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Agencies Trade Blame Over Slow Global Ebola Response

WHO ignored pleas for help, report says

A war of words broke out on Monday, March 23, between the aid agency Doctors Without Borders and the World Health Organization (WHO) over who was to blame for the slow response to the Ebola epidemic that started a year ago.

Doctors Without Borders released a scathing report on the global response to the epidemic, which has killed more than 10,000 people and infected nearly 25,000 since it was identified in March 2014, mostly in Guinea, Liberia, and Sierra Leone.

The aid agency — known by its French initials MSF — said “months were wasted and lives were lost” because the WHO, which is charged with taking the lead on global health emergencies and “possesses the know-how to bring Ebola under control,” failed to respond quickly or adequately.

But the WHO hit back, saying it was the MSF that had not alerted them to the earliest cases.

“It would have been much easier to control this outbreak had we known in January or December when the very first case occurred or the first cluster,” said WHO spokesperson Margaret Harris during a British radio broadcast.

The MSF’s General Director Christopher Stokes responded that those earliest cases happened in very remote areas, and that it took time to confirm that they were Ebola.

“Once the confirmation was obtained in mid-March, that’s when you have to kick in all your resources and you have to deploy massively,” he said. “But the very next day, the WHO said we were exaggerating.”

The WHO has acknowledged that its response was slow and insufficient, and has set up an independent review that will report back in May.

The MSF report accused the WHO’s Global Alert and Outbreak Response Network of ignoring pleas for help from Liberia when it met in June.

“It was early in the outbreak, and there was still time. The call for help was heard, but no action was taken,” said Marie-Christine Ferir, MSF emergency coordinator.

The WHO did not set up a regional hub for coordinating the response until July, by which time a second wave of the epidemic had struck.

“All of the elements that led to the outbreak’s resurgence in June were also present in March, but the analysis, recognition, and willingness to assume responsibility to respond robustly were not,” the MSF report said.

Particularly in the early months, much of the burden fell on MSF’s shoulders, but the organization had only 40 staff members with Ebola experience.

It was only when a U.S. doctor and a Spanish nurse were diagnosed with Ebola that the world woke up to the threat, MSF said.

The MSF also blamed the governments of Guinea and Sierra Leone for refusing to admit to the scale of the epidemic, and for putting “needless obstacles” in the path of MSF teams.

The crisis sparked the biggest training program in MSF history, which deployed 1,300 international staff and 4,000 locals.

The MSF’s efforts were initially focused on Guinea and Sierra Leone. However, when the aid agency Samaritan’s Purse withdrew from Liberia after the U.S. doctor’s infection, the MSF faced a difficult decision: abandon the country or take the risk of pushing its over-stretched staff still further.

“We couldn’t let [Liberia] sink further into hell,” said Brice de le Vingne, the MSF’s director of operations. “We would have to push beyond our threshold of risk, and we would have to send coordinators without experience in Ebola, with only two days of intensive training.”

MSF built a 250-bed treatment center in Liberia’s capital, Monrovia, but even that was far from enough. The center was able to open only 30 minutes each morning, filling beds vacated by deaths overnight.

The report describes people dying on the gravel outside the gates, and a father who brought his daughter in the trunk of his car, begging MSF to take her in so as to not infect his other children at home, but who was turned away.

There were so many patients and so few employees that the staff had on average only 1 minute per patient.

“Not since the early days of HIV care has MSF staff sustained the loss of so many patients dying in our facilities and never in such an intense short period of time,” the report said.

Source: Medical Xpress; March 23, 2015.

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