MSF rues ‘mistakes’ made in Ebola battle

outbreaks.” MSF’s public appeal in September for vaccine development had been months too late.

“We wasted time before speaking about a vaccine and treatments.… It’s hard to imagine controlling this epidemic now without a vaccine.”

MSF, known also as Doctors Without Borders, is the only organisation to have worked extensively with Ebola in the past 20 years. When the outbreak, identified in March, began to spread, the group focused on established protocols of isolating patients and tracing their contacts.

At the same time, the group – treating patients at its six centres in Guinea, neighbouring Liberia and Sierra Leone – criticised the slowness of the international response and clashed publicly with the Guinean government and the WHO, which accused it of alarmism.

The WHO has since been widely criticised for its slow response to the epidemic. It says it will publish a full review of its handling of the epidemic once it is under control.

Several companies are accelerating vaccine trials. Trials are under way in Africa and Europe of two candidates, made by GlaxoSmithKline and NewLinkGenetics.

Separately, MSF said on Thursday that clinical trials of three potential drugs would begin next month in Guinea and Liberia at medical centres it runs.

More than 13 000 people have been infected by Ebola.

MSF was founded in 1971 by a group of French doctors and journalists outraged by the aid community’s silence at Nigeria’s blockade and starvation of separatist Biafra.

It prides itself on its speed and independence: with 90 percent of its $1.3 billion (R146bn) global budget funded by a legion of small individual donors, MSF does not have to seek permission from any single major backer before acting. The group has made “bearing witness” a key part of its remit, from criticism of the military junta during the 1985 Ethiopian famine to calls for armed intervention to halt the Rwandan genocide in 1994.

This attitude extends to self-criticism, said Bradol. Crash looks at what MSF could have done better.

The Ebola outbreak has brought ethical challenges for the group. When Sierra Leone’s foremost Ebola specialist, Dr Sheik Umar Khan, lay dying of the virus in July, MSF doctors decided after fraught discussions not to treat him with an exper- imental drug, arguing that its effects were unknown and supplies were scarce, so it would be unfair to give him privileged care. But when international health care workers fell ill – including two European members of MSF’s staff – they were evacuated and given such treatments.

Such incidents sparked debate in MSF about why experimental treatments were not being offered to patients and its staff, an unprecedented 15 of whom have died.

“Crash said… if you argue the drugs are not safe because they are experimental, but you give them to the expatriates, that makes no sense,” Bradol said.

MSF staff complained at the start of the outbreak that other aid organisations failed to help treat Ebola. But the other aid groups complained that MSF refused to water down its rigorous safety protocols by training others.

The organisation has since shared its blueprint for treatment centres and is training non-MSF workers in its centre in Brussels. It also allowed staff from other NGOs to shadow its workers and use its logistical infrastructure.

Henry Gray, an operations coordinator for MSF-Brussels who worked for two months in Liberia and Sierra Leone, says the outbreak has also compelled the group to innovate, developing watertight body bags to stop the leaking of infected bodily fluids and climatecontrolled tents so doctors may work longer in their heavy protective suits.

MSF has deployed more than 700 foreign staff to fight Ebola, rotating people in six-week stints.

A surgeon working in Sierra Leone has been diagnosed with Ebola and is to be flown to the US for treatment.

Dr Martin Salia, 44, is to be treated at the Nebraska Medical Centre in Omaha, according to a source in the US government. A Sierra Leone citizen, he lives in Maryland and is a legal permanent US resident, according to the source.

The medical centre said it expected a patient from Sierra Leone to arrive this afternoon.

Salia is a general surgeon and has been working at the Kissy United Methodist Hospital in the Sierra Leone capital of Freetown, according to the government source.

He came down with symptoms of Ebola on November 6, but tested negative for the virus. He was tested again on Monday, and the result was positive. He is in a stable condition at an Ebola treatment centre in Freetown. It isn’t clear whether he has been involved in the care of Ebola patients. – Reuters-Sapa-AP