What it will take to fight the next epidemic

A new study of the Ebola epidemic that took more than 11,000 lives focuses much of its criticism on the World Health Organization (WHO) for delays and mismanagement that compounded rather than curtailed the global threat.

The report by an independent panel of health experts castigated the WHO, which operates within the United Nations, for being five months late in declaring the Ebola outbreak a global health emergency last year, despite having been notified of severe outbreaks by the governments of Guinea and Liberia.

Those two nations and Sierra Leone, another afflicted country, had no effective systems for detecting the disease and responding properly to the epidemic as it turned into “a worldwide crisis,” according to the joint study by the Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine.

The WHO declaration did not come until almost two months after Doctors Without Borders warned that the disease was “out of control” and needed far more global attention.

“The reputation and credibility of the WHO has suffered a particularly fierce blow,” the report found in proposing a series of far stronger steps to bolster the agency and guard against future Ebola outbreaks.

Chief among them was a call for leadership at the top of the organiza- tion that is willing to confront political leaders who go into early denial about the presence of diseases to protect their economies and head off public panic, thereby feeding epidemics. Specifically, the report said the WHO’s director general should have the “character and capacity to challenge even the most powerful governments when necessary to protect public health.”

The report also recommended the creation of a separate unit at the center of the WHO for combating infectious diseases, with its own budget and accountability, as well as more global funding of research. Above all, the study found the world as a whole needs a focused strategy, clearer standards and a rapid response to future threats, one with transparent management.

That is not an easy task in a disjointed world. The response to the thousands afflicted in Africa was haphazard, the report found, with media and public attention lagging until two infected American aid workers were evacuated.

Margaret Chan, the director general of the WHO, has acknowledged agency errors during the Ebola epidemic and says improvements are already underway. But the new report makes it clear that wholesale changes must be made, and quickly, before the next epidemic threatens an increasingly interconnected world.