The masked burden of COVID-19

The impact of the pandemic in Sierra Leone runs much deeper than what its morbidity suggests

If we consider just the numbers of COVID-19 infections and deaths, Sierra Leone has fared well. So far, the country has recorded just over 6,200 cases and about 120 deaths. It has been suggested that the relatively young population, the recent experience with Ebola, and a swift response to the pandemic, including the declaration in March last year of a 12-month state of emergency, may have helped slow the spread of the virus. One concern with such figures is that COVID-19 in Africa is “underdiagnosed and underreported”, and that mortality may be “hidden” due to limited testing and death recording capacities. A corollary of this is the impact of pandemic measures on livelihoods, food security, health, and disaster preparedness—which, too, remains concealed from public scrutiny. There is, hence, a need for a more holistic look at the situation, to consider how COVID-19, like other health emergencies before, has exacerbated existing vulnerabilities in Sierra Leone.

It is is well established that disasters are rarely the result of a single event. They are instead produced by an accumulation of hazards, risks, and vulnerabilities in a population. Sierra Leone is extremely prone to natural disasters, including floods and landslides in the rainy season and droughts and wildfires in the dry season. These disasters are usually complicated by chronic issues like uncontrolled urbanisation, poverty, poor sanitation, a fragile health system, and other infrastructural weaknesses. In this already precarious scenario, the COVID-19 pandemic has exacerbated the risks for communities. Therefore, it is necessary for Sierra Leone’s COVID-response strategy to be part of a wider disaster-risk framework that takes into account existing needs and vulnerabilities, rather than drawing away attention from them.

Livelihoods
‍COVID-19 has significantly disrupted people’s livelihoods and increased the risks associated with poverty. According to the World Bank, Sierra Leone’s economy contracted by 2.2 per cent in 2020, and 81 per cent of micro, small, and medium enterprises experienced a decrease in their profits due to the pandemic. This is partly a result of restrictions that the government has imposed to curb the spread of infection, including short-term lockdowns, curfews, and limits on the opening hours of restaurants and bars. With only limited state support, these restrictions have led to job losses and a reduction in the incomes of many people. The International Growth Centre estimates that 57 per cent of households in Sierra Leone have experienced a decline in income due to COVID-19.

The restrictions on movement and the temporary closure of markets have, in particular, affected rural communities and farming households. Small-scale farmers are not able to sell their products at normal levels, while day labourers and workers in the agricultural supply chain struggle to find employment. The resulting losses in income are naturally compounding food insecurity, which is already a serious issue. According to a 2020 World Food Programme report, more than 5 million Sierra Leoneans lack adequate nutrition.

Restrictions and lockdowns in other parts of the world have also impacted many Sierra Leonean families that rely on remittances sent from abroad. While exact figures are not available, Sierra Leone’s migrant workers often work in sectors most affected by the pandemic, such as construction and hospitality, and this has affected their ability to send money home.

This is just one example of how the local impacts of a disaster are shaped by global and structural drivers. COVID-19 is an international health emergency, but rather than acknowledging how different countries are interconnected in the risks and vulnerabilities they face, many governments are turning inwards and adopting more protectionist measures in their response to the virus. This is illustrated by the hoarding of vaccines by higher-income countries, as well as the cuts that some have made to their foreign aid spending.

The UK, for instance, has reduced its overseas aid budget in 2021 to 0.5 per cent of national income, down from 0.7 per cent. This translates to an estimated decrease in overall aid spending of £3.5 billion. The UK’s bilateral aid to Sierra Leone was £80 million in 2019–20, but this will be reduced significantly in 2021, according to the Center for Global Development. Inevitably, this will lead to significant cuts to programmes that provide essential services, such as water, sanitation, and access to healthcare to marginalised communities. With roughly half of public infrastructure and investment projects in Sierra Leone funded by foreign aid grants, such cuts have already led to the closure of some projects.

Together, these challenges show how COVID-19 is exacerbating economic insecurity in Sierra Leone. Given that approximately 60 per cent of people live below the national poverty line, recovery from such setbacks will not be easy. The socioeconomic impacts of COVID-19, as recent research shows, will aggravate other serious problems, including food insecurity.

Health needs
‍While the recent experience of Ebola provided a framework for countries in West Africa to respond to the emerging risk of COVID-19, the pandemic has diverted attention from other health vulnerabilities.

The most significant challenge for communities is access to healthcare, especially outside of major cities. While in 2010 the government of Sierra Leone introduced free healthcare for some groups, including children under 5, costs remain prohibitive for many families. There is a lack of trained clinicians, diagnostic services, basic medical equipment, and drugs in Sierra Leone, all of which contribute to adverse health outcomes. According to a 2019 report published in the African Journal of Primary Healthcare & Family Medicine, there are just 1.4 doctors, nurses and midwives per 10,000 population in Sierra Leone, equating to a qualified workforce of under 1,000 to serve a population of 7.8 million.

There are also apprehensions from some medical professionals that the focus on COVID-19 might hinder measures to fight endemic diseases like malaria, one of the leading causes of death in Sierra Leone. It is worth noting that in 2014 twice as many people died of malaria than in the Ebola outbreak. Improving maternal and birth outcomes must also remain a high priority in Sierra Leone. According to UNICEF, maternal mortality rates, as well as those for newborns and children under five in Sierra Leone are amongst the highest in the world.In addition to these chronic problems, the pandemic has resulted in fewer people seeking medical help across Africa, which may also lead to poorer health outcomes overall.

Disaster risk framework
‍While COVID-19 is a serious public health threat, it is important to acknowledge that some responses to the pandemic have heightened existing vulnerabilities in many communities. This is not unique to Sierra Leone — a recent report by Oxfam outlined the inordinate impact that COVID-19 has had on marginalised communities across the world.

Countries with underlying social and structural inequalities have limited capacity to respond to complex health emergencies such as COVID-19. It is also crucial to recognise that crises that consume a disproportionate share of resources and attention, like the ongoing pandemic, can aggravate existing insecurities, set back development gains, and make communities more susceptible to other types of disasters. Public health emergencies may increase poverty and inequality, divert investment from other social programmes (including education and health), and increase the risk of food insecurity.

It is therefore clear that public health emergencies are complex disaster-risk drivers, and should be integral to disaster-risk frameworks and planning for lower-income countries. This means not planning just for the direct effects of public health emergencies — which are more clearly identified in the existing frameworks for disaster risk reduction — but to also mitigate the risk of policy responses having unintended adverse impacts.

The Sendai Framework for Disaster Risk Reduction aims to “prevent new and reduce existing disaster risk through the implementation of integrated and inclusive economic, structural, legal, social, health, cultural, educational, environmental, technological, political and institutional measures that prevent and reduce hazard exposure and vulnerability to disaster, increase preparedness for response and recovery, and thus strengthen resilience”. This framework recognises that while a country’s leadership must be at the helm of such efforts, local governments, NGOs, and the private sector must also share responsibility.

How could Sierra Leone move towards adopting this approach? It is heartening to note that the nation has already begun to move in this direction in recent years. Following the 2014–16 Ebola outbreak, Sierra Leone took significant steps to enhance future epidemic preparedness, including participating in the West African Regional Disease Surveillance Systems Enhancement (REDISSE) programme, which coordinates access to resources, such as laboratory facilitates, personal protective equipment, medication, and vaccines. In 2019, Sierra Leone launched the National Action Plan for Health Security which seeks to improve healthcare access and also build resilience for future disease outbreaks and public health hazards. And crucially, in November 2020, the National Disaster Management Agency came into being, with the objective of being the nodal organisation for strategic coordination and management of “disasters and similar emergencies throughout Sierra Leone and to develop the capacity of communities to respond effectively to disasters and emergencies”. 

While these initiatives are certainly in the right direction, it is possible that there is still a tendency among disaster managers in Sierra Leone to look at disaster events in isolation—through the lens of immediate relief, often at the expense of recovery and resilience—rather than as part of a complex system (see related feature: The unintended consequence). This can be counterproductive. There is, hence, a pressing need for agencies such as Sierra Leone’s National COVID Emergency Response Centre (NACOVERC) and the NDMA to consider the indirect impacts of COVID-19. Mitigating such foundational issues are critical for building resilience in a disaster community. This will require the national agencies to enhance their coordination with external stakeholders—such as the World Bank Group’s COVID-19 response and other aid agencies—to include assessments for the less-visible vulnerabilities in communities, and fashion focussed interventions to reduce their impacts.

———————–

Jamie Matthews, PhD, specialises in disaster communication. He is the co-editor of Media and Disaster Communities (Palgrave).

NOTE: This article was first published on 6 August 2021 on www.tieuorja.org, which works to strengthen disaster communication in Sierra Leone.

Cover graphic: Felix Rhodes

What’s in the way of quality antenatal care for women in West and Central Africa

By Comfort Z. Olorunsaiye: Assistant Professor of Public Health, Arcadia University

Globally, nearly 300,000 women die from pregnancy-related causes each year. Most of these deaths are in the low-income countries of sub-Saharan Africa and South Asia.

The leading causes of maternal mortality include severe bleeding, hypertensive disorders, infection, unsafe abortion and embolism. There are also indirect causes such as HIV, malaria and anaemia. About three in four maternal deaths could be prevented if women had adequate access to quality care before, during and after pregnancy.

Quality antenatal care can save lives by identifying and addressing health problems that can cause pregnancy complications and poor birth outcomes. But the women most at risk tend to be the ones who do not access life-saving health services. Barriers to quality antenatal care include lack of information, cultural practices, poverty and distance to health services. Others are inadequate and poor health services.

There is already global evidence of social and economic differences in access to maternal health care and the quality of that care. We sought to understand the quality of antenatal care in sub-Saharan Africa. Countries in the West and Central African sub-region have notably poor reproductive health indicators, as well as high levels of poverty and civil unrest or political fragility.

Yet, the region has been largely underrepresented in empirical research. Research findings can help inform policy and programme interventions for improving the reach and quality of antenatal care. They can also contribute to reducing the unacceptable rates of maternal and newborn deaths in the region.

At the time of our study, household survey data from the same source were available for seven countries in the United Nations region of West and Central Africa: Central African Republic (CAR), Chad, the Democratic Republic of Congo (DRC), Ghana, Nigeria, Sierra Leone and Togo. We analysed the data on 32,718 women whose pregnancies resulted in a live birth, considering the levels of poverty in the households and communities where these women resided.

What we found

Our findings indicated that one in four pregnant women did not receive antenatal care. The majority of these women were in Chad (37%) and Nigeria (38%). Among women who had antenatal care, the majority received low-quality care. This means receiving fewer than five of six possible antenatal care services. The proportion of women who received high quality antenatal care ranged from 3% in Chad to 33% in Nigeria.

Among women who received antenatal care, the most common services provided across all seven countries were blood pressure monitoring and tetanus vaccination. The figures ranged from 79% in Chad to 99% in Ghana for blood pressure monitoring. For tetanus vaccination they ranged from 87% in the DRC to 97% in Sierra Leone.

Less frequently provided services included HIV testing, malaria treatment and blood tests. We also found that higher levels of household wealth increased the likelihood of women reporting high-quality antenatal care. Poorer households are in the top 20% of the household wealth index. This measures the living standard of a family, based on the possession of certain household goods and infrastructure. The relationship of household wealth with quality of antenatal care was more noticeable in the DRC, Ghana, Nigeria, Sierra Leone and Togo.

Similarly, women who had secondary or higher levels of education were between two and three times as likely to receive high-quality antenatal care as women without formal education. With the exception of Chad, women who had more antenatal care visits reported high quality care.

Our results indicate that the quality of antenatal care varied according to the level of poverty in communities. Women who lived in poor communities were between 15% and 52% less likely to report high-quality antenatal care. Poor communities are clusters of households headed by someone with no formal education, and in the lowest 20% of the wealth index. The poorest household wealth quantile is the lowest 20%.

The findings indicate that living in a poor household and in close proximity to poor households is a risk factor for low quality antenatal care. Poor women and their families are already vulnerable and may have underlying conditions that can increase their risks for experiencing pregnancy complications and poor birth outcomes. But these women may miss out on the benefits of antenatal care altogether because they face financial and social barriers to healthcare.

What should be done

In countries with low coverage of antenatal care, for instance Chad and Nigeria, policies should focus on expanding access to maternal health services. Educational policies that support the enrolment and retention of women in school can contribute to raising awareness on health and well-being. They also empower women to demand quality care. Although some countries provide free or subsidised health services for pregnant women and young children, it is evident that these policies do not adequately bridge the gap between need and access to services.

Therefore, additional economic policies that empower women financially to afford direct and indirect costs of services are needed.

Across all the countries in our study, there is a dire need to improve the quality of services. The health systems are clearly missing an important opportunity to intervene early in pregnancy to address behaviours and health problems that could cause serious complications or pregnancy-related deaths among the poorest women.

Targeted support for health systems should also be provided. These include ensuring adequate supplies of medicines and equipment, enhanced pre-service and in-service training and supervision of healthcare providers. Equitable distribution of healthcare resources, including providers, would also contribute to improved access and quality of antenatal care services in West and Central Africa.

These recommendations, if implemented, would significantly reduce maternal and newborn deaths and increase wellbeing and social capital in the region.

---

The article was first publshed by THE CONVERSATION

TEARS IN OUR LAND

Towns and villages become ghost places as people fled to safety. The virus on their heels inflicts one after the other causing, panic and total breakdown of lifestyles and cultural values.

News reports are rife with all sorts of news of the infection, about how people are dying in their hundreds. For most people, memories of the 11-year war creep back to their minds – the struggle to survive in a hostile environment amidst annihilating mayhem and destruction. The rebel war was no moment of patrimonial or matrimonial considerations or brotherhood; but the instinct to survive; and people used the most of their opportunity to escape from the clutches of horror as the combatants ravaged the towns and villages amidst the horrible sounds of children, the elderly and the sick. It was year’s back when the world was shocked with the inhuman treatment of innocent women and children with scenes so horrible, so unbelievable and cruel; the United Nations deployed one of the most massive peacekeeping forces in human history to save a nation from total anarchy.

Though the rebel war ranked among the worst in the world with the most horrific crimes in the 21st century, the people were never stigmatized. The neighboring borders opened to take in those that fled for safety. Western countries intervened and provided solace to fleeing people as regional peacekeeping forces from ECOWAS countries, and The United Nations landed their armies to help restore peace and stability.

Abstract from the Novella: Tears in Our Land

Malaria control campaign launched in Democratic Republic of the Congo to save lives and aid Ebola response

A spike in malaria cases is threatening the health of people in parts of the eastern Democratic Republic of the Congo (DRC) where health workers are also battling an Ebola outbreak. 

In response, a four-day mass drug administration (MDA) campaign was launched today in the Northern Kivu province town of Beni, with a target to reach up to 450 000 people with anti-malarial drugs combined with the distribution of insecticide-treated mosquito nets.

The malaria control campaign is being led by the DRC National Malaria Control Programme, supported by the World Health Organization (WHO), UNICEF, the Global Fund and the United States President’s Malaria Initiative (PMI). The campaign is modelled after the campaign implemented in Sierra Leone during the 2014 Ebola outbreak in West Africa, which was instrumental in lowering illness and deaths from malaria in the areas reached.

“Controlling malaria is critical in areas like North Kivu, as it causes widespread disease and death, especially among the region’s children,” says Dr Yokouide Allarangar, WHO’s Representative to the DRC. “This anti-malaria campaign will also help reduce the pressure on the overall health system, which is currently striving to protect people from the ongoing Ebola threat in the region.”

One campaign impacting two diseases

North Kivu’s malaria outbreak has overburdened Ebola responders; many suspected cases of Ebola have turned out to be malaria, as early symptoms of both diseases are similar. Up to 50% of people screened in Ebola treatment centers have been found to only have malaria.

Therefore, the anti-malaria campaign has two main aims.

Firstly, the distribution of insecticide-treated mosquito nets will prevent malaria transmission and its accompanying health consequences, thus saving lives.

Secondly, the mass drug administration will treat people who have already contracted malaria and curtail transmission of malaria among Ebola-affected populations and health centres. Having fewer people present with malaria will lessen the workload  on already stretched Ebola treatment centres.

DRC’s malaria challenge

From 2016-2017, DRC observed an estimated increase of more than half a million malaria cases (24.4 million to 25 million), according to the WHO World malaria report 2018. DRC is the second-leading country in the world for malaria cases, after Nigeria, accounting for 11% of the 219 million cases and 435 000 deaths from malaria in 2017.

In North Kivu province, the area experiencing the brunt of the Ebola outbreak, there has already been an up to eight-fold increase in malaria incidence as of early September 2018 (or approximately 2000 cases registered per week) compared to the same period in 2017.

Despite recent improvements in coverage of malaria interventions, DRC continues to experience challenges in access to preventive and curative malaria interventions, as well as an environment that supports very high transmission rates. Funding, infrastructure challenges and insecurity are all key obstacles to achieving the intervention coverage needed to protect populations at risk.

Ongoing Ebola outbreak in North Kivu Province

North Kivu province is the epicentre of an Ebola outbreak that was announced on 2 August and has caused more than 365 cases and 236 deaths. The town of Beni has been one of the most affected. Political instability, violence, and a refugee and internally-displaced people crisis have made the current Ebola outbreak one of the most complex and difficult public health challenges in recent history.

There are reports that Monkeypox has resurfaced in Nigeria. What you need to know

The Monkeypox virus was isolated most recently in 2012 from a dead infant mangabey (species of monkey) in Ivory Coast. Shutterstock

Oyewale Tomori

Fellow, Nigerian Academy of Science 

Disclosure statement

Oyewale Tomori does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Partners: Nigerian Academy of Science provides support as a hosting partner of The Conversation AFRICA.

The outbreak of a rare disease suspected to be Monkeypox is raising fears of an imminent epidemic in Nigeria. Infected people break out in a rash that looks a lot like chicken pox. But the fever, malaise, and headache from Monkeypox are usually more severe than in chicken pox infection.The disease can spread quickly and in previous outbreaks one of 10 people have died. The first suspected cases were reported in Bayelsa state in south Nigeria in late September. Since then suspected cases have been reported in seven of the country’s 36 states, including Lagos. A total of 31 suspected cases have been reported. What is Monkeypox and should the world be worried? The Conversation Africa’s Declan Okpalaeke asked Oyewale Tomori for some insights.

What is Monkeypox and how is it contracted?

Monkeypox is a viral zoonotic disease – it’s caused by a virus transmitted from animals to humans. The virus was first identified in Denmark in 1958 during an investigation into a pox-like disease among monkeys. Hence its name. The natural host of the virus remains undefined. But the disease has been reported in many animals including squirrels, rats, mice and primates.

There appear to be two distinct groups of the Monkeypox virus – the Congo Basin and the West African groups. The Congo Basin virus group is more virulent. According to the United States Centre for Diseases Control, the Monkeypox virus has only been isolated twice from an animal in nature; first in 1985 from an apparently ill African rodent in the Equateur Region of the Democratic Republic of Congo and in 2012 from a dead infant mangabey found in the Tai National Park in Cote d’Ivoire.

The first reported case of Monkeypox infection in humans was in 1970 in the Democratic Republic of Congo (DRC). A 9-year old boy was diagnosed in a region in which smallpox had been eliminated two years earlier. In 1996-97 there was a major outbreak of the disease in the country.

Most cases of human Monkeypox have been reported in the rainforest regions of the Congo Basin – particularly in the DRC where it’s considered to be endemic – and in western Africa. Other African countries reporting the disease include Ivory Coast (2 cases in 1971 and 1981), Liberia (4 cases in 1970), Sierra Leone (2 cases in 1970 and 2014), Nigeria (3 cases in 1971 and 1978), a total of six cases in Cameroon between 1976 and 1990, Central African Republic (32 cases with 2 deaths between 1984 and 2016), Gabon (8 cases in 1987 and 1992- 8), and 19 cases in Sudan in 2005. There are also reports of sporadic cases in the Republic of Congo (formerly Zaire).

In 2003 the first reported cases of human Monkeypox outside of Africa were confirmed in the US, with a total of 37 in six states. Most of the patients had had close contact with pet prairie dogs. The virus transmission is thought to have first occurred between animals imported from Africa which had been co-housed with prairie dogs.

Primary infection is through direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of an infected animal. Eating inadequately cooked meat of infected animals is also a risk factor.

Human-to-human transmission can result from close contact with infected respiratory tract secretions, skin lesions of an infected person or objects recently contaminated by patient fluids or lesion materials. Household members of active cases are at greater risk of infection via droplet respiratory particles during prolonged face-to-face contact.

Transmission can also occur by inoculation or via the placenta (congenital Monkeypox).

Monkeypox can easily be confused with other rash illnesses such as smallpox, chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies.

In the early stage of the disease Monkeypox can be distinguished from smallpox because the lymph gland gets enlarged. A laboratory test is needed for a definitive diagnosis.

Should the world be worried about Monkeypox? How can it be treated?

Sure, we should be worried. The disease can cause the death of one out of 10 infected people and can spread very quickly. The symptoms (fever, malaise, and headache) of Monkeypox are more severe than those of chickenpox.

The other reason for concern is that there is no specific treatment or vaccine available for Monkeypox infection. In the past, the anti-smallpox vaccine was shown to be 85% effective in preventing Monkeypox. But smallpox has been eradicated so the vaccine isn’t widely available anymore.

Nevertheless outbreaks can be controlled. The first step is preventing infections. This can be achieved through public health awareness campaigns to reduce the risk of animal-to-human transmission. Key messages would include the fact that people should avoid contact with sick or dead animals that could harbour the virus, especially in areas known to be Monkeypox hotspots. Other precautions include ensuring that infected people are isolated and that health workers caring for ill people must wear gloves and protective equipment.

A key part of managing the spread of the disease is good surveillance so that cases can be detected quickly and the outbreak contained.

What’s behind the recent outbreak in Nigeria?

At the moment all we can say is that there are suspected cases of Monkeypox in Nigeria. We still do not have laboratory confirmation of the current outbreak and claims are being made purely on the basis of signs and symptoms. But we must remember that there are other rash illnesses that mimic Monkeypox symptoms. This is not the first report of monkeypox cases in Nigeria. Between 1971 and 1978, ten human Monkeypox infections were reported in the country. Three were laboratory confirmed (two in 1971 and one in 1978).

Does the claim that the outbreak was triggered by government delivering free medical treatment hold any water?

The claim of government involvement in the outbreak is absolute nonsense, and it is an unwarranted and unnecessary diversion from the main issue of confirming and controlling the spread of the disease.

---

First published by The Conversation . Partners: Nigerian Academy of Science providess support as a hosting partner of The Conversation AFRICA. View all partners

APC Committed To Improve The Common Man – President Koroma

In his quest to salvage the nation from the grips of unemployment and poverty, President Dr. Ernest Bai Koroma has again launched the National Social Protection Strategy and Implementation Plan and the social safety Net Program to support extremely poor households and vulnerable communities throughout the country.

President Koroma: addressing the nation

Addressing stakeholders in Magburaka, Tonkolili District on Monday, President Koroma said “as a government committed to improving the condition of the common man and woman, we are determined to overcome challenges, build a unified system and ensure that we have more resources to increase the coverage of social safety nets for a large group of poor and vulnerable households. We have started in earnest in the four districts of Bombali in the North, Moyamba in the South and Kono in the East. We intend, with the support of our Partners to scale up to additional districts until we cover the whole country”.

The Government of Sierra Leone in collaboration with the World Bank and UNICEF had established a Social Protection Policy in 2011 which has culminated into a Social Safety Net programme to support extremely poor households and vulnerable communities throughout the country.

The  programme which was launched by His Excellency President Ernest Bai Koroma, in Magburaka, the headquarter town of Tonkolili – one of the country’s poorest districts – is financed by a US$7 million grant from the World Bank’s International Development Association (IDA), a US$300,000 grant from UNICEF, and US$1 million from the Government of Sierra Leone. Overall, the programme seeks to identify and assist poor and vulnerable households across the country, including those affected by the Ebola outbreak.

“In the last few years Sierra Leone has achieved remarkable economic growth and progress in the areas of health, education and food production. Poverty has declined in the last decade, though we still have large numbers of poor people. My government has ensured significant improvement in access to public services, such as primary education and maternal and child health, though, significant sections of the society still experience difficulties in using these services. My government is very committed to removing these difficulties by expanding services and putting in place social protection measures for the poorest and marginalized amongst our people.

“We demonstrated our commitment to social protection of the common man and woman in our Agenda for Change. My Government also adopted a National Social Protection Policy in March 2011, which was further developed into the Social Protection Pillar in the Agenda for Prosperity. This has informed the development of a Social Protection Strategy and Implementation Plan with strong institutional arrangements, strengthened coordination mechanisms (under the leadership of my Chief of Staff), pragmatic funding plans, robust program management and evaluation systems and appropriate means for addressing capacity constraints.

“…whilst we have reduced poverty, we remain committed to protect the over 150,000 poorest households from sinking into further economic difficulties, prevent the 413,000 moderately poor households from sliding into extreme poverty and promote the livelihoods of at-risk population.

Mr. Chairman, distinguished guests, the Ebola Virus Epidemic has caused unprecedented economic, social and humanitarian impacts on households of all income levels but the shock to the common man and woman is particularly severe. This is why Social Protection is important now more than ever before. We must not only cushion the effect of poverty, we must strive to ensure that social protection also becomes building blocks for lifting our people out of poverty. That is why we will work harder to mobilize more resources to reach more extreme poor households and harmonize and coordinate the different social protection interventions across all levels of government,” President Koroma continued.

“This new Social Safety Net program builds on the country’s Agenda for Prosperity whose core objective is to achieve middle income status by 2035 by reducing the number of Sierra Leoneans below the poverty line. It will strengthen coordination and implementation of social protection programs that improve nutrition and health services, and access to education, in order to break the inter-generational cycle of poverty”, said Saidu Conton Sesay, Chief of Staff in the Office of the President.

Progress in social and economic sectors has suffered a serious blow during the Ebola outbreak with many deaths, loss of livelihoods and income, delayed schooling, and a number of children orphaned by the disease. Therefore, this Social Safety Net programme is intended to mitigate these impacts and support people to lift themselves out of poverty and live productive and dignified lives.

Kaifala Marah, the Minister of Finance and Economic Development said, “This Social Safety Net program was developed in line with Sierra Leone’s development agenda, institutional and financial conditions and capabilities, and we hope that it will create a sustainable system to address the biting problems of poverty and inequity in the country.”

Basically, the program will provide regular cash transfers to 21,000 extremely poor households, benefiting 126,000 people, including children, Ebola survivors, and other vulnerable people. Cash transfers will enable families to buy food, send children to school, and protect assets such as livestock.

“The country has come a long way in moving from an uncoordinated approach toward building a coherent social safety net system capable of protecting the poorest and most vulnerable, including from shocks such as Ebola. Continued progress in this direction will become even more crucial in view of the devastating impact of the Ebola outbreak and as the country transitions back to the Agenda for Prosperity. The Bank remains committed to supporting the Government in these efforts”, said Francis Ato – Brown, World Bank Country Manager for Sierra Leone.

Though the initial phase of the programme covers only 14 percent of the approximately 147,000 extremely poor households in the country, it is a starting point for an accelerated pace to address the issues of poverty and inequity, and help poorer families cope with the Ebola aftermath. More than 2,700 beneficiaries have already started receiving the cash transfers.

“The progress made is great but the needs are greater! And as this programme is being implemented, we must keep in mind those children in the poorest households, undernourished and sick and more likely to die before they reach their fifth birthday,” said Roeland Monasch, UNICEF Representative in Sierra Leone. “UNICEF will continue to work with the Government and other partners in defining long-term national financing strategies to protect and expand expenditures on effective social protection programmes.”

The programme will be implemented by the National Commission for Social Action (NaCSA) and will include monitoring mechanisms led by the Anti-Corruption Commission to ensure resources reach the intended beneficiaries.

TAX BURDEN ON A SHRINKING ECONOMY! KPMG warns that the essence of taxes is not to kill businesses but to help them grow.

By Ahmed Sahid Nasralla (De Monk)

Heavily hit by the Ebola Virus Disease outbreak and declining Iron Ore prices in the international markets, it is indeed difficult and trying times for the Sierra Leone economy in general and the business community in particular. Add the burden of increasing tax obligations to the equation and you get the biggest enemy of the private sector: uncertainty!
This is the ugly picture that emerged from deliberations during a breakfast business forum organized by premier auditing firm KPMG SL recently in Freetown. The core aim of the meeting was to deliver objective and informed analysis on current tax and regulatory issues, particularly the introduction of the two recent Finance Acts, pointing out the relevant amendments to tax laws and their implication on businesses.

Only moments ago- 2011, 2012, 2013- the country’s economy was galloping at a phenomenal speed, growing at 12%, 15%, 20%, to the point where Sierra Leone was rated as one of the fastest growing economies in the world.
But suddenly came the Ebola Virus Disease. Many businesses across many industries scale down operations while others entirely shut down. The Public Health Emergency regulations restricted the movements of people and goods between towns and villages and limited the hours of doing business.
And in the midst of the Ebola crisis, the prices of Iron Ore in the global markets plummeted with devastating consequences on the two biggest drivers of the Sierra Leone economy in the past few years-Africa Minerals SL Ltd and London Mining.  This downhill trend continues to affect operations of new entrants- Timis Mining Corporation, Shandong Iron Ore Mining and Tonkolili Mining and Oil Company. The impact on the mining companies extended to contractors and other stakeholders of the industry including the banks and staff members and their families.
Generally, there is decline in transactions and revenue and it’s clearly uncertain when the once booming mining industry will kick-start again, at least in the short term. The projected growth that the government estimated for 2015 has been revised downwards and there has been a massive slowdown in economic activities in and around the country.
As if this is not enough, key amendments to the Finance Act 2015 (and the preceding Finance Act 2013) seem to add to the woes of the business community. Among these are the increases in threshold for Capital Gains Tax from Le1.8 million to Le 3.6 million per annum or per transaction and in the maximum redundancy/termination pay from Le 20 million to Le 50 million, with any excess above Le 50 million taxed at a flat 5%.
There’s also promotion of youth employment, as there is now a 6.5% tax credit on employee PAYE, for Sierra Leoneans 18-35 years old, previously unemployed or working part-time, and employed by a small or medium sized company between 1st December 2014 to 1st December 2015.
Importers of petroleum products must now pay 50% of duty and taxes upon submission of goods declaration, with the Masters of Vessels or Pilots held responsible for any irregularities. In addition, there is a fine of at least Le 200 million and up to Le 500 million and or imprisonment of 1 to 3 years.
The Act further made amendments to the Custom Tariffs Act of 1978, on the HS codes on certain imported items –e.g Port Land Cement 30% and glass bottles of capacity exceeding 0.15 litre and up to 1 litre at 5%.
Under the Mines and Minerals Act, Royalty payments on natural resources were revised as well, with 6.5 % on precious stones from large and small scale mining and 3% from artisanal mines and other minerals.
Furthermore, companies in the country that procure services out of Sierra Leone must ensure the appropriate tax is withheld and paid to the NRA, failure to do so may attract penalties.
For Rental Properties, the threshold has been increased from Le 1.8 million to Le 3.6 million, with the Commissioner-General now empowered to seal off premises for which rental income tax remain unpaid after 90 days.
Failure to make a payment of taxes or penalties due seven days after which such payment should have been made is liable to a rate 3% higher than the specified rate on the amount due.
In the area of interest and penalty regime, the ropes have been tightened and it is now more rigorous than before. Fees for Tax Clearance Certificates (TCC) and business registration were repealed and replaced with new rates: Le 20,000 per individual and Le 40,000 for businesses.
GST invoices issued by registered GST traders shall be printed under the authority and direction of the Ministry of Finance and failure to display a certified copy of GST registration now carries a penalty of Le 5 million and a further Le1 million per day after a taxpayer has been given a written notice and the taxpayer still fails to display certificate. There is a further penalty (liable to a fine of Le5 million) on failure to notify the NRA on any changes to their (taxpayers) registration.
Most businesses are not aware of the relevant changes and how they will affect their operations, observed Dr. Claudius Williams-Tucker, partner, tax KPMG SL.
“If you do a comparative analysis of taxation in neighbouring countries you will find out that it is more difficult to operate a business in Sierra Leone,” said Dr. Williams-Tucker. “The essence of taxes is not to kill businesses, but to help them grow.”
He added that any tax matter that is not proactively handled becomes a cost to a business because that business will incur interest and penalties.
Dr. Williams-Tucker believed there’s need for more forums where the business community can discuss and challenge issues of policy affecting their operations.
“We (the business community) need to be a lot more proactive. We need to engage the Ministry of Finance and Economic Development before these Finance Acts gets through Parliament,” he urged, and appealed to trade groupings such as the Sierra Leone Chamber of Commerce and the Sierra Leone Association of Commercial Banks to be vibrant and to lead such initiatives.
Another key issue that came out in the one day business forum is the minimum wage of Le500, 000 (Five Hundred Thousand Leones), which has already been gazetted. According to an official of the Ministry of Labour, the minimum wage is the base, excluding all other allowances. Most businesses don’t even understand this new employment policy and how it will affect their operations.
“This is because we’ve failed to challenge at the time we needed to engage. We are now only reacting,” noted Dr. Williams-Tucker.
The forum also raised salient questions surrounding the decline of the country’s mining sector, which had formed the base of the economy. Why is the mining industry declining in Sierra Leone but not in Guinea and Liberia, two countries equally hit by the Ebola Virus Disease?
“Is it that it is so expensive to produce iron ore in Sierra Leone or are there other factors involved in that pricing? Have we examined the pricing mechanism in Sierra Leone? Are we substantially different from Liberia and Guinea?” asked the Governor of the Bank of Sierra Leone, Mr. Momodu Kargbo.
The Bank Governor continued: “Is it a true reflection of what is happening in the market? Did we miss some points? Did we sit down to examine the growth? Or did we have time to study the trend?”
According to Mr. Kargbo, ‘we didn’t have time to study the trend’.
“Our mines have closed down because our cost of production is very high, whereas in other countries in the sub-region, production continues even at the depressed stage of the prices of iron ore in the global markets,” he declared.
“We should have seen it coming.”
Even more confusing is the fact that Timis Corporation bought London Mining at a time when Africa Minerals SL Ltd was going downhill.
“How does that sound? We need to reflect on those things. And now there’s a problem. London Mining cannot transport its iron ore through the rails of Africa Minerals. Again what are the arrangements? These are the things that are all built on uncertainty,” explained Mr. Kargbo.
Now driven by uncertainty, at least in the short term outlook, Sierra Leone’s economy is characterized by significantly high cost of doing business, and normally, according to the Bank Governor, where there is uncertainty people hedge.
“Investors hedge. They go elsewhere. That’s the situation,” Mr. Kargbo reasoned.
Credit: Development and Economic Journalists Association-Sierra Leone (DEJA-SL).