January 15, 2015: A tragic update: Just a day after the World Health Organization declared an end to the Ebola epidemic in West Africa, a woman has died from the virus in Sierra Leone. This new case may have exposed 27 people to the deadly virus. Sierra Leone had been declared Ebola free on November 7, 2015. This new case reminds the world that continued vigilance is necessary to stop this and future epidemics.

Today, the World Health Organization declared West Africa to be Ebola free for the first time in over 2 years. This marks the end of an outbreak that killed more than 11,300 people and infected about 28,600.

This is a major milestone in global health. The 2 year-plus outbreak peaked in October 2014, when health officials were warning that hundreds of thousands, if not millions, of people could die.

The estimates of death proved to be wrong in large part because of drastic efforts by regional governments and the international community.

Governments created widespread quarantine procedures, curfews and mobilized health initiatives of unprecedented scale. Aid organizations of all types got involved, from Polio vaccine networks helping to identify victims and spread information to educational organizations transitioning their schools into treatment centers.

The legacy of this outbreak will be one of fear and hope. Fear that this outbreak was only a taste of what a catastrophic epidemic could be on a global scale. And hope generated by the thousands upon thousands of dedicated health workers (many untrained prior to this outbreak) who risked their own lives to care for victims and stop the spread.

Ebola is a lesson that health systems CAN overcome epidemics, but also that thousands of people died because the existing infrastructure was not strong enough to deal with the epidemic when it started with a 1-year old in Guinea.

The wider impacts of Ebola may never be truly quantified. The outbreak ravaged the region's population, caused untold economic upheaval and contributed to the deaths of many from non-Ebola related causes. It’s this last impact that may need the most study.

The health infrastructure that was leveraged and built up to deal with Ebola in the region came at the cost of providing care and resources in other healthcare areas. Reports were widespread at the peak of the outbreak of expectant mothers unable to receive care because doctors were swamped with Ebola cases. There have also been reports that many long-standing vaccine programs--around things like measles for example--were abandoned during the chaos of the outbreak so that every available health worker could be mobilized. A sad trade-off that may have traded saving lives in the short-term but costing lives in the long term.

This sad choice during the height of the outbreak did have a silver lining: improved health infrastructure. The investment to stop Ebola's spread will have knock on benefits including a much wider pool of trained workers as well as facilities built during the crisis that are being repurposed now that the epidemic is over. Today is a day to celebrate but it is also a day for learning. The end of the Ebola is technically now official since it has been 42 days since the last patient tested negative. But this “waiting period” is still just a guess. The WHO is expressly warning that flare-ups of Ebola may still occur as doctors learn more and more about how long the virus can remain dormant between active cases.

And beyond victims stemming from this outbreak, Ebola will definitely resurface. This last outbreak was the worst yet from Ebola, but it was not the only time Ebola has been a threat. This deadly virus will return and so will many others.

Ebola has been stopped THIS time, but the lessons learned must not be forgotten. Today is about celebrating but tomorrow is about how to stop the NEXT outbreak. Specifically, how to build health infrastructures in West Africa--and eventually everywhere--that are flexible and capable enough to respond quickly and decisively to outbreaks while not neglecting their ongoing care responsibilities.

Extreme poverty cannot be ended when a population is struggling with a health crisis. Local economies cannot flourish when its best minds are sick and dying. The next step for West Africa is to continue the “build back better” movement, with a focus on creating a health system that will support the region's efforts to pull everyone out of poverty. 

Ebola has been stopped but the world cannot stop its efforts to improve health infrastructure and outcomes for everyone.