SARAH ZHANG | 11.22.15
IN THE EARLY days of the Ebola outbreak, the World Health Organization’s response was so lackadaisical it screwed up even the chlorine. The disinfectant doctors got was expired. The outbreak has since killed over 11,000 people, and three new cases flared up in Liberia this week—after officials had declared the country Ebola free. Twice.
To make sure that kind of thing never happens again, WHO is going to need major changes—including a new center dedicated to emergency outbreak response, and an independent commission that will hold the agency accountable for its actions. At least, those are the findings of a new report from international public health researchers, who say that the Ebola outbreak shouldn’t have gotten as bad as it did—and it was at least in part the aid agency’s fault.
“Ebola was really a wake up call,” says Suerie Moon, a public health researcher at Harvard and an author of the report. “If we don’t get together to make reforms after something as devastating as Ebola, you really have to wonder when we will.”
Researchers at Harvard and the London School of Hygiene & Tropical Medicine first convened the panel last year, at the height of the Ebola outbreak. “The WHO is too important to fail,” says Moon. But in this case, the organization was slow to recognize the problem of Ebola and slow to declare it a public health emergency. That meant that, early on, doctors on the ground lacked resources for equipment as basic as body bags.
The WHO has since gathered an independent panel of experts to investigate its response to Ebola. (The organization did not respond to requests for comment.)
The panel’s most ambitious recommendation is that the WHO needs independent oversight, like an Accountability Commission that reports to the United Nations Security Council.
Other recommendations include retooling WHO so it can be more nimble in emergency situations. The report recommends creating a dedicated center for outbreak response with a “protected budget” and a “politically protected” Standing Emergency Committee to declare emergencies. That language is deliberate—for emergency centers to respond quickly, they can’t be totally marginalized in between emergencies.
The authors also want the WHO to use its political sway to get individual countries in line, calling out countries who delay reporting outbreaks and commending ones that are transparent. Other international organizations can play a role, too. The World Bank, the report’s authors write, can offer emergency funds to countries with outbreaks to soften the economic blow.
Another section of the report deals with sharing scientific information about Ebola. By comparing the sequences of Ebola viruses from patients in different cities, geneticists can track its spread in near real time. Yet at the height of the Ebola epidemic, no one made virus sequences information publicly available for three months. Because gathering virus sequences during outbreaks is still somewhat new, there is confusion over who owns the data and, of course, the “ever present fear of getting scooped,” says Nathan Yozwiak, a geneticist at the Broad Institute who has worked on Ebola.
The report isn’t just about Ebola, the authors stress. “It’s about the next pandemic. It’s how we get ready for the virus we haven’t discovered yet,” says Ashisha Jha, director of Harvard Global Health Institute and another panelist. The outbreak revealed weak spots in the global health system, and now is the time to fix them. when we will.”