Ebola failings expose need for urgent reform at WHO, panel finds
The World Health Organization's handling of the Ebola outbreak in West Africa was a failure because the agency wasn't capable of responding quickly and effectively, an independent panel says.
For future emergencies, the London-based panel on Tuesday called for member countries to fully finance a $100-million contingency fund to support the WHO's work.
"At present, WHO does not have the capacity or organizational culture to deliver a full emergency public health response," the panel's head, Dame Barbara Stocking, former chief executive of the charity Oxfam, and her co-authors said.
The panel called for a culture change at WHO for it to embrace its lead role in emergency response.
Stocking blamed WHO for trying and failing to manage the crisis through diplomacy instead of action.
Stocking's panel also suggested an intermediate alert level to sound the alarm earlier globally and dedicate resources to avert an escalation of the situation without declaring a full "public health emergency of international concern."
The Geneva-based WHO has been widely criticized for its response to the Ebola epidemic that has killed more than 11,000 people in Guinea, Liberia and Sierra Leone and for its early assurances that the disease was under control despite repeated warnings to the contrary by the humanitarian group Doctors Without Borders.
The disease began spreading in Guinea in December 2013. WHO's emergency declaration didn't come until August 2014.
The WHO said it has started to implement some of the recommendations such as a global health emergency workforce and contingency fund. In a statement, the agency said it agrees there needs to be better integration between its emergency and humanitarian responses.
Engage communities
Canadian Dr. Joanne Liu, international head of Doctors Without Borders, said the focus needs to remain on ending the outbreak by engaging communities in the affected countries.
"It's been a roller coaster this whole epidemic. We went from global indifference to global fear and then finally a global response that was a bit late," Liu said of the panel's report from Geneva.
While Liu noted that the panel credited WHO on researching experimental treatments, she's focused on how about 20 new cases a week continue to fall through the cracks without knowing who they contracted the illness from or how.
"My concern is … we look into tailoring the response to the next epidemic through the lens of security and not putting the needs of the population of the affected communities at the forefront."
Dr. Allison McGeer helped health officials on the ground in Liberia and is director of infection control at Toronto's Mount Sinai Hospital.
McGeer said the WHO isn't set up for functions like running a hospital but was forced to do so.
"It's not WHO's fault. It's not that they were supposed to do something and didn't. It's that we as a global community didn't have the capacity to manage this kind of outbreak," McGeer said.
Bioethics Prof. Ross Upshur of the University of Toronto was a member of WHO's ethics group for experimental Ebola therapies and vaccines.
"The WHO has taken the bulk of the criticism, but there's plenty to share because we do not have a co-ordinated global health strategy," Upshur said.
Had the WHO assessed the situation and responded immediately, then problems such as distrust of authorities, poor burial practices and messages about getting treatment could have been handled sooner, Upshur said.
