From Ebola to COVID-19: China CDC is Supporting Sierra Leone to Strengthen its Public Health Capacity


The Chinese Center for Disease Control and Prevention (China CDC) and Sierra Leone’s Ministry of Health and Sanitation (MoHS) have been partnering in a long-term project to expand critical public health capacity in Sierra Leone. This partnership started during the Ebola epidemic and continues to this day with COVID-19.

The 2014-2015 West Africa Ebola virus epidemic, the largest since the identification of the virus, did not spare Sierra Leone. The coastal nation, with a population of nearly eight million, reported more than 14,000 cases and nearly 4,000 deaths.

At the beginning of the epidemic in 2014, China CDC sent a group of their own public health experts to Sierra Leone to help with the response. Chinese public health experts began working with leaders of MoHS to develop critical laboratory capacity.

This first collaboration led to the creation of the Sierra Leone China Friendship Biological Safety Laboratory or “Jui Lab” in Jui, Freetown. Jui Lab, a fixed Biosafety Level 3 (BSL3) laboratory, was built in just 87 days and became active in the detection of Ebola on March 11, 2015. 

When the epidemic ended later that year, Sierra Leone’s MoHS and China CDC launched a long-term technical cooperation project which is still ongoing. It entered its third phase in January 2021. 

The project aims to enhance Sierra Leone’s capacity for the surveillance, prevention and control of infectious diseases and to support the development of the National Public Health Agency (NPHA), a structure under the supervision of MoHS, which will become the country’s national public health institute. The NPHA is currently running the Emergency Operations Center (EOC), laboratory, risk communication, and surveillance.

Dr. George Fu Gao, director general of China CDC, and Dr. T.T. Samba, chief medical officer at MoHS, are leading the project for China and Sierra Leone respectively. Eleven Chinese experts were deployed in Sierra Leone until last year. Thanks to Sierra Leonean laboratory capacity progress, China CDC was able to reduce their team to five experts in September 2020, with another expected to join in 2021. A number of Chinese public health professionals continue to carry out short-term missions every year. 

Enhanced Capacity of Jui Lab

Jui Lab has considerably extended its detection capacity since 2015 and is now the only BSL3 laboratory in Sierra Leone with the ability to test and identify more than 30 pathogenic microorganisms. The laboratory is able to receive samples and send results within 24 hours to MoHS. The Ministry designated it as National Reference Laboratory for Viral Hemorrhagic Fevers and well as National Training Center for Viral Detection and Biosafety.

The China CDC team has been leading a long-term training project involving 13 Sierra Leonean laboratory technicians working at Jui Lab. The technicians were trained and mentored to acquire the qualifications necessary to operate in a BSL3 laboratory. Five technicians were then encouraged to pursue master’s and doctorate degrees in China. 

Strengthening the Public Health Workforce 

China CDC is also supporting workforce development through short-term training programs. Twenty-three training courses have been developed, focusing on the key public health challenges facing Sierra Leone. Over the past three years, more than 500 public health professionals throughout Sierra Leone received training on topics which include malaria control, biosafety, testing technics and surveillance. 

The China CDC experts also held several workshops on virus detection when certain situations arose, like in 2019, when the Marburg virus – a hemorrhagic fever virus – was detected in bats. 

Sentinel Surveillance System

Surveillance is key to early warning of emerging and reemerging infectious diseases. Since 2018 China CDC has been supporting Sierra Leone to establish a routine fever and diarrhea syndromic surveillance in ten sentinel hospitals. 

Sierra Leone health authorities are now able to monitor eight types of viruses, two types of bacteria and malaria, providing a picture of the epidemiologic situation on several major diseases.

Supporting the COVID-19 Response

Experts from China CDC also actively participate in Sierra Leone’s emergency response.  A recent example is the response to the COVID-19 outbreak. The project team started to support MoHS early in the national response. 

In January 2020, Jui Lab established SARS-Cov-2 testing capacity with gene sequencing technology. On February 4, 2020 Jui Lab received PCR detection kits from China. Sierra Leone became one of the first countries to establish detection capacity in Africa. The Chinese experts also conducted three training courses on SARS-Cov-2 virus laboratory testing nationwide for a total of 60 trainees. 

During the first three months of the pandemic, Jui Lab was responsible for approximately one third of the COVID-19 tests nationwide. As testing capacity improved in the country, Jui Lab continued to carry out 20% of the tests on average. 

Meanwhile, the project team has been working closely with MoHS experts, especially the Emergency Operations Center, providing suggestions on COVID-19 control strategies.


For a long time, the China-Sierra Leone Technical Cooperation Program has been fully supporting the development of Sierra Leone’s National Public Health Agency NPHA by carrying out the detection and surveillance of key infectious diseases, personnel capacity and leadership building, and strategic planning.

Dr. George Fu Gao, director general of China CDC

“The COVID-19 pandemic has alerted Africa to the urgent need for a new public health order to address the recurring threat of emerging and re-emerging infectious diseases, and the establishment of national public health institutions (NPHIs) is a major part of this new public health order,” said Dr. Gao. “Currently, NPHIs have been established in only a few countries in Africa, which is not conducive to countries and Africa effectively responding to outbreaks and epidemics of the emerging and re-emerging infectious diseases.” 

“For a long time, China-Sierra Leone Technical Cooperation Program has been fully supporting the development of Sierra Leone’s National Public Health Agency (NPHA) by carrying out the detection and surveillance of key infectious diseases, personnel capacity and leadership building, and strategic planning,” Dr. Gao continued. “During the COVID-19 pandemic and post-COVID-19 period, China will further support Sierra Leone's public health system to prepare for a more effective response to the emerging and re-emerging infectious diseases.”


There is strong political will to establish the NPHA in Sierra Leone, especially with the practical lessons learned from the Ebola Virus Disease pandemic of 2014-2016 and the ongoing COVID-19 pandemic.

Dr. T.T. Samba, chief medical officer at Sierra Leone’s Ministry of Health and Sanitation

“There is strong political will to establish the NPHA in Sierra Leone, especially with the practical lessons learned from the Ebola Virus Disease pandemic of 2014-2016 and the ongoing COVID-19 pandemic,” said Dr. Samba. “Demonstrable progress has been achieved in this process, including with the colocation of essential units (surveillance, laboratory, preparedness and response, research and risk communication, points of entry and workforce capacity building) and the creation of the One Health platform.” 

“The collaboration with China CDC is proving to be very productive and effective,” Dr. Samba continued. “There is ongoing capacity building in the areas of laboratory competencies, emergency preparedness and response, community engagement and availability of essential emergency supplies.”

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