WHO says it has learned its lesson from Ebola response mistakes

A child looks at a man suspected of suffering from the Ebola virus, while holding his hand over his nose, in a main street and busy part in Monrovia, Liberia, Friday, Sept. 12, 2014.

In what was already generally accepted to be the case, the World Health Organization finally publicly admitted its failings in responding to West Africa’s Ebola crisis. A statement from the leadership of the U.N.’s health organization outlined just what the organization did wrong and what it must do to rectify its errors.

“[W]hen faced with an emergency of this scale, our current capacities and systems – national and international – simply have not coped,” admitted World Health Organization Director-General Margaret Chan, Deputy Director-General Anarfi Asamoa-Baah and all of the regional directors, in the joint statement.

The document lists in general terms some of the failings of the WHO in its Ebola response. Examples include poor coordination, the failings of the private sector and the need to be better positioned for future emerging crises.

“We have taken note of the constructive criticisms of WHO’s performance and the lessons learned to ensure that WHO plays its rightful place in disease outbreaks, humanitarian emergencies and in global health security,” said the officials.

Criticism has been cutting. The New York Times uncovered that reports of people with Ebola-like symptoms in Sierra Leone last march did not reach senior health officials. At the time, Ebola experts thought the outbreak that started in Guinea was winding down, as happened in past cases. The disease continued to spread in Sierra Leone unchecked, stemming from the two cases in March. From there things only got worse. And it was entirely avoidable.

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“We infer that the present epidemic is exceptionally large, not principally because of the biologic characteristics of the virus, but rather because of the attributes of the affected populations and because control efforts have been insufficient to halt the spread of infection,” wrote the WHO Ebloa Response Team in a projection published by The New England Journal of Medicine in October.

Doctors Without Borders is among the loudest critics of the WHO’s Ebola response. The emergency medical group was one of the first outside groups to join the front line. It wasn’t until June when the WHO made the necessary changes to coordinate between the three affected countries and the body was not as directly involved in the response as it should have been, said Doctors Without Borders in a report.

“When it became clear early on that it was not simply the number of cases that was creating concern, but indeed the epidemic’s spread, clear direction was needed and leadership should have been taken,” said Christopher Stokes, Doctors Without Borders general director, in the report. “The WHO should have been fighting the virus, not [Doctors Without Borders].”

The response exposed coordination gaps within the WHO and an overall inability to respond quickly and efficiently to a crisis. The need to reform was heard and a resolution to enact significant reforms was adopted by the 34 countries that make up the WHO’s executive board, WHO said. The reforms will help strengthen standards for countries disaster preparedness, as well as the WHO’s own ability to respond quickly.

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Recent signs show that the outbreak is slowing – particularly in Sierra Leone and Liberia. Guinea, with a smaller number of cases has seen some progress stall. With more than 10,000 deaths and 25,000 people infected, the outbreak that started in December 2013 had a massive impact on the three countries and the entire region of West Africa.

The lessons learned by the WHO, Doctors Without Borders and others must be put into action. Reforms at the WHO were welcomed by Doctors Without Borders, but there is a concern that they will not be in place when the next global health crisis hits.

“The flexibility and agility for a fast, hands-on emergency response still does not sufficiently exist in the global health and aid systems,” said Dr. Joanne Liu, Doctors Without Borders international president, in the report. “Lessons that should have been learned in the mass cholera epidemic in Haiti four years ago were not.”

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Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.