UN: We botched response to the Ebola outbreak
Oct. 17, 2014
LONDON (AP) — In a draft document, the World Health Organization has acknowledged that it botched attempts to stop the now-spiraling Ebola outbreak in West Africa, blaming factors including incompetent staff and a lack of information.
In the document obtained by The Associated Press, the agency wrote that experts should have realized that traditional infectious disease containment methods wouldn't work in a region with porous borders and broken health systems.
"Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall," WHO said in the document. "A perfect storm was brewing, ready to burst open in full force."
The U.N. health agency acknowledged that, at times, even its own bureaucracy was a problem. It noted that the heads of WHO country offices in Africa are "politically motivated appointments" made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan.
WHO is the U.N.'s specialized health agency, responsible for setting global health standards and coordinating the global response to disease outbreaks.
The document — a timeline on the Ebola outbreak — was not issued publicly but the AP was told the health agency would be releasing it earlier this week. However, WHO officials said in an email Friday that the timeline would now probably not be released publicly. No official at the agency would comment Friday on the draft report.
Dr. Peter Piot, the co-discoverer of the Ebola virus, agreed in an interview Friday that WHO acted far too slowly, largely because of its Africa office.
"It's the regional office in Africa that's the front line," he said at his office in London. "And they didn't do anything. That office is really not competent."
WHO's other regional directors — the Americas, Southeast Asia, Europe, Eastern Mediterranean and the Western Pacific — are also not accountable to Geneva and are all elected by their regions.
Piot, director of the London School of Hygiene and Tropical Medicine, also questioned why it took WHO five months and 1,000 deaths before the agency declared Ebola an international health emergency in August.
"I called for a state of emergency to be declared in July and for military operations to be deployed," Piot said. But he said WHO might have been scarred by its experience during the 2009 swine flu pandemic, when it was slammed for hyping the situation.
In late April, during a teleconference on Ebola among infectious disease experts that included WHO officials, Doctors Without Borders and the U.S. Centers for Disease Control and Prevention, questions were raised about the performance of WHO experts, as not all of them bothered to send Ebola reports to WHO headquarters, according to the draft document.
In the timeline, WHO said it was "particularly alarming" that the head of its Guinea office refused to help get visas for an expert Ebola team to come in and that $500,000 in aid was being blocked by administrative hurdles. Guinea, along with Sierra Leone and Liberia, is one of the hardest-hit nations in the current outbreak, with 862 deaths so far blamed on Ebola.
The Ebola outbreak already has killed 4,546 people in West Africa out of at least 9,191 cases. WHO says within two months, there could be new 10,000 cases of Ebola every week unless stronger measures to fight the outbreak are put into place.
When Doctors Without Borders began warning in April that the Ebola outbreak was out of control, a dispute on social media broke out between the charity and a WHO spokesman who insisted the outbreak was under control.
At a meeting of WHO's network of outbreak experts in June, Dr. Bruce Aylward, normally in charge of polio eradication, alerted Chan about the serious concerns being raised about WHO's leadership in West Africa. He wrote an email that some of the agency's partners — including national health agencies and charities — believed the U.N. agency was "compromising rather than aiding" the response to Ebola and that "none of the news about WHO's performance is good."
Five days later, Chan received a six-page letter from the agency's network of experts, spelling out what they saw as severe shortcomings in WHO's response to the deadly virus.
"This (was) the first news of this sort to reach her," WHO said in the draft document. "She is shocked." In the following weeks, the WHO country office heads in Guinea, Liberia and Sierra Leone were all replaced.
Other experts said it was impossible to predict that the initial Ebola cases in Guinea would spark the biggest-ever outbreak of the lethal disease.
"There were a lot of mistakes made by WHO but a lot of the best public health minds would have thought we could handle this in July," said Michael Osterholm, an infectious diseases expert at the University of Minnesota.
"By the time we realized how bad things were, the genie was already out of the bottle," he said.
Osterholm said the U.N. health agency was far from the only organization to blame.
"If we fault WHO for the early dropping of the ball, the whole world has dropped the ball in some sense," he said. "Nobody is to blame because everybody is to blame."
Meanwhile, Ebola has sent food prices soaring, hurting people's ability to feed themselves in the three nations hardest hit by the outbreak, the World Food Program said Friday.
Spokeswoman Elisabeth Byrs told the AP that food shortages, panic-buying and hoarding have driven up food prices by an average 24 percent in Sierra Leone, Guinea and Liberia. The price of cassava, a key staple, doubled in Liberia's capital of Monrovia between July and August, she said.
In one hopeful note, WHO reported Friday that Senegal, which had only one case of Ebola, was now free of the disease.