WHO under fire over Ebola response

Staff of Médecins sans frontière’ carry the body of a person killed by Ebola at a treatment centre in Guinea. PHOTO BY AFP

What you need to know:

The disease has killed 4,877 people.Most of the victims died in Guinea, Liberia and Sierra Leone.

Geneva- The World Health Organisation (WHO) is the world’s biggest and most important health body.

There is no question that it has had some major successes: it has ensured that millions of children worldwide are free from polio.
It runs programmes aimed at combating HIV/Aids, malaria and tuberculosis, among others.

But when it comes to a sudden new health threat, or a danger in an unexpected region, many say the WHO does not really deliver.

The 2009 swine flu pandemic is, it is claimed, a case in point.
When the first cases of a new flu virus were reported in Mexico City, the WHO had already been preparing for a global influenza pandemic with many experts suggesting it could be as devastating as the post-World War One Spanish flu.

There were reasons for the fears. Medical historians knew that a serious flu pandemic could be expected once in a generation.

Furthermore the H1N1 “bird flu” virus did have a high mortality rate, although it had not shown much ability to spread from human to human.
So by 2009 the WHO had a huge “pandemic preparedness” plan, and when swine flu appeared, it swung into action.

A global pandemic was declared and pharmaceutical companies fast-tracked billions of doses of a new vaccine. Many countries diverted their public health budgets to buy a dose for every single member of the population.
The problem was, swine flu was not the major global health threat the WHO had been preparing for.

“What we experienced in Mexico City was a very mild flu which did not kill more than usual,” said German epidemiologist Wolfgang Wodarg in 2010.
But the voices raising doubts went largely unheard. The WHO’s pandemic preparedness had been long in the planning and, once up and running, seemed unstoppable.

And the very planning that went into preparing for an influenza pandemic seems to have worked against WHO during West Africa’s Ebola outbreak.
Although a flu pandemic was expected, Ebola was most definitely not expected in Liberia, Guinea or Sierra Leone. The virus had never been seen in West Africa before.

So when the first cases were reported in March there was no big WHO machine ready to roll. West Africa’s Ebola outbreak began in Guinea last December and seems to have gone almost unnoticed for three months.

“Nobody knew that Ebola would be possible in such parts of Africa,” said Dr Isabelle Nuttall, the WHO’s director of global capacities, alert and response.
“The speed of reaction was initially determined by the fact that the disease was not known to occur in this part of Africa,” she added.

But even if the WHO did not expect Ebola in West Africa, it did receive information, and warnings, from medical experts on the ground.

Medical charity Medecins Sans Frontieres (MSF) said on March 31 that Guinea was facing “an epidemic of a magnitude never before seen in terms of the distribution of cases in the country”.

MSF warned that the geographic spread of the cases indicated the epidemic would be very difficult to contain.

But just one day later, on April 1, the WHO’s senior communications officer, Mr Gregory Hartl, suggested that MSF was scaremongering.

“We need to be very careful about how we characterise something which is up until now an outbreak with sporadic cases. What we are dealing with is an outbreak of limited geographic area and only a few chains of transmission,” she said.

For the following three months, the WHO continued with that interpretation. Meanwhile media attempting to report the obviously spreading epidemic faced major hurdles.

The WHO’s regional headquarters in Africa issued irregular online statements as to new cases and death tolls, which were often not confirmed by WHO headquarters in Geneva for several days.

Calls to communications officers went unanswered, their voicemail boxes were full.

Only in June did the WHO call a meeting of its Global Outbreak Alert committee, and only then, it seems, did WHO Director General Margaret Chan take a long hard look at the situation and said she was “very unhappy” at what she had discovered.
Despite her dissatisfaction, it still took the WHO until August to declare Ebola to be a health emergency.

Today, although Nigeria has just been declared Ebola free, the epidemic is still raging in Guinea, where it began, in Liberia and Sierra Leone.

WHO admits there is no sign it is even close to being brought under control and almost 10 months after it first began this outbreak has claimed at least 4,877 lives - more than three times the death toll from previous outbreaks put together.