Ten years after the Ebola outbreak: Lessons, progress, and preparedness and response in West Africa

Introduction: The 2014 Ebola virus disease (EVD) outbreak in West Africa was the largest in history, exposing critical weaknesses in surveillance, health systems, and cross-border coordination. A decade later, regional institutions have implemented numerous initiatives to strengthen preparedness and response capacities for Ebola and other viral hemorrhagic fevers (VHFs). This paper reviews progress, lessons learned, and ongoing challenges in VHF preparedness and response across West Africa, based on the outcomes of a regional workshop organized by the West African Health Organization (WAHO) and the World Health Organization (WHO) in July 2024. Methods: A qualitative thematic analysis of workshop proceedings was conducted, encompassing country presentations, panel discussions, and group work sessions with representatives from 15 West African countries, the WHO, Africa CDC, UNICEF, Médecins Sans Frontières, the World Bank, and other key regional stakeholders. Data were analyzed to identify common themes related to achievements, gaps, challenges, and strategic priorities for strengthening regional preparedness and response. Results: Key lessons highlighted the importance of resilient health systems, early detection, cross-border collaboration, community engagement, and sustainable financing. Progress over the past decade includes the establishment of Public Health Emergency Operations Centres (PHEOCs), expanded surveillance and laboratory networks, capacity-building initiatives, and deployment of Ebola vaccines. Nonetheless, significant challenges remain, including limited laboratory capacity in rural areas, inadequate treatment centres, weak cross-border coordination, and dependency on external funding. Conclusion: Ten years after the West Africa Ebola outbreak, substantial gains have been made in preparedness and response capacities, but critical gaps persist. Sustained investments in laboratory systems, community engagement, and cross-border collaboration, supported by predictable domestic and regional financing, are essential to build resilient health systems and prevent future outbreaks.