Guinea may be rich in minerals but it is among the countries in the world with the lowest human development and the poorest population. Guinea is in a transition phase to democratic rule and its socio-economic prospects are bleak. Since the 1990s, the country has hosted up to half a million refugees from neighbouring Sierra Leone and Liberia, most of whom have now returned home. The country continues to be plagued by inter-ethnic violence and political instability. Violent clashes in the southeastern N’Zerekore region left 100 people dead in July 2012. The resource-strapped health authorities do their best to contain the widespread epidemics and waterborne diseases such as cholera. In 2012, a cross-border cholera outbreak affected the coastal region infecting 8 000 Guineans and leaving 100 dead. In 2013, very high malnutrition rates have been recorded in the eastern region of Kankan, bordering Mali.
The European Commission has been involved in the fight against epidemics such as meningitis, yellow fever and especially cholera at a regional level. As cholera is on the rise in West Africa where 100 000 people are affected each year, the European Commission's Humanitarian Aid and Civil Protection department (ECHO) has devised a regional strategy which was piloted in Guinea as of 2009. This strategy supports a so-called ‘shield & sword’ approach across the region whereby prevention measures are coupled with early detection, response and treatment so as to halt the spread of cholera outbreaks. This includes an investment in cross-border epidemiological surveillance and building the capacity of the health authorities. The reasonable success in curbing the 2012 cholera epidemic in Guinea is now serving as an example for similar approaches elsewhere. ECHO also plays an advisory role with regard to the attribution of EU funds aimed at preventing conflict related to competition for land and resources.