WHO's slow response to 2015 Ebola outbreak had devastating consequences, can it be trusted in this pandemic?
Although President Donald Trump's decision to halt funding of the World Health Organization over its "role in severely mismanaging and covering up the spread of coronavirus" is drawing criticism from all across the globe, this is not the first time that the WHO has been blamed for botching up its response to a health crisis.
In 2015, a report published in The Lancet medical journal, by 20 experts convened by the Harvard Global Health Institute and the London School of Hygiene and Tropical Medicine, recommended that the organization be disbarred from its role in declaring disease outbreaks to be an international emergency after its delayed response to deadly Ebola virus which claimed the lives of over 11,000 people in West Africa in 2014.
According to the National Library of Medicine National Institutes of Health (NCBI), "a perfect storm of factors" contributed to the massive scale of outbreak at the time - things which were not properly apprehended by the WHO. "These factors included the unprecedented size of the outbreak, the lack of sufficiently trained personnel, limited resources, weak national health systems, the spread of the outbreak to urban settings, a time lag between the initial appearance of the pathogen and the reporting of it to the national and international communities, the highly porous international borders, mis-trust of government and health officials, the virus' first appearance in West Africa, an exodus of international health providers and a structural failure of global health governance," the NCBI stated.
The WHO was made aware of the Ebola outbreak in May 2014. Although it dispensed field epidemiologists to West Africa, who established initial response efforts such as contact tracing, laboratory support, and infection control mechanisms, many of them ended up breaking WHO protocols for disease outbreak management as they had little knowledge of the specifics Ebola as a virus.
After the second wave of Ebola outbreak hit the area, public pressure started to mount on the organization to contain the spread of the virus. Finally, on August 8, 2014, WHO finally declared Ebola a Public Health Emergency of International Concern (PHEIC), five months after the WHO first received information about the Ebola threat. By then, there were already 1711 cases and 932 deaths related to the virus.
“The most egregious failure was by WHO in the delay in sounding the alarm,” said Prof Ashish Jha, the director of the Harvard Global Health Institute, the Guardian reported. “People at WHO were aware that there was an Ebola outbreak that was getting out of control by spring … and yet it took until August to declare a public health emergency. The cost of the delay was enormous.”
Following its incapacity in containing the outbreak just a month after declaring it a PHEIC, the WHO was forced to reach out to the United Nations for help and the UN Mission for Ebola Emergency Response (UNMEER) was created.
According to its website, "UNMEER, was established on September 19, 2014... UNMEER was set up as a temporary measure to meet immediate needs related to the unprecedented fight against Ebola. The Mission deployed financial, logistical and human resources to Guinea, Liberia and Sierra Leone to support the push to zero cases."
After widespread criticism, the WHO was forced to admit its own shortcomings. "The initial response was slow and insufficient, we were not aggressive in alerting the world, our surge capacity was limited, we did not work effectively in coordination with other partners, there were shortcomings in risk communication, and there was confusion of role and responsibilities at the three levels [Headquarters, Regional Office and Country Offices] of the organization," it said in a statement in 2015.
Following its botched response to Ebola, WHO's former Director-General Dr Margaret Chan announced a new program that will deal with health emergencies, at the World Health Assembly, which is the organization's annual decision-making meeting. The program, she said, will coordinate with a global health emergency workforce that could quickly deploy into the field. "I do not ever again want to see this organization faced with a situation it is not prepared, staffed, funded or administratively set up to manage," she said, CNN reported.
However, the WHO's response to the coronavirus outbreak differed vastly from its handling of the Ebola virus. Tolbert Nyenswah, a senior research associate at the Johns Hopkins Bloomberg School of Public Health pointed out that the global health body “made a very positive move” declaring a (PHEIC) within weeks of China’s acknowledgment of coronavirus outbreak last December.
It also followed the declaration with the creation of a global response plan calling for $675 million in donor funding targeted toward fighting the virus.
Dr Tom Frieden, former director of the US Centers for Disease Control and Prevention and now president and CEO of the public health initiative Resolve to Save Lives, also stated that the WHO’s response to the coronavirus pandemic “has been much better than the Ebola response.”
“This is an unprecedented situation and the WHO is generally doing a good job,” Frieden told the Washington Diplomat.