A man who should not be alive is now the conscience of a global health system that he says is failing the poor. Mohamed Sesay, a survivor of the 2014 West African Ebola outbreak, has watched the world stumble through COVID, monkeypox and now whispers of a new pandemic. His message is simple: speed saves lives, money corrupts them, and compassion is not a line item on a budget.
Sesay contracted Ebola while nursing his brother in a Freetown clinic that had no gloves, no isolation ward and no pay for staff. He survived because volunteer medics from Cuba and the WHO took risks that bureaucrats in Geneva would not. Today he works as a community health educator in Sierra Leone, paid a pittance by a government that receives millions in pandemic preparedness funds. He knows where that money ends up.
“The World Bank pledges billions,” he told me in a WhatsApp voice note. “But in our district, we have no ambulance. The cold chain for vaccines is broken. The money is in accounts, not in villages.”
Sources familiar with World Bank disbursements confirm that of the $14 billion pledged for pandemic preparedness in 2022, less than 40 per cent reached front-line health systems. The rest went to consultancies, data platforms and virtual training modules that local health workers cannot access. “Speed is the only thing that stops a disease becoming a catastrophe,” Sesay says. “Speed of detection, speed of response, speed of funding. But speed is expensive, and no one wants to pay for it.”
His own survival illustrates the cost. The Cuban medical brigade that treated him was mobilised within 72 hours of the Ebola outbreak being declared. They arrived with experience from dengue and cholera epidemics. They were paid a fraction of what UN contractors earned, but they stayed. “They didn’t wear suits,” Sesay remembers. “They wore plastic aprons and rubber boots. They touched us when everyone else ran away.”
That is the compassion gap. In the wake of COVID, the world’s richest countries stockpiled vaccines and treatments, leaving Africa months behind. The African Centers for Disease Control and Prevention now estimates it will need $15 billion annually to build its own pandemic response. Donors have committed half that, and much of it is tied to procurement from Western pharmaceutical companies.
“Money without transparency is just a delay,” Sesay says. “You need people on the ground who are trusted, who speak the language, who know the burial customs. In Ebola, we had to fight rumours that the white doctors were poisoning people. The only way to win that fight is compassion. You cannot put a price on it, but you must budget for it.”
Documents obtained by this newspaper show that WHO pandemic readiness audits for 2023 gave Sierra Leone a score of 47 out of 100 for community engagement. The funding for that audit came from a $50 million grant from the International Monetary Fund, which required the government to hire an international consulting firm to implement reforms. The firm billed $2 million for reports and proposals. The community health centres got new paint and a broken laptop.
“I am alive because of speed and compassion,” Sesay says. “I am tired of seeing money wasted on things that don’t save lives. The next pandemic is coming. Are we going to be ready, or are we going to write more reports?”
His question hangs in the air. The suits in Geneva and Washington will no doubt have answers. Sesay has seen enough to know which ones to trust.
