair the EPSMG meetings during the critical months.
First – what was EPSMG?
EPSMG was the name given to a hub created through international telephone conferences where multiple companies with operational interests in West Africa dialled-in to receive updates on Ebola, exchange information and share views.
I called EPSMG a hub because it never existed as a formal organisation. It was never a legal entity with a board, budget or articles of association. This hub was useful when the greatest need was information and a space to talk. From the global EPSMG came the EPSMG country groups. These were on the ground, in-country hubs mobilising their skills and resources to “bend the curve” in Guinea, Liberia and Sierra Leone, and prevent spread to the surrounding countries of Mali and Senegal. Most of the credit of the success of EPSMG was due to the country groups. The umbrella group created a sense of community and an efficient exchange of information but the actual deployment happened through the country groups.
From Risk management to mobilisation
The 2014 outbreak of the Ebola virus in West Africa is now accepted as the most extensive, severe, and possibly most complex, outbreak in the nearly four-decade history of the disease. Guinea, Liberia and Sierra Leone suffered 24,000 cases of reported, probable and suspected Ebola – along with more than 10,000 deaths, according to the World Health Organization.
What started as a major health emergency in a sub-region of one country quickly escalated into an international humanitarian, health and socioeconomic crisis, born of a host of factors – from porous country borders and communities and families that regularly cross these national borders, to fear and stigma, and national health services’ lack of capacity and resources to detect and contain the threat in its early stages. The countries at the heart of the epidemic were already amongst the poorest in the world, prior to the crisis. In Guinea, Sierra Leone and Liberia, for instance, over half the population lives below national poverty rates.
In the face of such poverty, concern soon mounted around the potential impact of the outbreak on regional healthcare infrastructures – and regarding the quality and availability of trained medical personnel. The risk was clear. But thankfully, risk is something businesses are well-equipped to manage.
As operators of an iron mine in Liberia, we were closely watching the initial developments of the Ebola outbreak and we put the virus on our risk register. Since the outbreak first became apparent, we worked very hard to understand the virus and make sure that our facilities were Ebola ready. We hired experts to advise the company, trained and counselled our staff, mobilised equipment including personal protective equipment and
Image: ArcelorMittal’s Adriano Duse trains staff at a local hospital
specialist medical equipment. We reviewed and strengthened our emergency response and evacuation procedures, and set up a management committee, procedures and systems.
For ArcelorMittal, it was July 2014 when the cases of Ebola in Monrovia were reported and the risk management triggers started to be pulled. Though we were of course hoping that the outbreak would not spread, and would not endanger any further areas or lives we had prepared for it, we knew what we had had to do but we realised that we were acting as if we were alone.
We were not the only company in the region, and we knew that we must be able to learn from others and share what we knew to help drive a stronger response to the escalating crisis. That’s why a call was made to companies we knew, inviting them to join an informal conversation in London to share information about the outbreak, compare best practices, and collaborate to limit commercial impacts across the West African natural resources sector.
EPSMG is born
EPSMG started in July 2014 as a one-off gathering of 11 London based companies coming together to share what they could do to help combat the growing threat of Ebola. These initial companies all had an operational footprint in the affected region. We talked openly and directly about how our teams were responding and we agreed to meet again, invite other companies and be accessible to other companies by conference call.
The existence of the group was spread by word of mouth and more companies asked to be involved. The number of companies dialling into EPSMG calls quickly grew, and we were soon joined by representatives of aid organisations, institutions and government representatives. At the peak there were over 100 companies and almost 50 public bodies and NGOs joining the calls. For one of our December 2014 calls, we believe we had over 400 individuals dialling in.
Our initial focus was to exchange notes on what we were each doing at our operations, and out of this we decided to write to the Director General of the World Health Organisation to ask advice on how we could strengthen our response. We also found where we could have a common voice.
Despite the unprecedented nature of the outbreak, group members made a joint commitment to continue operating in those Ebola-affected economies and to carry out business as usual, as far as was possible. This was important and perhaps before, during and after the Ebola outbreaks the private sector’s contribution was to maintain its commercial viability.
This was no easy feat in the face of emerging restrictions on national and international trade, and impending travel restrictions – further complicated by uncertainty about the way the outbreak would evolve. Falling commodity and iron prices bought extra complexity to this operating environment.
Looking after our own people was important, but that alone was not going to “bend the curve” of the outbreak. What started as an inter-company information exchange evolved to advocacy for a global response and a hub where the public and NGO sector had direct access to companies for bilateral collaboration.
Whilst these aid organisations had the humanitarian and health response expertise, we had heavy lifting equipment, transport, accommodation and other equipment, and perhaps most critically – many of us had this in country ready and waiting to help their response. EPSMG provided a quick and simple hub to learn what those needs were and for bilateral arrangements to emerge between donors and recipients.
To the surprise of founding members, international interest in the EPSMG was significant and widespread. A visit to New York and Washington saw us enjoy quick and high access to decision makers across the United Nations and American and international development networks. It is always hard to judge how important such meetings are, but they certainly open up channels of dialogue.
Invitations and opportunities to engage at humanitarian exchange platforms and intergovernmental response forums continued throughout the end of 2014 and into 2015. What started as an informal meeting in July 2014, by December 2014 included a formal speech at a United Nations General Council meeting and numerous more informal gatherings. The work and collaboration of EPSMG was discussed at presidential level in West Africa and some members even enjoyed a private audience with President Obama.
The real success was the country groups
We had a clear responsibility to foster stronger relationships with government and responders, ensuring that we had the information needed to fight the disease and ensuring these messages were shared with our communities. This could only happen at country level. The greatest success of EPSMG was the ability to help get things done on the ground.
The real heroes were therefore the companies that did this work, and the EPSMG contribution was through the EPSMG country groups chaired and co-ordinated by in country chairs. We had groups in Liberia, Guinea, Sierra Leone, Senegal and Mali.
So what did companies do? In some instances this meant giving cash. In others, it meant donating vehicles for use as ambulances, providing medical supplies, and providing access to logistics, infrastructure and communications technology. The country groups continue to receive praise from governments today in recognition of their proactive work in the field to keep Ebola at bay.
Image: a man is scanned for fever at an ArcelorMittal facility in Liberia
People like numbers, but numbers with meaning can be hard to get. We believe that, as a minimum, the EPSMG companies gave away least 50,000 litres of chlorine, 4 million latex gloves, 55 vehicles, but more importantly, we trained more than 50,000 employees, who we estimate would have reached 350,000 dependents let alone the communities.
Another outcome was the very low infection rates within member companies. Thanks to the rigorous planning and precautions taken by our Liberian colleagues, not one of our employees on our concession contracted the virus, a fact that most other companies could also report.
I, however, really saw the value of EPSMG as an efficient exchange of information and a sense of community, with zero cost and little structure. At all times, the EPSMG never sought to replace or compete with the governments, donors, or other coordination groups or task forces. It was created to provide a simple access point into the private sector for joint mobilisation.
Travel restrictions – our biggest distraction
With people dying of a highly contagious disease it was shocking how much time was spent having to work out and manage travel restrictions. It was a shock to many of us that governments had no policies or thoughts on what was the right approach to the movement of nationals to and from countries at risk.
For example, if I as a British national flew to Liberia to help on the Ebola outbreak and I were to contract Ebola, it was unclear whether I could go back to UK for treatment or would have to stay in Liberia. If so what would happen to me? What if I broke my leg or suffered an illness or injury completely unrelated to Ebola whilst in an Ebola affected area – would I be able to return to the UK? It was unclear.
Expatriate employees were concerned about the uncertainties surrounding routine return transport to their home countries, and fears grew about the availability of medical evacuation for suspected or confirmed cases of Ebola. We realised that blanket travel bans were also of significant concern to humanitarian responders struggling to get personnel and supplies to the affected areas.
We lobbied hard on this, but with no real outcome. If there is one long term outcome from this event I would ask for it is an international convention on the movement of nationals to and from countries suffering from a pandemic. There are no easy answers to this, but what is imperative is that a protocol be negotiated and agreed before the next pandemic. This was a distraction that the private and public sector can ill afford to see repeated.
However, the private sector’s biggest contribution to Ebola was keeping their business going and this was only achieved by companies’ rigorous risk-planning and health and safety systems. This ensured the risk of employees contracting the virus was deemed extremely low.
By January 2015, the Ebola growth in outbreak curve had been bent. While the numbers of new cases reported were still unacceptably high, there were fewer with each passing week. The talk became about “the road to zero” but the disease would not be deemed over until there were no new infections anywhere for 42 days. We observed that many private sector companies began disengaging from the EPSMG, instead channelling their efforts into the daily operations of running a business in post-Ebola West Africa.
But a smaller group wanted EPSMG to engage with the ongoing international debates, funding discussions, and thinking around lessons learned and economic recovery. As chair, I was, and still am, frequently invited to speak on behalf of the EPSMG on recovery and economic development.
This requires a lot of time, and furthermore the simplicity of EPSMG meant we were not equipped or mandated to create a single voice on such complex issues. EPSMG was about practical in-field action – not intellectual consensus building. By April 2015, we realised we needed to decide what the next steps and legacy for EPSMG were going to be. We focussed in on what we had learned.
So what did we learn?
> EPSMG’s best contribution was the preventative action
The epidemic was rightly seen as a humanitarian disaster, but we observed that it is important not to put Ebola in the same box as event-based disasters like floods and earthquakes, where the worst outcomes occur suddenly, before businesses can intervene, placing the focus on rescue and recovery. Whilst a death toll of 12,000 is a disaster, we should remember that the forecast number of cases exceeded 250,000 in September 2014. Perhaps the forecasts were wrong or more likely the joint government effort with NGOs, the public sector, and the private sector were successful. Either way, this success story is about what was prevented.
> Business has been here before – parallels with HIV
Parallels can be drawn with the long track record many businesses have in managing HIV in their workforces. Whilst the pace of the HIV outbreak was over months and years rather than hours and days, many companies in Africa proved to be highly effective in mobilising their staff and resources at preventing the worst of HIV in their sphere of influence. I saw this first hand, because for three years I oversaw the HIV programme for SABMiller across Southern Africa.
The parallels are noteworthy: the need to change behaviours, the need to have the right medicines, the value of peer to peer education and the issues of stigma are all similar. All that differed was the pace of change. Perhaps most noteworthy was the need for an employer to engage in conversations with employees about topics that they normally would avoid – for HIV this is about sexual behaviours, for Ebola it was about attitudes to funeral rites and traditional care behaviours. Anyone who is studying the EPSMG contribution should therefore, also draw lessons from HIV.
> Risk management works
Business risk processes provide an apt framework to plan for pandemic risks. Since SARS, contagious disease has become a theoretical business risk, but late-2013 and early-2014 Ebola cases in West Africa focused the minds of risk managers and their health and safety colleagues. During the worst moments of the outbreak, ArcelorMittal’s top-management reviewed the status of the outbreak and our actions. This model was replicated across the business network. It works.
> Businesses will look after their employees, which mean they look after citizens
The most significant private-sector contribution was undoubtedly the training and care these companies offered their own employees and those individuals’ families and neighbours. Employees are citizens so a mass outreach by all the employers will reach a significant proportion of the population. I am confident the companies operating in Ebola-affected regions would have done this regardless, but EPSMG provided value as a hub for sharing best practice on how to approach this most effectively.
> Business interests are also human interests
If EPSMG was about protecting business interests, did it make EPSMG cynical and self-serving? The answer is “no”: to protect a business from such a disease you need to protect your employees. Employees are citizens, so business interventions protect the human, as well as the economic, need. The logic extends from the employee, to their family and community. What’s more, the public sector asked the private sector to stay in-country and remain economically active. The other choice would be to leave the country, which would have made matters worse. By staying in the affected countries the private sector helped keep economies active.
> Rewiring public-private partnerships
Chairing EPSMG gave me the rare privilege of getting closer to the workings of the public sector. While I deeply respected the individuals with whom I engaged, I saw that their desire to deliver results quickly and pragmatically was constrained by governance, process and politics. Governance of the public sector is key, but it can pay a price in moments of need.
I was proud to see my business colleagues acting nimbly and quickly, but conscious that many public sector players saw business as merely a source of money. EPSMG was special because it helped to unlock the real contribution from the private sector, which was not cash, but skills, assets and awareness rising amongst its sphere of influence.
EPSMG helped collaboration and coordination of goodwill, skills and physical assets. It is now clear that the private sector has more to offer than donations, and I hope EPSMG (and the business response to HIV) are proof points. The challenge for the public and NGO sectors is figuring out how to utilise that in the future.
> The value of simplicity
It could be argued that the Ebola related events in West Africa were unique. The region simply didn’t have the means of containing the disease. An Ebola crisis would not happen in the UK, for example. Even airborne Ebola would be contained by measures implemented by the UK government since the SARS epidemic. But while this case was unprecedented, valuable lessons can be taken and applied in future global challenges. Today, for example, there is general recognition that the private sector has a valuable role to play in crises and the humanitarian response.
But perhaps the most important lesson is the value of simplicity. With EPSMG, a group of businesses saw value in collaborating to protect their people, companies and entire communities from a terrible disease. Learning and resources were shared when they were needed. Practical action happened when it was needed. When these things were no longer needed, EPSMG was no longer needed – naturally, it fizzled out.
So what now?
I have six ambitions:
I. We get to zero and stay at zero. EPSMG is about Ebola. Whilst the road to zero is hard for EPSMG to lead on, it is nonetheless vital. The private sector, I trust will remain vigilant until we reach zero and maintain it.
2. Recovery in West Africa is vital. EPSMG is not the home for such work, but I know myself and other members are available to help and advise on what projects and ideas emerge for other agencies better equipped to house the governance and skills required for such important work.
3. The EPSMG model is codified and embedded somewhere, so that it can be repeated by design and not by chance when it is needed again. I believe the World Economic Forum has a huge role to play there.
4. I truly hope that the United Nations and other response groups look at the private sector as equal partners in the future and not just as donors. I think the Office for the Coordination of Humanitarian Affairs has a role to play here in leveraging new relationships and partnerships.
5. We need world leaders to fill an important policy gap – we need an international convention on the movement of people across borders during a pandemic. Let’s get this agreed before the next pandemic.
6. I hope Ebola never happens again in West Africa or anywhere else. If it does, I know myself and my EPSMG peers will be ready to pick up the phone and start talking again.
As the founder of EPSMG, I am once again in awe of the power of people and humanity to pull together and help when the chips are down. What started as a small meeting with 11 companies in London was, for a few critical weeks, a vitally important hub. We live in world that overcomplicates things – EPSMG proved the power of simplicity. I am grateful and full of admiration for the hundreds of private sector individuals who for a few critical weeks dropped everything, alongside hundreds of people from the public sector and NGOs.
So I have one very simple conclusion: EPSMG was clever because it was simple.
Learn more at www.epsmg.com, which chronicles the history and interventions of the group
Image credit: Derek Keats, Flickr