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THE EBOLA virus has not been eliminated from West Africa, but the public health crisis has eased. The virus, for which there is no ready cure, infected more than 27,000 people and caused more than 11,000 deaths since the outbreak began in early 2014. The pain and suffering have been immense. Now it is time to confront another hard problem: addressing the weaknesses in global response that allowed the virus to spread so rapidly. Without the urgency of another outbreak, national governments and the World Health Organization will be disinclined to change the way they do business. But change they must, or there will be another wave of disease, panic and unnecessary death.
The WHO’s lethargic response to Ebola in West Africa has brought calls for creation of a new organization that would have responsibility for emergency response. The belief in the need for rapid response to infectious disease has been gathering steam with a succession of outbreaks that spanned national borders: severe acute respiratory syndrome, or SARS; bird flu; swine flu; Middle East respiratory syndrome, or MERS; and Ebola virus disease. Although different in transmission, virulence and danger to people, all of these tested the ability of humankind to respond.
Now, a panel appointed by WHO Director General Margaret Chan has examined all aspects of the organization’s response to the Ebola outbreak and concluded that a new organization is not the right answer. The panel declared in a report that such an agency would take too much time to set up and be unnecessarily duplicative. Instead, the panel said, the WHO “must re-establish its pre-eminence as the guardian of global public health.”
This is a tall order, and the panel’s report explains why. A sea change in thinking and organization will be needed. The WHO “does not currently possess the capacity or organizational culture to deliver a full emergency public health response,” the panel stated. “There are no core funds for emergency response.” The WHO’s overall weakness in this field was underscored by the stark fact that it was not the WHO but rather Doctors Without Borders, a charity, that took the early lead in warning about Ebola and in battling the virus in West Africa.
The panel offered a host of valuable ideas for improvement, including creation of a WHO center for emergency response and a contingency fund to support it. The WHO says it is already working on the fund. The panel also pointed out that the WHO was slow in declaring a “public health emergency of international concern” because messages from the field about Ebola either “did not reach senior leaders or senior leaders did not recognize their significance.” A more sensitive early warning system is needed. The WHO is made up of member states, but they, too, performed poorly. Many have failed to implement stronger standards for public health adopted a decade ago with the goal of spotting and reporting local outbreaks that could become a global emergency. This neglect is irresponsible and could be repaid in deadly epidemics to come.