A. Background Context
Sierra Leone is one of three countries in the Mano River Union to suffer from the worst recorded Ebola outbreak since the disease was first diagnosed in 1976 in the Democratic Republic of Congo. The socio-economic impact of the disease has been devastating.
To date more than 8,000 infection cases and more than 3,000 deaths have been recorded.
Medical personnel are among the victims, with at least 295 health care workers infected and 221 dead, including 11 specialized physicians.
This is especially worrying, as these personnel were already in short supply. The ratio of skilled health personnel to population size has reduced from an already low level of 17.2 personnel per 10,000 people before the outbreak to the current record low of 3.4 per 10,000. The required minimum ratio is 25 per 10,000. Of the cumulative deaths, 446 are children: 222 girls and 220 boys. Orphans are estimated at 8,345: 4,182 girls and 4,163 boys. Widows are estimated at 954 and widowers at 465.
The epidemic has crowded out the effective response to other diseases (including traditional killers such as malaria) in the national health care system; non-Ebola illnesses certainly will have added to the death toll recorded during this period. Following substantial efforts by the government, communities and international agencies, the disease is trending downward, with the number of new infections significantly decreasing in the past couple of months, but it cannot be said to be contained until zero cases are recorded.
Economic growth rates have slumped since the onset of Ebola virus disease (EVD), which followed very strong growth rates in 2012 and 2013, of 15.2 and 20.1 percent respectively.
The economy suffered a double shock from the Ebola outbreak and the simultaneous sharp decline of iron ore prices that resulted in both iron ore companies being placed under administration and a sharp curtailment of production and revenues to government.
The gross domestic product (GDP) growth rate for 2014 is estimated at 7 percent, and 1 percent excluding iron ore, compared to the 11.3 percent projection at the beginning of the year. For 2015, the economy is projected to contract by 23.5 percent, and by 1 percent excluding iron ore. Inflation rates increased modestly over the second half of 2014, while the monthly average exchange rate depreciated by around 13.5 percent, and the trade balance deteriorated from US$362.3 million in 2013 to US$6.8 million. The government’s fiscal deficit doubled to 3.8 percent of GDP (compared with 2013), reflecting higher current spending and decline in revenues (both associated with EVD, although revenues were also impacted by the decline in iron ore revenues late in the year). Despite the higher deficit, official interest rates remained low, reflecting increased system liquidity from unsterilized foreign exchange inflows associated with the Ebola efforts. The fiscal position is expected to deteriorate sharply in 2015, reflecting full year effects from the same pressures, and there is an increased risk of higher domestic financing costs raising debt sustainability risks. The country’s fragility has been increased once again; the hopes embodied in its Agenda for Prosperity (2013–2018) and chances of achieving Vision 2035 have been badly undermined.