Professional instruments for trading and investments, first grand capital.

First grand capital


We set high requirements for liquidity providers and aim to provide the most favorable conditions for your work with the market: small fees, highly liquid instruments, immediate execution, 24/7 support.

Free forex bonuses


Professional instruments for trading and investments, first grand capital.


Professional instruments for trading and investments, first grand capital.


Professional instruments for trading and investments, first grand capital.

We allow using any robots and eas, high-margin trading is available. Risk diversification is possible thanks to the variety of accounts and instruments. Our clients are always under the protection of the international financial commission finacom that has an insurance fund of 20,000 euros for every client. Moreover, the funds of our clients are protected by the cutting-edge blockchain technology of serenity escrow that prevents any manipulation with the deposit. We offer 500 instruments for trading: cfds on stocks, indices, metals, commodities, currency pairs, cryptocurrency.
ECN and crypto accounts are available to professional traders. Beginners may be interested in our cent account micro. For the most clients, the recommended account type is standard. Algorithmic trading is available on all accounts, including the possibility to create of your own robots in metatrader 5. The following trading platforms are available at grand capital: metatrader 4 metatrader 5 and the mobile app grand trade.


Professional instruments for trading and investments


To start, open a trading account
or practice with demo.


Select a service


Active offers


Claim 40% with every deposit!


Probably the best bonus for traders.


Subscribe to our trading blog


Lift your forex trading skills!


Stable instrument. High returns.


We believe that it’s important to to get clear answers to all your questions on the way to successful moneymaking in financial markets.


Ready to begin?


In most cases, the recommended starting amount is $1,000. This sum is sufficient for trading any instruments, can withstand a drawdown, allows to hedge volatility risks in currency markets with commodity CFD trades.


After you register, a standard trading account will be created for you automatically. Make a deposit using a bank card, a payment system or cryptocurrency. If you’re depositing via bank card, you’ll have to pass a verification procedure and provide all the necessary documents required by the processing system.


Start trading. First you’ll need to download a trading platform: MT4, MT5 (for experienced traders) or mobile app grand trade (works for everyone), choose an instrument and start trading. The most popular currency pairs for trading are EUR/USD, USD/CHF, USD/JPY, BTC/USD, ETH/USD, LTC/USD.
If you prefer trading commodities, turn your attention to oil, gas and metals, and if you’re interested in stocks and indices, you can choose from our wide selection of these instruments.
If you don’t know what to start with, visit our page for beginners or contact your personal manager through the ticket system in your private office.


What we offer


RAMM is for investment and management. Connect to the available strategies that are proven successful and create your own. The service is fully automated and easy to use, provides a high level of capital protection, allows setting limits for profit and loss, weekly profit.
Recommended initial deposit is $2,000. Minimum amount of investment in one strategy is $50. Open a RAMM account.


Choose an investment portfolio and make money from stocks of major corporations.
Readily available ideas for trading, free advice, high profit rate.
You can also take advantage of our free service and order a custom portfolio.
Compare services


We offer 500 instruments for trading: cfds on stocks, indices, metals, commodities, currency pairs, cryptocurrency.
ECN and crypto accounts are available to professional traders. Beginners may be interested in our cent account micro. For the most clients, the recommended account type is standard. Algorithmic trading is available on all accounts, including the possibility to create of your own robots in metatrader 5. The following trading platforms are available at grand capital: metatrader 4 metatrader 5 and the mobile app grand trade.


We set high requirements for liquidity providers and aim to provide the most favorable conditions for your work with the market: small fees, highly liquid instruments, immediate execution, 24/7 support. We allow using any robots and eas, high-margin trading is available. Risk diversification is possible thanks to the variety of accounts and instruments. Our clients are always under the protection of the international financial commission finacom that has an insurance fund of 20,000 euros for every client. Moreover, the funds of our clients are protected by the cutting-edge blockchain technology of serenity escrow that prevents any manipulation with the deposit.


Our support


We profit when you profit.


Grand capital is a provider of technology for trading in currency and derivatives markets since 2006. Over these years, we have become a financial partner of more than 500,000 traders all over the world. Stable and reliable operation of the company paired with its vast experience in the field allowed to implement the concept of a long-term mutually beneficial partnership. High standards of the provided services and technology earned prestigious awards from the professional community. Our work is for the benefit of the client, and our income relies on fees for using our services and instruments.


You become a part of the international trading community and use the most advanced services in the field of trading and investing. You participate in loyalty programs and get firsthand access to new instruments and technologies as they are introduced by the company. Each client gets their own personal manager who will help them become more successful. Working with a stable world-class company, you won’t have to worry about the safety of your funds.


First you need to decide whether you want to work as an independent trader or invest funds. If you plan to trade on your own, start with our classic account standard, recommended deposit amount is $500. Download the mobile app. Visit our page for beginners.


If you plan to start as an investor, open a RAMM account and start copying the top-performing strategies in the rating: it’s really a low-risk and profitable way of earning for investors of any level of experience with any budget.
Compare investment services


Let’s take the next step together


Trade and invest with grand capital broker!


Grand capital is a forex broker that provides high-quality services for online trading in financial markets to clients around the world since 2006. Trading in metatrader 4 and metatrader 5. Over 500 financial assets: currency pairs, cfds on the stocks of global corporations, indices, metals.


Download mobile app for trading
and account management


Only demo accounts currently available



  • Forex and CFD trading

  • Deposit/withdrawal



  • Market analysis

  • Account management



  • Forex and CFD trading

  • Deposit/withdrawal

  • Market analysis

  • Account management


Trading instruments


Trade the most popular assets!
We offer a wide variety of financial instruments for online trading, making the market available to you, always and everywhere.



Nos avantages


Récompenses et réalisations


Cotes en ligne


instrument bid ask spread percentage
BTCUSD 33812,176 33817,066 1.5 -2.33%
ETHUSD 1335,340 1336,670 0.4 -3.72%
LTCUSD 131,02025 131,18974 0.1 -2.41%
BCHUSD 409,195 411,255 0.7 -1.10%
ETCUSD 7,337 7,591 0.1 -1.58%
XMRUSD 142,333 143,968 0.5 +2.08%
ZECUSD 85,729 87,321 0.5 +1.85%

instrument bid ask spread percentage
eurusde 1,20610 1,20616 0.1 -0.47%
gbpusde 1,36610 1,36619 0.1 -0.41%
audcade 0,97951 0,97967 0.1 -0.54%
nzdusde 0,71546 0,71565 0.1 -0.21%
eurjpye 126,593 126,607 0.1 +0.23%
eurchfe 1,08171 1,08186 0.1 +0.45%
USDRUB 75,94579 76,25920 0.2 -0.17%
USDCNY 6,4742 6,4761 0.1 +0.03%

instrument bid ask spread percentage
#AA 18,79 18,81 0.1 +0.86%
#CSCO 45,46 45,48 0.1 +1.34%
#MCD 207,68 207,73 0.1 +2.12%
#MSFT 240,18 240,21 0.1 +2.11%
#APPLE 134,81 134,84 0.1 -1.03%
#FORD 10,84 10,86 0.1 +1.31%
#TESLA 839,30 839,50 0.1 -0.05%

compte rendement pour 3 mois âge
trade tanzania:4794816 675,38% 39 jours
LO 2.0:4752263 233,66% 121 jours
shadow2020:4809613 175,22% 48 jours
aisha is'haqu mohammed:4428442 169,63% 793 jours
blackrock:532377 163,96% 1442 jours
alexander smirnov:4749218 162,7% 189 jours
money maker:4810394 160,62% 46 jours
rafalk:4461092 132,82% 770 jours



    • Grand capital ltd.

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Divulgation des risques: avant de commencer à spéculer sur le marché de change, assurez-vous s'il vous plaît que vous êtes au courant des risques reliés à la spéculation en utilisant l'effet de levier et que vous avez un niveau de formation suffisant.


Politique de confidentialité explique comment la société rassemble, utilise et protège les renseignements personnels de ses clients


- grandcapital ltd. 24598 IBC 2018 (suite 305, griffith corporate centre, P.O. Box 1510, beachmont, kingstown, st. Vincent and the grenadines)


- grand capital ltd. 036046 (suite 102 aarti chambers, mont fleuri, victoria, mahe, seychelles)


- ces informations sont destinées aux investisseurs hors des états-unis qui ne sont ni les citoyens américains ni les citoyens japonais / résidents.



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Профессиональные инструменты для трейдинга и инвестиций


Чтобы начать, откройте торговый
или тренировочный счёт


Выберите услугу


Актуальные предложения


Бонус на любое пополнение +40%.


Пожалуй, лучший бонус для трейдеров!


Подпишись на наш блог про торговлю


Стабильный инструмент. Высокие заработки.


Мы считаем, что на пути к успешному заработку на финансовых рынках важно получить ответы на самые важные вопросы.


Готовы начать?


Оптимальная сумма для начала работы считается $1 000. Эта сумма достаточна для торговли любым инструментом, позволяет выдерживать просадки и хеджировать риски волатильности на валютном рынке за счёт сделок на сырьевых CFD.


Чтобы открыть счет для торговли, зарегистрируйтесь, вам будет автоматически открыт счет standard. Затем пополните счет картой, платежными системами или криптовалютой. Пройдите верификацию личности в случае пополнения картой, предоставьте требуемые документы — это необходимое требование процессинговых систем.


Приступите к самостоятельной торговле. Для этого скачайте торговую платформу МТ4, MT5 (если у вас достаточно опыта) или мобильное приложение grand trade (подойдет всем) и начните торговать, выбрав инструмент. Самые популярные валютные пары — EUR/USD, USD/CHF, USD/JPY, BTC/USD, ETH/USD, LTC/USD.
Если вы предпочитаете торговать сырьем, обратите внимание на нефть, газ и металлы, если интересуют акции и индексы, выберите из широкой линейки инструментов.
Если вы не знаете с чего начать, посетите страницу "новичкам" или свяжитесь с персональным менеджером через тикет-систему в личном кабинете.


Что мы предлагаем?


RAMM — инвестирование и управление. Подключайтесь к готовым доходным стратегиям и создавайте собственные. Сервис прост в управлении, так как полностью автоматизирован. Высокая степень защиты капитала. Выставление лимитов на прибыль/убытки, еженедельный доход.
Рекомендуемая сумма для старта — $ 2000. Минимальная $50. Открыть счёт RAMM.


Выбирайте инвестпортфели для заработка на акциях крупнейших корпораций.
Готовые торговые идеи, бесплатные консультации, высокая доходность.
Воспользуйтесь бесплатной услугой "заказ инвестпортфеля".
Сравните сервисы


Торговля ведется более 500 инструментами: CFD на акции, индексы, металлы, сырье, валютные пары, криптовалюта.
Профессиональные трейдеры могут использовать счета МТ5, ЕСН или crypto. Для начинающих может быть интересен центовый счет micro. Для большинства рекомендован standard. Алгоритмическая торговля доступна на всех счетах, в том числе создание собственных роботов в платформе metatrader 5. Торговля ведется в metatrader 4, metatrader 5 и мобильном приложении grand trade.


Мы предъявляем высокие требования к поставщикам ликвидности и стремимся давать максимально выгодные условия для работы на рынке - низкие комиссии, ликвидные инструменты, мгновенное исполнение, круглосуточную поддержку. Мы позволяем использовать любых роботов и советников, доступна высокомаржинальная торговля. Диверсификация рисков достигается за счет разнообразия счетов и инструментов. Наши клиенты под защитой международной финансовой комиссии финком, со страховым фондом 20 000 евро на каждого клиента. Кроме того, средства клиентов защищены современной блокчейн-технологией эскроу серенити, которая исключает манипуляции с депозитом.


Как мы помогаем?


Мы зарабатываем, когда вы зарабатываете.


Компания grand capital является провайдером технологий для торговли на рынках валют и деривативов с 2006 года. За эти годы мы стали финансовым партнером более полумиллиона человек во всех странах мира. Стабильная надежная работа компании и большой опыт позволили воплотить в жизнь концепцию долгосрочного взаимовыгодного сотрудничества. Высокие требования к уровню предлагаемых сервисов и технологий были отмечены престижными наградами от профессионального сообщества. Мы работаем в интересах клиентов, так как наш заработок складывается из совокупного дохода, получаемого от комиссий за пользование сервисами и инструментами.


Вы становитесь частью международного сообщества трейдеров и пользуетесь передовыми сервисами в области трейдинга и инвестирования. Вы участвуете в программах лояльности и первыми получаете доступ к новым инструментам и технологиям, внедряемым компанией. За каждым клиентом закреплен персональный менеджер, который помогает вам работать эффективнее. Вы можете быть уверены за свои средства, потому что работаете со стабильной компанией мирового уровня.


Определите для себя: вы хотите торговать сами или инвестировать средства? Если хотите самостоятельно торговать, стоит начать с классического счёта standard, рекомендуемый депозит $500. Скачайте мобильное приложение. Начальное обучение пройдите по авторским курсам или бесплатным видеоурокам. Посетите страничку "новичкам".


Если вы хотите начать как инвестор, откройте счет RAMM и подключите самые доходные стратегии из рейтинга — это действительно низкорискованный и в то же время доходный способ заработка для инвесторов любого уровня.
Сравнить инвестиционные сервисы


Давайте сделаем следующий шаг вместе


Торгуйте и инвестируйте с брокером grand capital!


С 2006 года форекс-брокер grand capital обеспечивает трейдеров по всему миру качественными онлайн-сервисами для торговли на финансовых рынках. Торговля ведется в терминале metatrader 4 и metatrader 5. В распоряжении трейдеров более 500 финансовых активов: валютные пары, CFD на акции российских и зарубежных компаний, индексы, металлы.


Скачайте мобильное приложение для трейдинга
и управления своими счетами


Временно доступны только демосчета



  • Торговля форекс и CFD

  • Ввод/вывод



  • Аналитика

  • Управление счетами


Инструменты для торговли


Торгуйте на самых популярных активах!
Мы предлагаем большое количество финансовых инструментов для онлайн-трейдинга, делая торговлю доступной всегда и везде.



Наші переваги


Котирування онлайн


інструменти bid ask spread percentage
BTCUSD 33888,145 33894,285 1.9 -2.11%
ETHUSD 1335,200 1336,530 0.4 -3.73%
LTCUSD 131,21025 131,34976 0.1 -2.27%
BCHUSD 408,985 411,085 0.7 -1.15%
ETCUSD 7,336 7,591 0.1 -1.60%
XMRUSD 142,681 144,229 0.5 +2.33%
ZECUSD 85,789 87,371 0.5 +1.92%

інструменти bid ask spread percentage
eurusde 1,20619 1,20624 0.1 -0.47%
gbpusde 1,36625 1,36637 0.1 -0.40%
audcade 0,97993 0,98005 0.1 -0.50%
nzdusde 0,71567 0,71588 0.1 -0.18%
eurjpye 126,592 126,607 0.1 +0.23%
eurchfe 1,08195 1,08209 0.1 +0.47%
USDRUB 75,98680 76,29620 0.2 -0.12%
USDCNY 6,4729 6,4749 0.1 +0.01%

інструменти bid ask spread percentage
#AA 18,79 18,81 0.1 +0.86%
#CSCO 45,50 45,52 0.1 +1.43%
#MCD 207,99 208,04 0.1 +2.27%
#MSFT 240,13 240,17 0.1 +2.09%
#APPLE 134,58 134,60 0.1 -1.20%
#FORD 10,85 10,87 0.1 +1.40%
#TESLA 839,55 839,86 0.1 -0.02%

рахунок дохідність за 3 місяці вік
trade tanzania:4794816 675,38% 39 days
LO 2.0:4752263 233,66% 121 days
shadow2020:4809613 175,22% 48 days
aisha is'haqu mohammed:4428442 169,63% 793 days
blackrock:532377 163,96% 1442 days
alexander smirnov:4749218 162,7% 189 days
money maker:4810394 160,62% 46 days
rafalk:4461092 132,82% 770 days



    • Grand capital ltd.

    • Contacts

    • Company news




    • Trading

    • CFD, futures contracts

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    • Analytics

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Повідомлення про ризики: починаючи працювати на валютних ринках, переконайтеся, що ви усвідомлюєте ризики, з якими пов'язана торгівля з використанням кредитного плеча, і що ви маєте достатній рівень підготовки.


Privacy policy пояснює, яким чином компанія збирає, використовує та захищає персональну інформацію своїх клієнтів


- grandcapital ltd. 24598 IBC 2018 (suite 305, griffith corporate centre, P.O. Box 1510, beachmont, kingstown, st. Vincent and the grenadines)


- grand capital ltd. 036046 (suite 102 aarti chambers, mont fleuri, victoria, mahe, seychelles)


- this information is intended for investors outside of the united states who are not the US/japanese citizens and residents.



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First heartland, independent broker dealer


Real people. Real relationships. The perfect fit.


FHC offers you a one-stop solution for your business as a broker-dealer, brokerage general agency, and registered investment advisory firm. Learn more about how FHC's fierce independence and focus on strong relationships can help grow your business successfully at joinfhc.Com.


Current producers


Account information


In addition to SIPC protection, pershing also provides coverage in excess of SIPC limits through a private insurer, lloyd’s of london. The excess account protection purchased through lloyd’s of london offers the highest level of coverage that is available in the industry today.1 the excess insurance policy provides the following protection for assets held in custody by pershing and its london-based affliate, pershing securities limited:



  • An aggregate loss limit of $1 billion for eligible securities - across all client accounts

  • A per-client loss limit of $1.9 million for cash awaiting reinvestment - within the aggregate loss limit of $1 billion



The lloyd’s of london insurance does not protect against loss due to market fluctuation. For more information about lloyd’s of london, please see www.Lloyds.Com.


1 the $1 billion aggregate loss limit for eligible securities is the highest policy offered in the industry.



Check the background of this firm on FINRA's brokercheck.


This site has been published in the united states for residents of the united states. The entire site has been prepared solely for informational purposes, and it is not an offer to buy or sell or a solicitation of an offer to buy or sell any security or instrument or to participate in any particular trading strategy.


First heartland® capital inc., member FINRA & SIPC and any of its employees or representatives acting as an agent, may transact business in a particular state only if first registered, excluded or exempted from registration requirements either individually or as a firm. In addition, follow-up conversations or meetings with individuals in a particular state by either first heartland® capital, inc. Or any of its employees or representatives acting as an agent to effect transactions in securities or discuss securities, investment planning or other personal investment advice will not be made without first becoming registered, excluded or exempted from registration requirements either individually or as a firm.



Capital in the twenty-first century


Based on the international bestseller by rock-star economist thomas piketty (which sold over three million copies worldwide and landed piketty on time's list of most influential people), this captivating documentary is an eye-opening journey through wealth and power, a film that breaks the popular assumption that the accumulation of capital runs hand in hand with social progress, and shines a new light on today’s growing inequalities. Traveling through time, the film assembles accessible pop-culture references coupled with interviews of some of the world’s most influential experts delivering an insightful and empowering journey through the past and into our future.


"engaging. [piketty] is not only a brilliant economist but also one with a gift for making complicated ideas accessible."


“A financial detective story that exposes our current crisis. Provokes a consistent sense of 'whoa!'"


“A brilliantly assembled, blood-boiling examination of the past 100 years in economics.”


“lively, informative… lays out the economist’s arguments with lucidity and persuasiveness, using a slew of pop-culture references."


"A spry, erudite, and consistently watchable documentary that articulates how we got here, and why things are only going to get worse if we don’t right the balance between economic growth and consolidated wealth."


“bold, incisive, riveting… one of the best documentaries in recent years.”


"an easily digestible cinematic companion to such a crucial and potentially prophetic book."


"piketty has transformed our economic discourse; we’ll never talk about wealth and inequality the same way we used to."


Thomas piketty
francis fukuyama
joseph stiglitz


What is kino marquee?


Kino marquee is a new initiative that creates "virtual cinemas" for temporarily closed independent theaters. It lets audiences see at home newly released films that these theaters would otherwise be playing on the big screen, and which are not yet available on other digital platforms.


Join us in supporting your community's theater in these uncertain times by buying a virtual “ticket” to watch award-winning international films, acclaimed documentaries, and restored classics on kino marquee. You’ll be directly supporting your local art house as all revenue is being shared between distributor and exhibitor just as if you bought your ticket at the theater's box office.


How can I watch the film?


To get your ticket, click the screen button above. You’ll have to register for an account if you don’t already have one. After you’ve entered your payment information, your rental period will start immediately and last for five days. You can watch the film as many times as you want in those five days.


You can watch on your computer, phone, or most tablets. You can also download the kino now app for roku, amazon fire stick, or apple TV (tvos 9.0 or later). See below for more detailed information about app-based viewing options. All viewing methods require high bandwidth internet connection.


Instructions for watching on apple TV.


You must first purchase the film from your theater’s virtual cinema page on desktop or mobile. After doing that, please follow these steps to install the kino now app on your apple TV (requires tvos 9.0 or later).


Important: you will need to log in using the same email address and password you just created.


To install the kino now app for apple TV, search for “kino now” in the app store and follow the instructions for installation.


Once installed, open the app and click the “sign in” button. The app will ask for your email and kino now password.


This is a private showing of the film and is hidden from general view. To watch the film please access "my library" on top of the page. Enjoy the film for five days from the time of purchase.


Instructions for watching on roku.


You must first purchase the film from your theater’s virtual cinema page on desktop or mobile. After doing that, please follow these steps to install the kino now app on your roku.


To install the kino now app for roku, click here . Or search for “kino now” in the app store and follow the instructions for installation.


The first time you open it, it may take an extended time for the app to load. You will be prompted with a code. Visit kinonow.Com/activate to activate the app.


This is a private showing of the film and is hidden from general view. To watch the film please access "my library" on top of the page. Enjoy the film for five days from the time of purchase.


Instructions for watching on amazon fire TV / fire stick.


You must first purchase the film from your theater’s virtual cinema page on desktop or mobile. After doing that, please follow these steps to install the kino now app on your amazon fire stick.


Important: you will need to log in using the same email address and password you just created.


To install the kino now app for amazon fire stick, click here . Or search for “kino now” in the app store. If the app does not open immediately upon installing, you can find it under “apps and channels.”


Under “account,” either click “sign in with email” and enter the same email and password you used to purchase the film or click “link device” and you will be prompted with a code. Visit kinonow.Com/activate to activate the app using this code.


This is a private showing of the film and is hidden from general view. To watch the film please access "my library" from the menu (three horizontal lines) on the top of the page. Enjoy the film for five days from the time of purchase.


Other devices.


We apologize if your device of choice is not currently supported. We are working on adding more ways to watch, but at this time cannot provide support for devices other than those listed above. We cannot guarantee it will work using chromecast or airplay, although it does for some people. We also recommend you check your manufacturer instructions. Kino marquee was set up very quickly in response to the COVID-19 pandemic, so we appreciate your patience.



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Liberia: a country вђ“ and its capital вђ“ are overwhelmed with ebola cases


One year into the ebola epidemic. January 2015


When the virus entered monrovia, the outbreakвђ™s calm start turned into an illusion.


Chapter 5 - liberiaвђ™s first two cases of ebola, in the foya district of lofa county near the border with guinea, were confirmed on 30 march 2014. On 2 april, an infected traveller from lofa passed through monrovia, the countryвђ™s capital, but was not known to have transmitted the virus to others.


On 7 april 2014, the country reported 21 confirmed, probable, and suspected cases and 10 deaths. All five laboratory-confirmed cases died, including one in monrovia. In a pattern that would become a striking feature of the outbreak, those numbers included three cases in health care workers, all fatal.


The situation in liberia then stabilized throughout the rest of april and most of may, with cases still largely concentrated in lofa county. For weeks on end, whoвђ™s disease outbreak news about the ebola situation in west africa reported вђњno new confirmed cases in liberiaвђќ or described the situation as вђњstableвђќ. By the end of may, liberia had reported no new cases since 9 april.


Further cases were detected in early june, mainly in lofa county, but the trend still looked calm, especially when compared with the situation elsewhere. At the end of june, liberia reported 51 cases, compared with 390 in guinea and 158 in sierra leone.


Monrovia turns a calm start into an illusion


"this morning, I went into my community, searched house to house and interviewed a few people. It is something I love to do because it will save my community."

Robbin george, student, an active ebola case finder


That appearance of calm turned out to be an illusion. The first additional cases in monrovia were reported in mid-june 2014. The city was ill-prepared to cope with the onslaught of infections that rapidly followed.


Monrovia was home to the countryвђ™s only large referral hospital, the john F kennedy medical center, but that facility had been heavily damaged during the civil war and never fully repaired. Frequent floods and electrical fires were hazards for patients and staff alike. Several prominent doctors working there became infected and died. By the end of september, liberia would have the highest number of infections in health care workers вђ“ at nearly 200 вђ“ among the three countries.


No hospital anywhere in the country had an isolation ward. Few medical staff had been trained in the basic principles of infection prevention and control. Facilities had little or no personal protective equipment вђ“ not even gloves вђ“ and virtually no knowledge about how to use this equipment properly.


Under such conditions, treatment of the first hospitalized patients ignited multiple chains of transmission, among staff, patients, and visitors, in ambulance and taxi drivers who ferried the sick to care, in relatives, neighbours, and eventually entire neighbourhoods. Case numbers that had multiplied quickly began to grow exponentially.


On 6 august, president sirleaf declared a three-month state of emergency and announced a string of new regulations, which included the closing of markets, curfews, and restrictions on the movement of patients and their contacts, to be enforced by the countryвђ™s military. In her view, such restrictions were justified as the disease threatened to undermine the nationвђ™s вђњeconomic and social fabricвђќ.


In august, liberia made the cremation of people who died from ebola mandatory in monrovia. That decree followed the refusal of several monrovian neighbourhoods to allow burials near their homes, leaving hundreds of highly infectious bodies unattended.


A WHO emergency team begins its investigation


In mid-august, a WHO team of emergency experts, working alongside staff from the ministry of health and other key partners, began a three-week long investigation of the situation in liberia. That investigation revealed that an outbreak had been simmering in the country for at least several weeks before the first cases in monrovia were detected, giving the virus a huge head-start on control measures.


All agreed that the demands of the ebola outbreak had outstripped the governmentвђ™s and partnersвђ™ capacity to respond. By that time, 14 of the countryвђ™s 15 counties had reported confirmed cases. Some 152 health care workers had been infected and 79 of them had died, representing a significant loss of talented and dedicated doctors and nurses at a time of immense need.


By 8 september, liberia had the highest cumulative number of reported cases, reaching nearly two thousand cases and more than one thousand deaths.


In monrovia, bed capacity could not keep up with the growing number of very ill ebola patients. New treatment centres were opened by MSF and others, but were rapidly filled to overflowing. The WHO team estimated that 1000 beds were needed just for the treatment of currently infected patients. Only 240 beds were available. Although another 260 beds were planned, the shortage meant that only around half of patients could be admitted to treatment facilities over the next several weeks and months.


One treatment facility, quickly set up by WHO at the ministry of healthвђ™s request, was equipped and staffed to manage 30 patients but had 70 as soon as it opened.


At the end of august, the government quarantined the cityвђ™s west point slum, home to at least 75,000 people crowded together under unsanitary conditions, as part of efforts to slow the explosive spread. Violence broke out and one teenager was killed as armed forces struggled to contain the event.


Overwhelmed by a runaway virus


As the first week of september ended, data indicated that that exponential growth of cases had overwhelmed response capacity in the capital city. Taxis filled with entire families, of whom some members were almost certainly infected with ebola, constantly crisscrossed and circled the city, searching for a treatment bed. They found none. MSF announced that its facilities were overstretched and began to turn patients away.


WHO sent one of its most experienced emergency responders to monrovia to head its office there. More logisticians arrived from geneva to address urgent material needs, while field epidemiologists were deployed to undertake case finding and contact tracing. Nonetheless, the outbreak still ran ahead of all these stepped-up efforts.


The lack of adequate numbers of treatment beds provided the most dramatic evidence of a runaway virus. It also jeopardized key control measures, such as the isolation of confirmed and suspected cases, and ensured that the virus would continue to race through families and neighbourhoods. The countryвђ™s president pushed partners hard to build more treatment centres.


In september, WHO began construction of a new treatment centre in monrovia, using teams of 100 construction workers labouring in round-the-clock shifts. On 21 september, the island clinic was formally handed over by WHO to liberiaвђ™s ministry of health. The clinic added 150 ebola treatment beds to the cityвђ™s existing 240 beds. However, within 24 hours after opening, the clinic was overflowing with patients, again demonstrating the desperate need for more treatment beds.


Epidemiological trends were difficult to assess. Accurate monitoring of the situation suffered from the weak surveillance and reporting systems in place prior to the start of the outbreak. The onslaught of cases strained those mechanisms further. At times, the overwhelmed systems were unable to confirm or discard probable and suspected cases, as laboratory backlogs delayed testing and confirmation of positive cases вђ“ sometimes for weeks.


The first drop in ebola cases: a model of success


The first encouraging trend was detected during the last days of september, when reports of new cases in lofa county, the initial epicentre of intense transmission, began showing an apparent decline. WHO watched that encouraging trend with hope but also caution, given the well-known problems with under-reporting.


By the end of october, WHO could conclude that the decline of cases in lofa was persistent, consistent, and likely real. The trickle of cases then dried up in november, with no new cases reported for four consecutive weeks. Confidence that lofa had indeed beaten back the virus increased throughout december. No new cases were reported.


In one of the most encouraging investigations in all three countries during 2014, WHO was able to find a direct link between implementation of the full package of control interventions, including community engagement, acceptance, and ownership of the response, and the decline and then end of new cases. Those findings were all the more impressive given lofaвђ™s proximity to guinea, where transmission was still ongoing and intense.


The situation in lofa underscored the value of stratifying the response to this extremely complex and challenging outbreak to meet the unique context and challenges at the district level in all affected countries. This was not an epidemic with three different national patterns, but likely hundreds of distinct patterns, with their own transmission dynamics, playing out within individual districts and sub-districts.


Fortunately, that observation coincided with better reporting at the district level as WHO deployed more experienced epidemiologists to the field. The US CDC likewise sent more staff to help correct deficiencies in the surveillance and reporting systems.


Support escalates in monrovia


At the start of october, WHO estimated that 1,500 treatment beds were needed in addition to those already in place or planned. Support escalated, as commitments, made by the US government and others following the september emergency meeting of the UN security council on ebola, began to materialize. Two US navy mobile laboratories arrived and began processing samples in bong and monrovia on 5 october.


More treatment facilities were built by US military personnel. They used WHO master plans for a treatment centre that strictly separated вђњhotвђќ and вђњsafeвђќ zones, allowed no contaminated wastes to leave the patient ward, and provided space for safe triage. Safe triage reduced the risk that people suffering from another illness or entirely healthy contacts would be placed near confirmed cases, increasing the risk of infection.


The number of trained and supervised staff conducting case finding and contact tracing, and the daily monitoring of contacts increased considerably in monrovia, but was still insufficient elsewhere in the country. Laboratory capacity improved, but WHO concerns about the quality of data and the under-reporting of cases continued.


The first signals that the situation in monrovia had stabilized began in late october, with a slow decline detected in the early weeks of november. As a precaution, WHO staff conducted a study of data collected from funeral homes, crematoria, and coffin makers to assess the likelihood that hidden burials might account for the decline in reported mortality. The results of that study supported the conclusion that the decline in cases and deaths in monrovia was real and robust. In mid-november, the government set a target of no new ebola cases by 25 december.


As the year concluded, the main risks in liberia were two-fold: complacency as a traumatized population began to feel safe and vigilance relaxed, and the move of the virus from cities to remote rural areas.


Exchanging one set of problems for another?


During the second week of december, only 6 of the countryвђ™s 15 counties reported new cases. That situation contrasted sharply with the one reported by WHO on 22 october, when all counties had recorded at least one case and monrovia was reporting more than 300 new cases each week.


During late november and early december, rural outbreaks were seeded as people who had been working in the cities returned to their rural homes, sometimes to die. By mid-december, the virus had largely moved from cities to remote rural areas that lie well beyond the places where the road system ends.


Apart from continuing вђ“ though declining вђ“ cases in monrovia, the districts of greatest concern included grand bassa, bong, grand cape mount, and margibi. In a ping-pong effect, the genuine successes recorded in monrovia and lofa risked coming unravelled: travellers from affected rural areas could re-ignite infections in the cities. Based on available evidence, WHO viewed that risk as greater than the risk that new cases would be imported, especially from sierra leone.


Given the very different challenges seen in urban and rural areas, the virusвђ™ retreat from the cities might turn out to mean that one set of problems has been exchanged for another. As experience has shown, especially in guinea, areas that come under control remain at risk of re-infection as long as virus circulation continues anywhere in the country or its neighbours.


In grand bassa and grand cape mount, health officials struggled to cope with almost no staff properly trained in case detection, patient management, contact tracing, and the safe collection of patient samples. Personal protective equipment was in short supply, as were essential medicines. Almost no villages had ambulances or trained ambulance crews and burial teams. The few vehicles available were poorly maintained and fuel was scarce.


These problems were vastly amplified by the absence of transportation and telecommunications networks. Some villages can be reached only after an eight-hour hike across rough terrain. Prompt reporting of cases and responses to calls for help have been further impaired by patchy and sporadic telecommunication services. Health staff in these remote counties were lucky to have brief internet access once or twice per week.


In yet another complication, patients in rural areas did not want to be sent for treatment to monrovia, where abundant beds were available, as they knew that bodies in the capital city would be cremated, in line with the presidentвђ™s august decree. In liberia, вђњdecoration daysвђќ вђ“ holidays when the graves of relatives are cleaned and decorated вђ“ are a deep-seated cultural tradition.


At year-end, liberia had 10 beds available for each ebola patient in monrovia, but faced an urgent need to shift this capacity to rural areas. As experience has shown, moving testing and treatment facilities closer to where cases are occurring is a far better strategy than moving patients, often over long distances, to treatment facilities. Such movements are hard on patients, poorly accepted by families, and fraught with risks of further transmission en route.


WHO has shifted its strategy to the use of rapid response teams sent to rural areas. In the best-case scenario, these teams will catch flare-ups early enough to stamp them out вђ“ before entire villages are paralyzed by illness and deaths and the virus inevitably spreads to new areas. However, the difficulty of reaching these remote areas and the absence of so many essential services, personnel, vehicles, and other material support work against the kind of speed that is so badly needed.


Getting an upper hand on the ebola virus?


As the year concluded, four important lessons could be drawn from liberiaвђ™s experiences with the ebola virus.


First, lofa county, which reported no new cases since early november, demonstrated the feasibility of вђњbending the curveвђќ and defeating the virus вђ“ even in heavily affected areas with intense transmission.


Second, intensification of technical interventions, like increased laboratory capacity, more treatment beds, and a larger number of contact tracing and burial teams, will not bend the curve in the absence of community engagement and ownership.


Third, with the right support, a country can permanently improve its capacity to collect and report health-related data, even under the demanding pressures of a severe outbreak. At year-end, laboratory capacity had improved, in less than three months, to the point where all probable and suspected cases were being tested, with the results promptly reported.


Finally, strong, hands-on, and frequently courageous support from the countryвђ™s president helped match the severity of the disease with forceful вђ“ though sometimes controversial вђ“ control measures. President sirleaf also undertook numerous field visits to severely affected areas to show citizens the level of her engagement and concern.


This leadership helped coordinate the activities of a large number of partners, including US government agencies and military personnel, supporting the response effort.


A presidential task force on the ebola response, which brought partners and donors together with senior government officials and civil society leaders, was established on 26 july and functioned through the end of september, when it was replaced by a presidential advisory committee on ebola, or PACE, again chaired by the president. Additional task forces operated in each county to tailor the response to local needs and keep partners working in tandem.


In a worrisome trend, six health care workers were infected nationwide during the first week of december, of whom three died. An investigation was launched to determine how staff were getting infected and what additional protective measures were needed.


At year-end, despite imperfections in the surveillance and reporting systems, evidence indicated that liberia вђ“ which long showed the most explosive transmission вђ“ was getting an upper hand on the virus.





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