WHO delayed Ebola emergency declaration by 2 months – for political expedience

In October last year it was revealed that the complacency of the WHO African country heads (mainly political appointees) and who “seem to have been unwilling to even acknowledge that there was a problem on their turfs” had caused avoidable delays.

Now the Associated Press reports (NY Times) that the WHO leadership delayed declaring an emergency by 2 months for reasons of political expediency; to avoid upsetting some African countries, to avoid economic damage and to avoid any interruption to the annual Haj pilgrimage to Mecca. The emergency was declared on August 8th 2014 but from emails obtained by AP, it should have been declared 2 months earlier. That probably means that about 1000 deaths might have been prevented. The death toll from the outbreak is now estimated to have reached over 10,000.

Ebola deaths in West Africa (Data: WHO / Chart CC BY 4.0: JV Chamary / Source: http://onforb.es/1sCVxE1)

The Hindu:

Among the reasons the United Nations agency cited in internal deliberations – worries that declaring such an emergency akin to an international SOS could anger the African countries involved, hurt their economies or interfere with the Muslim pilgrimage to Makkah. ….. 

In public comments, WHO Director-General Margaret Chan has repeatedly said the epidemic caught the world by surprise. ……

But internal documents obtained by AP show that senior directors at the health agency’s headquarters in Geneva were informed of how dire the situation was early on and held off on declaring a global emergency. Such an alert is meant to trigger a surge in outside help, or, as a WHO document put it, “ramps up political pressure in the countries affected” and “mobilizes foreign aid and action”.

When WHO experts discussed the possibility of an emergency declaration in early June, one director viewed it as a “last resort”.

The delay in declaring an emergency was one of many critical problems that hobbled the agency’s ability to contain the epidemic. When aid agency Doctors Without Borders warned Ebola was spiralling out of control, WHO contradicted it, even as WHO’s own scientists called for backup. When WHO did send staffers to Africa, they were of mixed calibre. Fellow responders said many lacked Ebola experience; one WHO consultant who got infected with Ebola broke his own agency’s protocol, putting others at risk and getting WHO kicked out of a hotel, the AP found.

……..  The vacuum of leadership at WHO was so damaging the U.N. created the Mission for Ebola Emergency Response to take over the overall fight against the disease.

….. By the time WHO declared an international emergency, nearly 1,000 people were already dead. Overall, more than 10,000 are thought to have died in the year since the outbreak was announced.

NYT: 5 Key Findings

1. WHO officials privately floated the idea of declaring an international health emergency in early June, more than a month before the agency maintains it got its first sign the outbreak merited one — in late July — and two months before the declaration was finally made on August 8, 2014.

2. WHO blamed its slow response partly on a lack of real-time information and the surprising characteristics of the epidemic. In fact it had accurate field reports — including scientists asking for backup — and it identified the unprecedented features of the outbreak. The agency was also hobbled by a shortage of funds and a lack of clear leadership over its country and regional offices.

3. Politics appear to have clouded WHO’s willingness to declare an international emergency. Internal emails and documents suggest the U.N. health agency was afraid of provoking conflict with the Ebola-stricken countries and wary that a declaration could interfere with the economy and the Muslim pilgrimage to Mecca.

4. An Ebola-infected WHO consultant in Sierra Leone violated WHO health protocols, creating a rift with Doctors Without Borders that was only resolved when WHO was thrown out of a shared hotel.

5. Despite WHO’s pledges to reform, many of the proposed changes are recycled suggestions from previous outbreaks that have never taken hold. Any meaningful reform to the organization would likely require countries to rewrite the constitution, a prospect many find unpalatable.

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