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Politics, Bureaucrats Slowed WHO’s Ebola Response, Report Says

Image: Rose Johnson’s family

Rose Johnson’s family got word of her death from an acquaintance who saw her bed being cleared for another patient. Here, her mother, Ethel Konneh, is consoled by her other daughters outside a Monrovia clinic. Jerome Delay / AP

The World Health Organization bungled its response to the growing epidemic of Ebola in West Africa by relying too much on slow diplomacy and an over-sensitivity to local politics, a new report says.

But the countries themselves acted slowly, and the report also places blame on world governments as a whole, which have underfunded WHO and left it weak and inept.

“The Panel believes that this is a defining moment for the health of the global community. WHO must re-establish its pre-eminence as the guardian of global public health; this will require significant changes throughout WHO,” the report from an independent, international panel reads.

“The world simply cannot afford another period of inaction until the next health crisis.”

“The world simply cannot afford another period of inaction until the next health crisis.”

WHO officials have admitted several times they were too slow to act when Ebola started to spread in Guinea, Sierra Leone and Liberia. It’s now infected more than 27,500 people and killed more than 11,000 of them.

Ebola is still spreading in all three affected countries, despite efforts to stamp it out, has wrecked economies and devastated what were already rickety health systems.

WHO didn’t declare a global health emergency for Ebola until August 8, months after a true epidemic had started.

"It was an escalation of incompetence all the way to the top," Oyewale Tomori, a member of the separate WHO Ebola Emergency Committee, told the Associated Press. He thought the report should have named names.

"Nowhere in the report was any recommendation made to sanction staff," Tomori said. "A system is not made of tables and chairs, it's made of people."

Liberia Fears Another Ebola Outbreak 0:36

WHO was too sensitive to internal politics, the report says. “In some instances, there was initial denial of both cases and the extent of the outbreak on the part of national authorities; there was also an understandable concern about the economic consequences of transparency,” it says.

“Politicians and media were not always helpful in explaining risk of disease and its transmission, and in some cases were irresponsible in their messaging,” it adds.

The panel’s report says the 2005 International Health Regulations, signed by 196 countries and considered a legally binding agreement, did not work.

“The Ebola crisis not only exposed organizational failings in the functioning of WHO, but it also demonstrated shortcomings in the International Health Regulations,” it says. “If the world is to successfully manage the health threats, especially infectious diseases that can affect us all, then the Regulations need to be strengthened.”

The regulations require all countries to intensify their internal monitoring for diseases and then report what they find, but most countries haven’t done it, the report finds.

“In violation of the Regulations, nearly a quarter of WHO’s Member States instituted travel bans and other additional measures not called for by WHO, which significantly interfered with international travel, causing negative political, economic and social consequences for the affected countries,” it adds.

"It was an escalation of incompetence all the way to the top."

WHO should be strengthened so it can identify health risks itself more quickly and declare health emergencies so aid can get rolling faster.

“The Panel considers that WHO does not currently possess the capacity or organizational culture to deliver a full emergency public health response,” the report says.

WHO says it’s working on some of the weaknesses.

“WHO is already moving forward on some of the panel’s recommendations including the development of the global health emergency workforce and the contingency fund to ensure the necessary resources are available to mount an initial response,” it said in a statement. It’s also, separately, called for countries and aid groups to help build up the health systems in West Africa and elsewhere.

“Outbreaks of contagious diseases can flare up anywhere,” said Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation.

“But the size of the Ebola outbreak in West Africa is directly related to the lack of resilience of the national health systems. In West Africa, the governments did not have the tools or resources to identify the initial cases or control the outbreak that resulted.”