Sunday, January 25, 2015

WHO mulls reforms to repair reputation after bungling Ebola; must guard against donor fatigue/ AP, BBC, Businessweek

From the AP:
GENEVA — The World Health Organization is debating how to reform itself after botching the response to the Ebola outbreak, a sluggish performance that experts say cost thousands of lives.
On Sunday, WHO's executive board planned to discuss proposals that could radically transform the United Nations health agency in response to sharp criticism over its handling of the West Africa epidemic. 
"The Ebola outbreak points to the need for urgent change," said Dr. Margaret Chan, WHO's director-general. She acknowledged that WHO was too slow to grasp the significance of the Ebola outbreak, which is estimated to have killed more than 8,600 people, mainly in Guinea, Liberia and Sierra Leone.
Critics say the kinds of reform being debated are long overdue.    
"The groundswell of dissatisfaction and lack of trust in WHO over Ebola has reached such a crescendo that unless there is fundamental reform, I think we might lose confidence in WHO for a generation," said Lawrence Gostin, director of the WHO Collaborating Center on Public Health Law and Human Rights at Georgetown University...
But fear not.  WHO already has the solution: send money. From Bloomberg Businessweek:
The World Health Organization proposed creating a special fund to respond to outbreaks such as Ebola and the establishment of a global health emergency workforce after the organization acknowledged mis-steps in its response to the epidemic.    
The WHO’s executive board agreed “in principle” to establish a contingency fund in a draft resolution at a meeting in Geneva Sunday. Director General Margaret Chan should take “immediate steps” to establish a public-health reserve workforce that can be promptly deployed in response to health emergencies, the board said.    
The WHO was too slow to respond to the Ebola outbreak, which it says has killed 8,675 people in Liberia, Sierra Leone and Guinea. The epidemic highlights the need for “urgent change” at the United Nations agency, Chan said in opening remarks to the board meeting.     
The WHO “did not have the systems and capacities in place to respond to a health emergency that was both severe and sustained,” Chan said...
But why did WHO deny Ebola was a major problem for 3 months after it had been notified of the outbreak? Isn't that the biggest problem for WHO to understand and fix, wrt future outbreaks, both at WHO offices in Africa and Geneva? 

Ebola appears to be halting, and the West doesn't even know why. This is something WHO ought to be on top of, since it signifies major gaps in understanding of Ebola spreads, and appears now to be controlled by nature!  (Are the bulk of exposed but unaffected Africans immune from inapparent infections?  Are they genetically protected?)

But instead of focusing on why the epidemic rapidly flared and as rapidly is extinguishing, WHO has other concerns, like the dreaded donor fatigue. From BBC:
...Liberia announced on Friday that it was down to just five confirmed (Ebola) cases - there were 500 a week in September. Guinea and Sierra Leone have both also experienced falls in infection rates.
Dr Chan said the worst-case scenario had been avoided, but warned: "We must maintain the momentum and guard against complacency and donor fatigue."

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