Rapid Guidance on the Decommissioning of Ebola Care Facilities. March 2015
(2015; 45 pages)


The 2014 Ebola outbreak, which has affected several countries in West Africa, is the largest in history. The three countries most affected by the outbreak – Guinea, Liberia and Sierra Leone –have reported almost 25,000 cases as of March 2015. In response to the urgent need for Ebola treatment beds, several facilities were reconfigured to admit, isolate, and treat patients. Many such facilities were constructed in existing hospitals, schools or buildings that provided other functions prior to the outbreak. New facilities were also constructed to deal with the epidemic.

In light of the decline in new Ebola cases, strategies are now needed to scale down the activities and bed capacities in Ebola care facilities. These facilities include Ebola treatment units, community care centres, Ebola treatment centres and isolation centres. Thus, the closure of such facilities or repurposing for other uses not related to the treatment of Ebola should be approached using evidence-based, best practices, while at the same time respecting the social and psychological impact of the outbreak on the affected populations.

One major challenge is decontamination. Decontamination renders an area, device, item or material safe to handle (i.e., safe in the context of being reasonably free from a risk of disease transmission). The primary objective is to reduce the level of microbial contamination so that subsequent infection and transmission are eliminated. The decontamination process to clean an instrument, device or area may range from using ordinary soap and water to sterilization.

The Governments of Guinea, Liberia and Sierra Leone; WHO; CDC; ICAN and UNICEF have jointly developed this rapid guidance to assist national governments and partners as they begin the process of decommissioning Ebola care facilities. This rapid guidance pertains to protecting the safety and repurposing of infrastructures and resources previously used for the Ebola outbreak. The guidelines in this document apply to facilities that cared for Ebola patients. The process should be conducted in a well-informed and coordinated manner in order to minimize the environmental, health, safety and social risks associated with it. The precautionary principle implies that a high degree of care should be taken during the process of decontaminating Ebola care facilities. Such attention will ensure the greatest possible degree of health and safety for the staff carrying out the exercise, as well as the individuals who may access the structures after decontamination. This guidance provides an overview of the measures for the planning, demolition and completion of the decontamination of Ebola care facilities.

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