A panel of global health experts has strongly criticized the World Health Organization, saying it mishandled the response to the Ebola outbreak in West Africa.
The panel, convened by Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine, called for extensive reform in the way infectious diseases are managed around the world, but singled out the WHO in particular for criticism.
“The most egregious failure was by WHO in the delay in sounding the alarm,” said Ashish K. Jha, director of the Harvard Global Health Institute. “People at WHO were aware that there was an Ebola outbreak that was getting out of control by spring… and yet, it took until August to declare a public health emergency. The cost of the delay was enormous,” Jha said.
In a statement to CNN, Dr. Margaret Harris, spokeswoman on Ebola for the WHO, said the organization welcomed the report and was reviewing its recommendations carefully, along with those provided by other groups.
“A number of its recommendations cover work that is already being done — including steps set in place by WHO in early 2015,” she said. “It is gratifying to see that there is consensus of thought on many of these key issues.”
The long-delayed and problematic international response to the outbreak resulted in needless suffering and death, social and economic havoc, and a loss of confidence in national and global institutions,” wrote the panel of experts convened by the Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine.
The panel called for countries to build stronger outbreak detection and response systems and mechanisms to track progress. The WHO should publish lists of countries that delay reporting an outbreak or those that implement trade and travel restrictions without scientific justification, the panel said. A new global health committee within the United Nations Security Council would put major health threats on the radar of top political officials and review trade and travel restrictions.
The panel said its recommendations are meant to counteract systemic problems such as political disincentives, lack of investment and poor accountability that led an outbreak that started in a Guinean village nearly two years ago to spin out of control.
“This epidemic has really exposed the fault lines in national and international systems,” said Peter Piot, director of the LSHTM and chair of the panel.
Ebola could be a game-changer much like HIV/AIDS, which “created global health,” bringing scientists and human-rights activists together, Dr. Piot said.
Some of the changes would be relatively easy to implement or don’t cost much, while others require strong political leadership, Dr. Piot said.
The WHO said in a statement that it is reviewing the recommendations as well as those made in reports by other panels. “A number of its recommendations cover work that is already being done—including steps set in place by WHO in early 2015,” the agency said. “It is gratifying to see that there is consensus of thought on many of these key issues, but some will need further review and discussion.”
The Ebola epidemic isn’t over: three members of a family were diagnosed with the disease late last week in Liberia, even though that country has been declared free of the virus twice. Officials say they don’t yet know the source of infection. The Ebola virus has been shown to persist in the semen and other bodily fluids of survivors and has caused new infections in a few rare cases.
The Harvard-LSHTM report is the hardest-hitting so far of at least six expected assessments of the Ebola response, from the United Nations itself to outside panels. A panel of outside experts commissioned by the WHO said in May that the epidemic could have been averted if the WHO had moved faster.
David Nabarro, the U.N. special envoy on Ebola, praised the recommendations in the Harvard-LSHTM report. “They very much reflect a lot of the concerns I have and have had,” said Dr. Nabarro, who chairs another panel that issued a report last week proposing WHO reforms.
But he cautioned against proposals that would move some authority out of the WHO’s hands. For example, an executive director of a new WHO outbreak response center would report both to the WHO’s director-general and an outside board that includes scientific and operations experts and government representatives. Declarations of international public health emergencies would involve a new independent committee.
The Ebola outbreak created “immense human suffering, fear and chaos, largely unchecked by high-level political leadership or reliable and rapid institutional responses,” the panel said in a poignantly worded report published in the renowned medical journal “The Lancet.”
It was collated from the findings of 19 experts across academia, think tanks, humanitarian agencies, and the legal profession.
Its findings were released one day after Liberia’s health ministry confirmed three new cases of the deadly disease, despite the WHO declaring the nation clear two months earlier.
Liberian health minister Dr. Bernice Dahn said it is possible that more cases will be found.
More than 11,300 people have died from Ebola since the West African outbreak began. Liberia had the highest number of fatalities with 4,808 deaths, followed by Sierra Leone and Guinea.
Ebola re-emerged in Liberia
Liberia has placed 153 people under surveillance as it seeks to control a new Ebola outbreak in the capital more than two months after the country was declared free of the virus, health officials said.
Three Ebola cases emerged in Liberia on Friday. The first of the new patients was a 15-year-old boy called Nathan Gbotoe from Paynesville, a suburb east of the capital Monrovia. Two other family members have since been confirmed as positive and they are all hospitalized.
“We have three confirmed cases and have listed 153 contacts, and we have labeled them as high, medium and low in terms of the risk,” Liberia’s Chief Medical Officer Dr. Francis Kateh told Reuters late on Saturday.
The West African country has suffered the highest death toll in the worst known Ebola outbreak in history, losing more than 4,800 people. It has twice been declared Ebola-free by the World Health Organization, once in May and again on Sept. 3, only for new cases to emerge.
It is not known how Gbotoe was infected and Kateh did not offer any explanation, saying that investigations were ongoing. Cross-border transmission seems unlikely since neighboring Guinea has zero cases while Sierra Leone was declared Ebola-free this month after 42 days without a case.
In the Duport Road neighborhood of Paynesville, health officials went from house to house on Saturday delivering food and water to neighbors of the infected family, deemed at risk of catching the disease.