Tag: DEC

Ebola Lessons from 2014 for 2026

June 1, 2026     Germane to the current outbreak of Ebola Virus Disease in eastern DRC this month are lessons from the large humanitarian efforts to curtail transmission of Ebola in West Africa in 2014-2016.

The USG commissioned an evaluation of that response, which looked not only at USG response, but that of other donors, UN agencies, NGOs, academia and other actors.  The reports from that evaluation are linked below.

Four key lessons jump out from the research:

First, the aid response of separating family members with symptoms of Ebola had the unintended effect of discouraging honest reporting or referrals, such that the total official death count across West Africa was much lower than the true cause of death.

Second, what mattered the most in interrupting transmission was when local populations observed deaths of people they knew which led them to take seriously new changes in behavior (not touching the bodies of people wiht Ebola).  This was the essential change that had to occur.

Third, much of the efforts overall by aid agencies had less of an effect in “bending the curve” of the epidemic than the simple communications by the families and communities affected.

Fourth, while many health professionals died early in the outbreak, attention to protecting them, including provision of protective gowns/gloves and equipment was necessary for further work to be achieved.

Food and Nutrition:

Food aid functioned less as a nutrition intervention and more as an enabler of disease control.  Its main value was making isolation and quarantine viable. Qualitative data indicated that food distributions to isolation and treatment units, facilitated by Food for Peace (FFP), improved the effectiveness of isolation, quarantine, and  response actions at community-based sites of transmission. FFP food distribution played a critical role in supporting isolation and restrictions on mobility,  in response to warnings from implementing partners about food shortages among quarantined communities.

The scale was significant:  through the end of 2014, USAID awarded nearly $35 million in food assistance to WFP through the Office of Food for Peace.  Examples include WFP providing all patients discharged from the Guékédou treatment unit in Guinea with a 60-day food ration on leaving, and continuing general distributions of 45-day rations (rice, oil, pulses, salt) in affected communities.

 The proportion of quarantined households that received food support was roughly similar across all three countries, between 60 and 70 percent.  In Guinea, quarantined families with Ebola cases were more likely to have received food support in urban areas (89%) than in rural areas (53%),  part of a broader urban bias the evaluation flagged in how supplies were targeted. Notably, the reports treat food almost entirely as rations/in-kind support for isolation; there is essentially no analysis of nutritional outcomes per se.

Behavior change

Behavior change was identified as one of the most decisive factors in bending the epidemic curve — arguably more than clinical capacity. The most effective USG-funded activities were nationally-led incident management and coordination, social mobilization, and safe human remains management; as OFDA scaled up community engagement — health education, household isolation, hygiene kits, community outreach, adapting safe burial practices, and involving local leadership — a downward trend in new cases is clearly seen in the data.

The substance of the behavior change effort was straightforward but hard to achieve: much of the social mobilization effort was oriented toward changing simple behaviors such as shaking hands, other physical contact, washing hands, and the handling of infected persons and dead bodies. The key lesson was sequencing — which donors under-prioritized at first.  Whereas  early priorities focused on facility-based responses, case isolation, treatment, and safe burial, donors and NGOs failed to prioritize social mobilization and community-level responses.  Key lesson: social mobilization is the most relevant at the outset of the response.  Aid agencies should hire and deploy anthropologists.

When trusted local actors led it, the payoff was fast:  one Government of Guinea informant noted that within 1–2 months of accelerated social mobilization, the number of prefectures reporting social resistance dropped from 27 to 4.

A cross-cutting theme among evaluators were that while more than 90% of activity monitoring targets were reported as achieved, this reflected only activities and reveals little about actual change in bending the epidemic curve,  a major limitation in analyzing the USG contribution.

These reports, led by the independent evaluation organization IBTCI were available on the USAID Development Experience Clearinghouse until a year ago when the Administration dissoved it.  They are accessible via these links below:

 Synopsis:     https://www.worldhunger.org/wp-content/uploads/2026/06/Synopsis-of-Ebola-West-Africa-Evaluation.pdf

        Coordination:  https://www.worldhunger.org/wp-content/uploads/2026/06/Ebola-Response-Eval-4-Coordination.pdf

        Effectiveness:  https://www.worldhunger.org/wp-content/uploads/2026/06/ebola-ibtci-eval-effectivenes-1.pdf

         Relevance:   https://www.worldhunger.org/wp-content/uploads/2026/06/Ebola-evaluation-Relevance-of-response-3.pdf

        Components:   https://www.worldhunger.org/wp-content/uploads/2026/06/Ebola-evaluation-vol.-2-effectiveness-of-components-2018.pdf

A 2020 review of some selected lessons about the West Africa and DRC Ebola responses, largely non-medical, was commissioned by ALNAP here, focusing on community trust and messaging.

at the same time, ALNAP recommends these infection and control guidelines from WHO.

USAID Library of Project Reports and Evaluations Now Available from Third Parties

By: WHES Board (*Note this post was updated from its original Feb 18, 2025 version to add the two new pages with DEC resources.)

 

American Taxpayers often have questions about how funds for foreign aid work.  In early 2025 there has also been claims — and false information — by Congress and social media about an overall lack of transparency about this aid.

The primary or lead aid agency for the US Government is the United States Agency for International Development or USAID.  In tracking the tens of thousands of projects that have been funded, USAID has maintained a public, transparent, free, easy, searchable database, called the “Development Experience Clearinghouse”, or DEC.   Indeed, World Hunger Education Service has turned to the DEC many times in the last few decades to help provide educational content to the public.

The Development Experience Clearinghouse (DEC) is large database of several hundred thousand reports for sharing and accessing USAID-funded technical and program documentation, including reports, evaluations, studies, and other resources related to international development.   Most of the independent rigorous evaluations conducted of USAID activities can be freely download or read from this site.  In addition to serving as a historical record of USAID’s work, it also fosters knowledge sharing about American solutions to problems and technical advances between countries.  There is no comparably comprehensive, one-stop-shop source of information about development insights, for instance by the UN or in Europe or the UN.

Reports on the DEC are typically written by groups implementing programs overseas, including American nonprofits, universities, research groups and other independent specialists or front-line implementers summarizing their programs.

Ironically, during the January/February 2025 period of claims by some Congresspeople that USAID is not transparent, the new Administration shut down the DEC, so that it is no longer accessible for American citizens, including students or Congresspersons, to learn from.  No explanation was given about why the new Administration is blocking transparent access to details about USAID-funded programs.

However, two different independent groups have attempted to recreate the DEC (or at least portions of it) and make it available to the public for free again.

Why the Destruction of USAID Increases Hunger and Harms America

March 21, 2025

The United States Agency for International Development (USAID), the agency created by Congress in 1961 to lead America’s development and humanitarian assistance, has been decimated by President Trump’s January 21 Executive Order freezing U.S. foreign assistance.

Why should Americans care? For several reasons. First, USAID, until it was decimated, was the world’s largest provider of food aid, nutritional, health, and humanitarian assistance, saving millions of lives of women and children around the world. While many Americans believe that foreign aid takes a large share of federal spending, in fact this assistance accounts for less than 1% of government spending.

Cancellation of this aid has direct and immediate impact on vulnerable people in low- and middle-income countries. Nicholas Enrich, the acting assistant administrator for global health at USAID, who was placed on administrative leave on March 2 for documenting the failure of the Trump administration to follow through on its pledge to allow waivers for lifesaving foreign aid, has written that the consequences of halting $7.7 billion in funding for lifesaving global health programs will lead to the following each year:

  • 5–17.9 million cases of malaria, with an additional 71,000–166,000 deaths;
  • a 28-32% increase in tuberculosis globally;
  • an additional 200,000 paralytic polio cases;
  • more than 28,000 cases of Ebola, Marburg, or related diseases;
  • 17 million pregnant women without access to life-saving services when faced with delivery complications;
  • 11 million newborns not receiving critical postnatal care;
  • 1 million children not treated for severe acute malnutrition.

“USAID’s failure to implement lifesaving humanitarian assistance under the waiver is the result of political leadership at USAID, the Department of State, and DOGE, who have created and continue to create intentional and/or unintentional obstacles that have wholly prevented implementation,” wrote Enrich on Feb. 28. “This will no doubt result in preventable death, destabilization, and threats to national security on a massive scale.”

Second, the decimation of USAID hurts American businesses, faith-based organizations, and farmers. USAID had a well-established strategy to prioritize contracts for American small businesses like Rhode Island-based Edesia which manufacturers a lifesaving paste for severely malnourished babies. Cancellation of Edesia’s contract not only harmed this business of 150 employees but also the farmers across 25 states, the U.S. ocean liners Edesia paid to ship hundreds of metric tons of its Plumpy’Nut therapeutic paste, and finally, to the international organizations that distributed it to children staving off death.

Third, this assistance, proudly branded by USAID as “From the American People”, created good will towards the United States and its citizens. It also contributed to America’s and global health security by fighting infectious diseases and strengthening local capacity to detect and fight scourges like Ebola, Mpox, and Avian flu which continue to be threats to the United States. Wholesale cancellation of support for infectious disease and research on how to prevent and mitigate pandemics makes Americans less safe and more vulnerable.

Presidential Advisor Elon Musk bragged on X on February 3 that “We spent the weekend feeding USAID into the wood chipper. Could have gone to some great parties. Did that instead.” Under the direction of Musk’s Department of Government Efficiency, USAID’s headquarters in Washington, DC was closed, over 4,000 USAID staff terminated, and another 4,765 direct hires placed on administrative leave.

By early February, USAID contractors and implementing partners, including those providing humanitarian assistance and emergency food relief like Catholic Relief Services and Lutheran World Relief, began receiving stop-work orders. Some of these contractors and implementing partners then received communication that the stop-work orders were lifted, but then in many cases were contacted again to say the stop-work orders were still in effect.

Effectively gutting the USAID workforce means that actions to issue waivers for lifesaving programs, as the Trump Administration claimed it was doing, or to support the continuance of “approved” programs, are not happening. USAID’s payment system is not accessible. As a result, most contractors and implementing partners have not been paid for work they did before the freeze, and many have been forced to lay off and furlough staff or even cease operations.

While U.S. Secretary of State Marco Rubio, now the acting administrator of USAID, has repeatedly said he has issued a blanket waiver for lifesaving programs, including food and medical aid, no staff at implementing partners or USAID means promises of such waivers are cruel hoaxes. In early March, Rubio announced that 5,200 USAID programs had been terminated and that about 1000 USAID programs would be continued but administered by the State Department.

In addition to stopping the delivery of food and humanitarian assistance, the Trump Administration also ended the USAID-funded Famine Early Warning Systems Network (FEWS NET) which monitored drought, crop production, food prices, and other indicators in order to forecast food insecurity in more than 30 countries. FEWS NET was created following the 1984 famine in Ethiopia, which killed an estimated 400,000 to 1 million people – and caught the world off guard. President Ronald Reagan then challenged USAID to create a system to provide early warning and inform international relief efforts in an evidence-based way. Managed by contractor Chemonics International, FEWS NET employed researchers in the United States and around the world to provide eight-month projections of where food crises will likely emerge. Now, its work to prevent hunger in Sudan, South Sudan, Somalia, Yemen, Ethiopia, Afghanistan, and many other countries has been stopped. Amid the aid freeze, FEWS NET has no funding to pay staff in Washington or those working on the ground. The wealth of data that underpinned global analysis of food security – used by researchers around the world and paid for by the American people – has been pulled offline.

Aside from the immediate damage to health and health security that the decimation of USAID poses, the assault on USAID has also removed access to the world’s largest public repository of development assistance documentation, the USAID Development Experience Clearinghouse. A public good paid for by American taxpayers, the Clearinghouse and its thousands of resources are now unavailable. It is clear from the draconian cuts to USAID programs and staff that it is not a priority for the Trump Administration to make development knowledge and information available.