donations.7 In a report by the WHO Ebola Interim Assessment Panel in January 2015, it acknowledged that “problems with information flow and decision-making within WHO and difficult negotiations with countries” explained much of the failure to respond as robustly as it should have, and those 16 problems and negotiations involved desires primarily by Guinea and Sierra Leone to control or delay the messaging about a health emergency.66 Ministries overseeing both the economy and finance in Sierra Leone were concerned about what closing the borders would mean to the post-conflict improvements in Sierra Leone’s economic outlook, which in early 2014 were significant and promising.68 ii. Domestic Political Pressures Similarly, domestic political pressures affected data sharing as national responders worked around internal political divisions and international responders met political resistance they did not understand. WHO had recruited all 25 members of the district council, but didn’t realize they were in an intra-political conflict within the [Sierra Leone] APC [All People’s Congress]. This dated back to a point where the district councils were divested of development budget administration, particularly the health budget. In order to punish the APC party, and in particular the president, all 25 members of the district council, in their capacity [as] having been recruited by WHO to be contact tracing supervisors, would simply drag their feet . . .. They would see everything happening and they would do nothing to effect positive outcomes in contact tracing. These kinds of things were really railing against us and it took a bit of time to understand this.65 This was especially true of the relationship between Sierra Leone’s Ministry of Health and the National Ebola Response Centre, which – though nominally partners – often acted as rivals. In one incident in the Guinea forestière, emergency response workers assumed village chiefs would be the most effective liaisons for communication and collection of information. 43 Later investigation revealed distrust of those chiefs based on old colonial affiliations as well as the identity of leaders with more legitimacy in the community.44 17 3. Enablers to data sharing during the Ebola outbreak: Over the course of the outbreak, ad hoc and rapidly assembled data sharing enabling forums, committees, digital platforms, shared email accounts, mobile applications, and decisionmaking hierarchies developed to address the barriers identified above. Responders developed community interventions that lowered barriers to community members sharing information about new cases, secret burials, and recent contacts. Informal networks developed between governmental, for-profit and charitable actors that facilitated the creation of rapid diagnostics and promising vaccine candidates. a. Standardized data collection and sharing forms Most interviewees agree that the data sharing problems around epidemiological and surveillance data were never fully addressed. In Liberia, field reports from general community health volunteers were often incomplete or very late because of transporting paper copies and the illegibility of completed or semi-completed forms. Shared calendars, listservs, and common platforms emerged, but were underused.69 A national alert system with a single, national toll-free phone number, 117, was introduced in Sierra Leone in August 2014 to facilitate prompt identification, investigation, isolation and testing of potential Ebola cases and deaths.67 During this period, the government maintained a policy of mandatory reporting and Ebola testing for all deaths. The 117 system remained an integral response component during the enhanced surveillance period from the official end of the Ebola epidemic in Sierra Leone in November 2015 until June 2016.67 Although the 117 system became the primary mechanism for reporting deaths to the Sierra Leone District Ebola Response Centres and to District Health Management Teams after the DERCs were wound down in December 2015, according to one interviewee, the U.S. Centres for Disease Control Prevention and the World Health Organization rejected the system “out of principle” because incorporating information from the system might require integration of the data in formats incongruous with those they had put in place to assess probable or unlikely cases, build line lists, and inform WHO situation reports. In Liberia, cell phones were similarly deployed with a “Monitoring, Evaluation, and Learning System” (MELS) that measured knowledge and uptake of behaviors and attitudes. The data could be analysed according to county and district level data. The use of personal digital assistants (i.e., small, mobile, handheld device that can store and retrieve information) has the potential to avert the problem of missed data collection in future outbreaks.76 Because data was shared through portable document formats (PDFs), Microsoft PowerPoint presentations, and Excel spreadsheets, especially for line lists, responders in Liberia developed a shared Gmail account. Username and password information to the email account was shared, facilitating information relevant to the response. 18 b. Community Engagement Mechanisms A number of community engagement mechanisms enabled more rapid data sharing of relevant information. Social media