UN Investigators Find Numerous Flaws With WHO’s Ebola Response

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May 11, 2015 – The World Health Organization is ill prepared to respond to international health emergencies and poorly managed the initial response to last year’s Ebola outbreak in West Africa, an independent team of investigators appointed by the UN has concluded.

The esteemed panel of investigators, in an interim report, said the WHO did not seek support early enough from other United Nations agencies that have experience in emergency response, did not engage with local communities early enough on changing behaviors that spread the disease, and its authoritative status was undermined by a combination of the above as well as fluffed communications including belatedly declaring Ebola a Public Health Emergency of International Concern.

“At present, WHO does not have the operational capacity or culture to deliver a full emergency public health response,” the investigators concluded. Among their recommendations are establishing a new agency for emergency health response or reforming WHO.

The latter is preferable, the investigators said, because “establishing a new agency would take time to put in place and substantial new resources would be required to establish its basic administrative systems, and operational response capacity.”

“A new agency would, in any case, have to rely on and coordinate with WHO for public health and technical resources, creating an unnecessary interface,” the report says. “A WHO that is capable of adequately responding to public health emergencies requires deep and substantial organizational change.”

Although WHO leads the health response cluster during humanitarian emergencies, the investigators write that “it is unclear…how a public health emergency fits into the wider humanitarian system and at what point an outbreak becomes a humanitarian emergency that requires a broader United Nations-wide response.”

They add that “one of the difficulties is that the risk assessment of public health emergencies and so-called humanitarian emergencies differs, because of uncertainty in assessing the likelihood of disease spread.”

Among other recommendations are that WHO should have used medical anthropologists for developing communications strategies for changing traditional burial and funeral practices that contributed to the spread of Ebola and that UN member states should increase their contributions to WHO so that it can effectively respond to public health emergencies.

“Now is the historic political moment for world leaders to give WHO new relevance and empower it to lead in global health,” the report concludes. “In response, the (WHO) Secretariat needs to take serious steps to earn this leadership role in relation to outbreaks and emergency response and to regain the trust of the international community.”

Full report is below.

Denis Fitzgerald
On Twitter @denisfitz

 

Ebola Interim Report on WHO Response