One year ago, the Ebola virus broke out for the first time in West Africa. Now, at least 24,000 cases and 10,000 deaths later, the worst-ever Ebola epidemic seems to be finally subsiding, though it is far from over. There are still more new cases per week than in any previous epidemic and Liberia, which briefly seemed to be free of the virus, .
The first assessments of what allowed Ebola to spin out of control in Guinea, Liberia and Sierra Leone are now trickling in. Fingers, unavoidably, are pointing at the World 午夜福利1000集合 Organization. But a closer analysis shows the story is one of a dysfunctional international health system which the WHO has neither the means nor the power to lead, especially without support from national governments. That doesn鈥檛 bode well for future outbreaks.
In a , the aid group M茅decins sans Fronti猫res, which provided most of the medical care in the outbreak, says the WHO鈥檚 lack of leadership prompted the United Nations to set up an emergency unit to manage the Ebola response, the first of its kind for a public health issue. MSF called the outbreak 鈥渦nprecedented鈥� on 31 March, because it had already spread so far, only to be contradicted by the WHO.
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Treading too carefully
The WHO seems to have been trying to avoid alienating the affected countries, whose cooperation the organisation needed to tackle the outbreak at all. An criticises the WHO for not declaring a Public 午夜福利1000集合 Emergency of International Concern, earlier than August. Leaked WHO show it knew in mid-April that known cases were the 鈥渢ip of an iceberg鈥� and 鈥渨e need to change strategy urgently鈥�.
Declaring an international public health emergency was suggested in early June. But a leaked email from Sylvie Briand, WHO head of epidemics, , as affected countries could 鈥渨ithdraw鈥� and 鈥渋mperil鈥� open communications with the WHO.
In another leaked email a week later, WHO expert Pierre Formenty to 鈥渞eassure expatriates working in the mining industry鈥� and prevent Saudi Arabia banning Guineans from the Hajj pilgrimage.
MSF says it told a high-level WHO meeting in June that it had reached its capacity in terms of the number of people it was able to care for 鈥� but if more resources could be committed, the Liberian outbreak could still be halted. 鈥淭hese warnings were again ignored, with horrendous consequences,鈥� the report states.
Hidden epidemic
MSF also blames the rest of the world for sending little help, especially medical staff, until cases were diagnosed in the US and Spain 鈥� something declaring an international public health emergency could have accelerated.
It also says a 鈥渉idden epidemic raged in Sierra Leone until May鈥� and reignited the epidemic in neighbouring countries after controls had started beating it. MSF partly blames researchers from , a US biomedical company, working in Sierra Leone before the outbreak started.
It says they refused to share surveillance information when MSF arrived in Sierra Leone in late April after the country had confirmed its first Ebola case, and found that in fact, 鈥渃ases were everywhere鈥�.
Once again, the stumbling block seems to have been a lack of government openness. A Metabiota spokesman says the company 鈥渋s not authorised to share any results in Sierra Leone to parties other than official government health authorities鈥�.
