WHO ‘failed’ in early Ebola response

The WHO is accused of underestimating the impact of Ebola

Poor communication and incompetent staff meant the World Health Organization failed to react swiftly Ebola outbreak in Africa, reports say.

An internal document said those involved “failed to see some fairly plain writing on the wall”, according to the Associated Press.

Separately, sources close to the WHO told Bloomberg of multiple failures in the outbreak’s early stages.

In response, a senior official told the BBC time would come for an inquiry.

In the worst affected countries – Liberia, Guinea and Sierra Leone – the Ebola virus has now killed 4,546 people with cases of infection numbering 9,191, according to the latest WHO figures.

‘Perfect storm’

The reports have brought into focus the way the WHO dealt with the outbreak in the months after it received the first reports of Ebola cases in Guinea in March.

Medical charity Medecins Sans Frontieres (MSF) warned in April that the outbreak was out of control – something disputed by the WHO at the time.



Sierra Leone boy whose relatives died of Ebola

Sierra Leone boy: “I’ve lost five members of my family”

“Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall,” the document obtained by AP says.

The draft document – a timeline of the outbreak – also reportedly says that experts should have realised that traditional methods of containing infectious disease would not work in a region with porous borders and poor heath systems.

Among the problems cited in the information obtained by AP and Bloomberg are:

  • A failure of WHO experts in the field to send reports to WHO headquarters in Geneva
  • Bureaucratic hurdles preventing $500,000 reaching the response effort in Guinea
  • Doctors unable to gain access because visas had not been obtained

‘Focus’

Responding to the allegations, the WHO’s head of global response and alert, Isabelle Nuttall, told the BBC: “Time will come for investigation. Right now we have to focus on the response [to Ebola].”

Head of global response and alert at the WHO, Isabelle Nuttall, 16 October 2014“By June it became something different”, says Dr Nuttall

On the alleged failure of the WHO to react quickly enough, she said the disease had, up till then, not been common in West Africa, only in Central Africa.

“When we scaled up, the beginning of the outbreak was very comparable to what we had seen elsewhere in Africa,” she said. “And then, by June, it became something different.”

“We indicated that this outbreak was different. I’m afraid we probably didn’t say it loud enough for the world to understand what we were saying and for all the international community to be mobilised.”

Earlier, WHO Director General Margaret Chan told Bloomberg that she was “not fully informed of the evolution of the outbreak” and response may not have matched the “scale” and “complexity” of the spread.

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A medical worker dons protective gear before entering an Ebola treatment centre in Freetown, Sierra Leone - 16 October 2014The World Health Organization is ramping up efforts to stop Ebola from spreading elsewhere in Africa

Analysis: Imogen Foulkes, BBC News, Geneva

The combination of a leaked internal document and frank comments from the WHO’s director general signal growing concerns about the effectiveness of the agency’s efforts against Ebola.

Back in April MSF described the outbreak in West Africa as unprecedented, warning that it risked spiralling out of control.

The WHO responded that it had seen only sporadic cases, in a limited geographic area. It was not until August that the organisation suggested international reaction to Ebola may have been too slow.

Perhaps WHO officials feared accusations of overreacting: in 2009 the organisation swiftly declared a global pandemic of swine flu, advising countries to spend billions on treatments and vaccines against a virus which caused far fewer deaths than regular seasonal flu.

There are allegations too that the WHO’s regional office in Africa may be part of the problem, that its staff failed to properly monitor West Africa’s Ebola outbreak: we now know it began in December, but the first cases were not notified until March.

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‘Ridiculous’

Earlier, MSF said international pledges of deployments and aid for Africa’s Ebola-hit regions had not yet had any impact on the epidemic.

MSF’s Christopher Stokes said the disease was still out of control.



Medecins Sans Frontieres sign

Christopher Stokes: “[The crisis] has never been under control”

He said it was “ridiculous” that volunteers working for his charity were bearing the brunt of care in the worst-affected countries.

Mr Stokes, who leads MSF’s Ebola response, said international efforts would not have any effect for another month and a half.

MSF runs about 700 out of the 1,000 beds available in treatment facilities Liberia, Sierra Leone and Guinea.

The BBC’s Mark Doyle, at the UN Ebola logistics base in Ghana, says it is generally agreed that at least three times that number are needed.

Donors have given almost $400m (£250m) to UN agencies and aid organisations, following an appeal launched in September for $988m.

Separately, the UN is seeking $1bn for an Ebola trust fund, to provide a flexible source of back-up money to contain Ebola.

But UN Secretary General Ban Ki-moon on Thursday made another urgent appeal, saying the trust fund had received only $100,000 – from Colombia – though $20m has been pledged.

Meanwhile, the WHO has announced that Senegal is now officially free of Ebola, as it has gone 42 days without any sign of the virus.

There was one confirmed case of Ebola in the country, in late August, and the patient survived.

In other developments:

  • President Obama named Ron Klain – former chief of staff to Vice President Joe Biden – as Ebola “tsar” in charge of combating the virus in the US
  • A US healthcare worker who may have come into contact with Ebola victim Thomas Eric Duncan is on a cruise ship in the Caribbean and has voluntarily isolated herself in her cabin
Graphic showing pledges in fight against Ebola - 16 October 2014

Calls for more aid have also been made in recent days by Mr Obama, UK PM David Cameron, and World Bank President Jim Yong Kim.

The US, UK and France are among countries spearheading the aid effort, with the UK committing £125m ($200m) to Sierra Leone.

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How not to catch Ebola:

  • Avoid direct contact with sick patients as the virus is spread through contaminated body fluids
  • Wear goggles to protect eyes
  • Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
  • People who recover from Ebola should abstain from sex or use condoms for three months

Ebola basics: What you need to know

How Ebola attacks

What virus has hit – in maps

Uncertainty over figures

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