Centre for Accountability and the Rule of Law et al v. Sierra Leone

Public Health Compromised by Mismanagement of Ebola Emergency Relief Funds

In 2014, Sierra Leone confronted an Ebola outbreak that led to almost 4,000 deaths from over 14,000 infections. A government audit conducted during the outbreak identified significant mismanagement and possible loss of government-held funds earmarked to combat Ebola, thereby diminishing the quality of the emergency response. The plaintiffs are seeking damages and other remedies for survivors.

Facts

Between May 2014 and March 2016, an Ebola epidemic affected several West African countries, principally Sierra Leone, Liberia, and Guinea. According to the World Health Organisation (WHO), Sierra Leone recorded a total of 14,124 confirmed cases and 3,956 deaths. Many of those deaths included healthcare workers who took on the task of containing the outbreak. The Sierra Leone Ministry of Health and other government agencies were tasked with containing the outbreak, coordinating the country’s response, and mobilizing and managing resources. 

In February 2015, Audit Service Sierra Leone issued a special audit covering the activities of the Ministry of Health and the Ebola Emergency Operations Centre from May to October 2014. The audit found significant mismanagement and possible loss of funds earmarked for the government’s Ebola response. Specifically, the audit found that the Ministry of Health had mismanaged approximately US $14M in direct donations and tax revenue. It concluded that the lapses in budgetary and procurement oversight had led to “a reduction in the quality of service delivery in the health sector.” In other words, mismanagement of the Ebola funds meant a materially less effective government response and, as a result, more infections and deaths occurred.  

These lapses identified by the Audit Service ultimately resulted in inadequate quantities of medical equipment, such as personal protective equipment for healthcare workers and ambulances; a shortage of Ebola treatment centers; and a failure to provide hazard pay to frontline healthcare workers. 

In 2015, the Public Accounts Committee (PAC) of the Sierra Leone Parliament reviewed the findings of the Audit Service through public hearings and interviews. In June 2015, the PAC concluded that officials responsible for management of the Ebola funds had failed to apply necessary procurement laws. The PAC also found inadequate controls over disbursement of funds from Ebola response accounts. 

In a related development, in 2018 the Sierra Leone government established a Commission of Inquiry to investigate potential financial crimes arising from misuse of the Ebola Funds. 

The two individual plaintiffs in this case are Sierra Leoneans who were healthcare workers assigned to care for Ebola patients. While attending to their patients, they both contracted the Ebola virus likely due to lack of and/or inadequate protective equipment provided to them by local health authorities. Both plaintiffs survived the virus, but continue to deal with the numerous physical and psychological challenges commonly confronted by Ebola survivors. The two individual plaintiffs are joined by the Centre for Accountability and Rule of Law in Sierra Leone (CARL-SL), a Freetown-based civil society organization committed to promoting human rights through accountability.

Arguments

The suit alleges that the mismanagement and possible loss of funds earmarked for Ebola response caused violations of the rights of the plaintiffs to life and health under various international covenants. These include the African Charter on Human and Peoples’ Rights, the International Covenant on Civil and Political Rights, and the International Covenant on Economic, Social and Cultural Rights, to each of which Sierra Leone is a party. The plaintiffs argue:

• That the government violated the right to life by failing to comply with relevant accounting and procurement controls, which led to the mismanagement and possible loss of one-third of available monetary resources held by the government for Ebola response, and was therefore responsible for a greater number of Ebola infections than would otherwise have occurred.
• That the government violated the right to health by failing to dedicate its maximum available resources to the Ebola response, and that the government’s poor stewardship of the Ebola funds materially diminished the human and physical resources needed to handle the Ebola outbreak. These included, for example, basic medical supplies such as personal protective equipment, ambulances, and Ebola treatment centers.
• That the government violated the right to life by failing to conduct an effective investigation into the mismanagement of the Ebola funds. Effective investigation is essential to ensure accountability and prevent future violations. 

Role of the Justice Initiative

The Justice Initiative is providing legal advice on issues of international human rights law to plaintiff Centre for Accountability and Rule of Law.