The medical organization that sounded the first alarm about the deadly outbreak of Ebola virus in West Africa last year has once again blasted the United Nations World Health Organization (WHO) for refusing to recognize the epidemic’s magnitude, downplaying its rapid spread, and failing to take the lead in the battle against the disease even after it was well under way.
Moreover, “the flexibility and agility for a fast, hands-on emergency response still does not sufficiently exist in the global health and aid systems,” warns Joanne Liu, president of Medicins Sans Frontieres/Doctors Without Borders (MSF) the front-line, private medical relief organization that first warned of the fast-growing Ebola disaster a year ago this month.
Even though WHO has since voted to reform some of its torpor, she says that putting the U.N. organization on an efficient and effective footing will not “happen overnight.”
In response to the MSF accusations, a WHO spokesman told Fox News that MSF had offered “several criticisms that WHO has already acknowledged and has taken action to address,” pointing to a series of measures the organization had passed at a special session of the organization’s supervising Executive Board in January 2015.
Despite his acknowledgment that MSF had a point, the WHO spokesman also declared that the U.N. agency’s response to the initial Ebola crisis was “robust,” but that “the world, including WHO, was too slow to see what was unfolding before us.”
Liu’s comments are part of a first-anniversary retrospective on the Ebola disaster published by MSF on Sunday. In it, the organization warns that the West African epidemic is not over: even though the extent of the disease has dramatically abated, “the overall number of cases in the region is still fluctuating and has not significantly declined since late January.”
“Ebola is not over until there are zero cases in the region for a period of 42 days,” MSF declares.
“The flexibility and agility for a fast, hands-on emergency response still does not sufficiently exist in the global health and aid systems.”
– Joanne Liu, president of Medicins Sans Frontieres/Doctors Without Borders (MSF)
According to a March 20 U.N. update, there were six new cases of Ebola in Sierra Leone the previous day.
Overall, the update says, there have been 24, 743 “confirmed, probable and suspected ” Ebola cases in Guinea, Liberia and Sierra Leone — the three worst-affected countries — since the outbreak began, and 10,206 reported deaths.
That toll includes nearly 500 health workers, including 14 members of MSF’s own staff.
One important reason for the massive flowering of the fast-moving, high-fatality virus –the biggest eruption of Ebola ever — was the inaction and ineptitude of WHO, MSF charges.
According to the MSF retrospective, WHO’s negative role went beyond foot-dragging to actually fighting against the warnings first voiced by the voluntary organization, and included accusations that MSF was causing “unnecessary panic.”
Some of WHO’s alleged torpor was due to pressure from governments in the afflicted countries, who are part of WHO’s basic membership, the volunteer agency observed. But even that is less an excuse than a description of how the international medical organization works. “Realistically,” MSF says, “few member states have any interest in empowering an outside international body to respond to epidemics in their territories.”
Eventually, however, the governments themselves were overwhelmed by the catastrophe, and the full extent of the disaster was formally recognized in June 2014. But, by that time, more than 1,000 people had died.
“For months, ill-equipped national health authorities and volunteers from a few private aid organizations bore the brunt of care in this epidemic,” MSF president Liu says. “There is something profoundly wrong with that.” (MSF does not accept aid from governments.)
Even when awareness began to spread along with the disease, MSF says, WHO failed to provide much-needed information-sharing between stricken countries that would have helped turn the tide more quickly, even after millions of dollars worth of aid started pouring in.
“Meetings happened. Action didn’t,” says Marie-Christine Ferir, who presented MSF’s analysis of the epidemic and response to a session in Geneva of WHO’s Global Alert and Outbreak Response Network, which is supposed to coordinate the international response to epidemic outbreaks.
According to the MSF retrospective, “there was a clear lack of leadership from the WHO: decisions on setting priorities, attributing roles and responsibilities, ensuring accountability for the quality of activities, and mobilizing the resources necessary were not taken on the necessary scale.”
WHO’s response to questions from Fox News about the MSF accusations claimed that the first reports of the outbreak were published on the U.N. agency’s website in late March 2014, and that WHO rapidly mobilized laboratories and interdisciplinary teams to determine the extent of the outbreak.
Quoting extensively from a speech given by WHO’s Director General, Margaret Chan, at the reform session in January 2015, the spokesman blamed “factors of culture, history, geography, and weak road and health infrastructures” for a “mix of opportunities that the virus quickly exploited.”
The WHO measures adopted at its January session took the form of an 11-page resolution that, among other things, called on Director General Chan to “review the system for nomination, selection, training,” and performance evaluation of WHO’s in-country representatives, as well as “immediately” create a new series of international emergency response teams.
In a time-honored bureaucratic response to accusations of failure, Chan soon thereafter appointed a panel of “outside independent experts” to undertake an assessment on all aspects of WHO’s response during the Ebola outbreak. The panel, headed by a former chief executive of the relief agency Oxfam, is scheduled to report in May.
MSF argues that most of the rapid response in the early stages of the Ebola crisis came from private organizations like MSF and the U.S. relief organization Samaritan’s Purse, adding that attention in the rest of the world only began focusing after U.S. relief workers began to be infected with the disease.
Eventually, the response began to move faster: WHO’s top Africa bureaucrat left his job and the U.N. Security Council got involved. Secretary General Ban Ki-moon appointed a special U.N. Mission for Ebola Response, and the Obama administration pledged billions for Ebola and other forms of emergency medical relief.
But even then, MSF warned at the time, the response was often aimed at the wrong places, many areas were not getting help, and U.N. coordination was less than advertised.
Yet for all of WHO’s blunders, resistance and apparent ineptitude, MSF says the U.N. organization shouldn’t take all the blame: “It would be a mistake to attribute full responsibility for the dysfunctional response to just one agency.”
“World leaders cannot turn their backs on health crises in the hope that they remain confined to poor countries far away,” MSF concludes. “It is to everyone’s benefit that lessons be learned from this outbreak, from the weakness of health systems in developing countries, to the paralysis and sluggishness of international aid.”
So far, the retrospective strongly implies, the lessons still haven’t sunk in.