H.E. Dr. Sinéad Walsh:

A statistic that I discovered recently which really stuck in my mind is that for every doctor in Sierra Leone there are 160 doctors in Ireland. That was pre-ebola. There were only 120 doctors in Sierra Leona of which 10% have died so that figure is lower again. Many more nurses than doctors have died, partly because there were so few doctors around the country. The situation was critical before and is now even more critical. In terms of what we have done about it, frankly we have not resolved this and we will not be able to resolve it in the short-term because it will require a huge and long-term investment in training and systems, as it did pre-ebola.

It already required a huge and long-term investment in training and also in systems because one can send all sorts of Sierra Leoneans and Liberians for training courses, but then why would they not stay in Ireland, the UK and the US? This is what we find and that is human nature. How then do we build up capacity for people to be trained in-country and also to work within systems that function? When someone is being trained they are very enthusiastic, then they come back and go to work and say "I have all this training but I have no drugs, no equipment, no electricity and no water supply in my clinic." So it comes back again to the longer term agenda of health system strengthening. In Liberia for example we have a health sector fund. This puts the Liberian government in the driving seat for these long-term system strengthening programmes. Ireland is the lead donor to that fund. That is the avenue we are using for Liberia to try and work with all the international partners to make the long-term plan. Although our role is specifically about nutrition, for Sierra Leone we are very much trying to contribute to the new plans around this issue of human resources but also the broader issues around the system.

The committee asks how confident I am on this issue. We still have lots of challenges in Sierra Leone but I believe it is on the right track. Last week's numbers were encouraging, but I am still worried about Guinea. We are not as involved there. Its response is led by the French government and other international actors, but just the other day I believe that Guinea commemorated one year of having Ebola and it does not look like it is going away. The numbers in Guinea never get as dramatic as those in Sierra Leone and Liberia, but its numbers never go down either. That is a really big concern.

It is too early to tell how serious the governments are around these systemic issues. We have had really good discussions with the governments in both countries, particularly in the lead-up to the Brussels EU conference. One of the challenges is that we are really trying to focus, with the governments in Sierra Leone and Liberia, on first of all getting to zero cases of Ebola - before we get too much into long-term recovery planning. This is very difficult because that is urgent also. But if we do not really nail Ebola then the countries will never be able to move further ahead. The conversations are still at fairly early stages and it is too early to see the kinds of decisions and prioritisation the governments will make. Of course they are very economically challenged. Sierra Leone and Liberia have a lot of difficult decisions to make and we understand that. We have said this, and Minister, Deputy Sherlock said it to President Koroma and President Sirleaf in Brussels in the plenary session and also in a bilateral meeting with President Koroma. We are really looking at these issues of corruption in centralisation. We say "We are willing to support you, but we need to see your commitment". I believe it is a little early to know that yet but we will be keeping a close eye on it.