CDC in Liberia

CDC in Liberia

The Centers for Disease Control and Prevention (CDC) first started working with the country of Liberia in 2007 under the U.S. President’s Malaria Initiative (PMI). In 2014, CDC rapidly increased support in response to the 2014-2016 West Africa Ebola outbreak. Following Liberia´s successful recovery from the Ebola epidemic, CDC Liberia expanded support in Global Health Security and is now supporting the COVID-19 response. CDC continues to help strengthen laboratory systems, disease surveillance, emergency management, and workforce capacities to respond to disease outbreaks in alignment with the Global Health Security Agenda (GHSA).

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CDC Impact in Liberia

Global Health Security

In today’s globally connected world, disease threats spread faster and more unpredictably than ever before. CDC’s global health security work in Liberia increases the country’s ability to prevent, detect, and respond to disease outbreaks before they become global events with epidemic potential. CDC Liberia provides expertise and support to the Ministry of Health (MOH), National Public Health Institute of Liberia (NPHIL), and other government institutions for 11 GHSA technical areas. These GHSA technical areas focus on strengthening core public health capacities in disease surveillance, laboratory systems, workforce development, emergency management, infection prevention and control (IPC), and points of entry.

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CDC established Emergency Operations Centers (EOCs) at the national level and in all 15 counties since 2014

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In 2021, a Liberian graduate of CDC’s Public Health Emergency Management (PHEM) Fellowship led an emergency and incident management training for 22 county-level EOC personnel

Field Epidemiology Training Program (FETP)

CDC helped launch Liberia’s FETP the public health workforce capacity to investigate and respond to disease outbreaks. Two levels of FETP— frontline and intermediate— train entry-, mid-, and senior-level health professionals to identify and contain outbreaks before they become epidemics. Participants develop critical data collection and disease investigation skills that inform evidence-based action. FETP trainees and graduates support outbreak responses, including: Ebola Virus Disease (2015-2016), measles (2015 – 2021), Lassa fever (2017 – 2021), meningitis (2018), pertussis (2017), scabies (2018), and COVID-19 (2020 – present).

FETP graduates also:

  • Sustain Liberia’s Integrated Disease Surveillance and Response platform
  • Increase data quality, timeliness, and completeness of surveillance reporting
  • Expand scientific literature and promote scientific writing in Liberia
  • Strengthen national, regional, and local capabilities to stop diseases at their source
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As of September 2021, 270 Frontline and 81 Intermediate FETP graduates completed Liberia’s FETP courses. 20 Liberians completed regional Advanced FETP courses in Ghana (18) and South Africa (2)

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Out of 20 outbreaks investigated in 2017, 90% were documented in investigation reports within the first 35 weeks (37% increase from 2016) and 78% were responded to within 48 hours (41% increase from 2016)

COVID-19

The first case of COVID-19 in Liberia was confirmed on March 16, 2020. Since the pandemic was declared, CDC has supported Liberia with epidemiology, laboratory functions, infection prevention and control (IPC), procurement of materials, and acceleration of COVID-19 vaccination. Pre-pandemic collaborations between CDC and the MOH to expand regional public health diagnostics and community-based surveillance were foundational to Liberia’s COVID-19 response. FETP graduates engage in various COVID-19 response activities, including case identification, contact tracing, home-based care, and data management. FETP graduates also provide county and district-level leadership to ensure COVID-19 surveillance and case management activities follow established protocols.

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In 2021, COVID-19 testing was incorporated into the existing CDC-supported Acute Febrile Illness (AFI) surveillance platform that identifies causes of fever in people seeking medical care in Monrovia

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CDC supports Liberia’s COVID-19 response by conducting IPC assessments at health facilities, and enhancing workforce capabilities in sample collection and specimen transport

Malaria

Malaria remains a leading cause of morbidity and mortality in Liberia. Since 2008, CDC partners with USAID to lead and implement PMI to control and eliminate malaria. In 2021, CDC helped distribute insecticide treated nets, strengthen malaria surveillance activities, and strengthen workforce capacity.

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With support from PMI, CDC distributed 2.5 million insecticide-treated bed nets in 2021

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In 2020, CDC supported trainings for over 450 healthcare workers on national malaria case management guidelines

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CDC helped strengthen routine malaria surveillance at public health facilities, resulting in an increase of malaria testing rates from 82% in 2015 to 94% in 2020

Ebola

In March 2014, the largest known Ebola outbreak in history began in West Africa, primarily affecting Liberia, Guinea, and Sierra Leone. Liberia reported more than 10,600 cases and 4,800 deaths. During the outbreak, CDC and partners supported the response by:

  • Strengthening health system surveillance and epidemiological capacities
  • Strengthening laboratory systems to diagnose disease
  • Identifying people sick with Ebola and monitoring contacts
  • Implementing effective IPC measures
  • Building a strong public health workforce
  • Enhancing emergency management and response capabilities
  • Adapting and validating rapid response team training materials

Following the confirmation of Ebola in Guinea in February 2021, NPHIL enhanced Ebola preparedness in counties with higher risk of Ebola transmission. In April 2021, NPHIL and county health teams from Lofa, Bong, and Nimba participated in a simulation exercise to identify gaps in border health. NPHIL, county health teams, and partners addressed gaps within case identification, points of entry, rapid response teams, and vaccine campaign planning.

CDC also supported the MOH’s Men’s Health Screening Program, which provides screening and counseling services for male Ebola survivors. The program also educates men and women on how to reduce the risk of sexual transmission of the Ebola virus. Since research data suggests that the Ebola virus can stay in the body of a survivor for more than a year, the screening program is a valuable component to rapid identification of potential outbreaks.

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CDC supported trainings at the National Public Health and Reference Laboratory to enhance serology and molecular testing techniques used in the Demographic Health Survey to characterize individuals’ risk of exposure to Ebola

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In 2021, CDC and partners supported training for 114 county and district rapid responders to detect, respond, and control the spread of COVID-19 and Ebola

Vaccine-Preventable Diseases

CDC works with partners to support Liberia’s polio eradication and measles pre-elimination activities. When the 2014 measles vaccine campaign was suspended due to the 2014-2016 West Africa Ebola outbreak, the immunity gap led to the largest measles outbreak Liberia had seen in years. In response to this outbreak, Liberia began a systematic community outreach campaign to restore vaccination rates. CDC also partnered with NPHIL’s Emergency Operation Center to conduct polio campaigns using the oral polio vaccine to stop polio virus transmission.

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In 2021, clinical health workers engaged community health providers, community leaders, and disease surveillance officers in 15 districts to support polio vaccination and increase awareness and reporting of vaccine-preventable diseases

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Since 1999, 30 CDC experts have deployed to Liberia to support immunization activities under the Stop the Transmission of Polio program

CDC Staff in Liberia
  • 4 U.S. Assignees
  • 8 Locally Employed
Liberia at a Glance
  • Population: > 5 million
  • Per capita income: $1,250
  • Life expectancy: F 66 / M 63 years
  • Infant mortality rate: 63/1,000 live births

Sources: World Bank 2020, Liberia; Population Reference Bureau 2021, Liberia

Liberia Top 10 Causes of Death
  1. Malaria
  2. Diarrheal diseases
  3. Neonatal disorders
  4. Lower respiratory infections
  5. Ischemic heart disease
  6. HIV/AIDS
  7. Stroke
  8. Tuberculosis
  9. Cirrhosis and other chronic liver diseases
  10. Maternal disorders

Source: GBD Compare 2019, Liberia

Page last reviewed: February 8, 2022
Content source: Global Health