This makes the observation most of us here have about WHO.
World Health Organization ‘intentionally delayed declaring Ebola emergency’
http://www.theguardian.com/world/2015/mar/20/ebola-emergency-guinea-epidemic-who
Sarah Boseley 20 March 2015
The World Health Organisation dragged its feet for two months over declaring the Ebola outbreak a global emergency for fear of damaging the economy of Guinea and other afflicted countries, leaked documents show. The internal documents obtained by the Associated Press in Geneva reveal that WHO’s Geneva headquarters was receiving emails by mid-April 2014 from staffers on the ground in Guinea calling for help with an epidemic that had already killed 100 people but was recognised to be largely hidden and spreading.
One of the emails was from an experienced Ebola expert with WHO’s Africa office, who wrote to a Geneva official saying the situation had taken a critical turn because many health workers at the Donka hospital in Guinea’s capital, Conakry, had been exposed to the virus. “What we see is the tip of an iceberg,” wrote Jean-Bosco Ndihokubwayo. The scientist requested the help of half a dozen veteran outbreak responders, writing in all capitals in the email’s subject line: “WE NEED SUPPORT.”
WHO official Stella Chungong said she was very worried, warning in an email that terrified health workers might abandon Donka Hospital and that new Ebola cases were coming out of nowhere. “We need a drastic ... change [of] course if we hope to control this outbreak,” she said.
WHO sent a top Ebola expert, Pierre Formenty, to the region. But many of the other managers sent to Conakry “had no idea how to manage an Ebola epidemic,” according to Marc Poncin, who was mission chief in Guinea for Médecins Sans Frontières, the volunteer doctors who bore the brunt of the epidemic until after WHO declared a global public health emergency in early August. That, together with the publicity around the infection of two American health workers who were repatriated for treatment, brought the US, UK and other countries together in the fight against the disease.
But in early April, WHO was downplaying concerns. Spokesman Gregory Hartl told reporters that “this outbreak isn’t different from previous outbreaks”. In a Twitter message sent by Hartl and preserved by ITV News, he is shown asking: “You want to disrupt the economic life of a country, a region, [because] of 130 suspect and confirmed cases?”
The news worsened throughout April. Formenty said teams in Conakry had seen patients pop up all over the city with no known links to other cases. “This means there is one part of the epidemic that is hidden,” he later wrote in an internal report. “The Ebola outbreak could restart at any time.”
In early June, there were discussions at WHO over whether to call a global health emergency. An internal document says such a declaration “ramps up political pressure in the countries affected” and “mobilises foreign aid and action.”
But one director viewed it as a “last resort”. WHO was having to contend with other outbreaks, including polio, which has a high political priority. There were also issues with the government of Guinea, which, according to WHO documents, was reporting only confirmed Ebola cases and not those suspected or probable, in a bid to downplay the dangers and avoid alarming foreigners working in the mining industry.
Dr Sylvie Briand, head of the pandemic and epidemic diseases department at WHO, acknowledged that her agency made wrong decisions, but said postponing the alert made sense at the time because it could have had catastrophic economic consequences. “What I’ve seen in general is that for developing countries, it’s sort of a death warrant you’re signing,” she told AP.
On 10 June, Briand, her boss, Dr Keiji Fukuda, and others sent a memo to WHO chief Dr Margaret Chan, noting that cases might soon pop up in Mali, Ivory Coast and Guinea-Bissau. But the memo went on to say that declaring an international emergency or even convening an emergency committee to discuss the issue “could be seen as a hostile act”.
But others argue that although declaring an international emergency is no guarantee of ending an outbreak, it functions as a kind of a global distress call.
“It’s important because it gives a clear signal that nobody can ignore the epidemic any more,” said Dr Joanne Liu, MSF’s international president.
In a meeting at WHO headquarters on 30 July, Liu said she told Chan: “You have the legitimacy and the authority to label it an emergency ... You need to step up to the plate.”
After WHO declared an international emergency on 8 August, Barack Obama sent 3,000 troops to west Africa and promised to build more than a dozen 100-bed field hospitals. Britain and France also pledged to build Ebola clinics, China sent a 59-person lab team, and Cuba sent more than 400 health workers.
Dr Bruce Aylward, WHO’s top Ebola official, maintains however that labelling the Ebola outbreak a global emergency would have been no magic bullet. “What you would expect is the whole world wakes up and goes: ‘Oh my gosh, this is a terrible problem, we have to deploy additional people and send money,’” he said. “Instead what happened is people thought: ‘Oh my goodness, there’s something really dangerous happening there and we need to restrict travel and the movement of people.’”
Medecins Sans Frontieres names the names in the Ebola outbreak.
See below —
Ebola outbreak reached catastrophic scale due to slow global response: MSF
Helen Branswell, The Canadian Press
Published Sunday, March 22, 2015 9:42PM EDT
http://www.ctvnews.ca/health/ebola-outbreak-reached-catastrophic-scale-due-to-slow-global-response-msf-1.2292293
TORONTO — West Africa’s ongoing Ebola outbreak reached its catastrophic scale because of the failure of a variety of international agencies and the lack of global health rapid response capacity, a new report says.
Medecins Sans Frontieres, which is also known as Doctors Without Borders, released the report to co-incide with the year anniversary of the recognition that Ebola had broken out in Guinea, a part of Africa that had never before dealt with the disease.
The report notes that many observers have suggested the scale of the outbreak was due to a perfect storm-like confluence of factors. The disease appeared at the juncture of three countries with porous borders and fragile health-care systems. And it ravaged people with no prior experience with Ebola and no understanding of how it spreads.
But the report says that analysis is “too convenient an explanation.”
“For the Ebola outbreak to spiral this far out of control required many institutions to fail. And they did, with tragic and avoidable consequences,” says Christopher Stokes, general director of the doctors’ group.
The report says the World Health Organization displayed a lack of leadership, downplaying the threat the outbreak posed when MSF officials were desperately trying to get the world to realize how dangerous the situation in West Africa had become.
“Meetings happened. Action didn’t,” says Marie-Christine Ferir, MSF’s emergency co-ordinator.
The Associated Press reported last week that the idea of declaring the outbreak a global health emergency was floated in early June, but the Geneva-based agency held off taking that step until early August. Emails obtained by the AP suggest the WHO worried the move would anger the affected countries, might restrict travel of Muslims to the annual pilgrimage to Mecca and might have economic consequences. [Isn’t that the definition of a political action, which is exactly what the WHO claimed they didn’t do?]
But the report says the WHO is not the only agency that bears blame. “It would be a mistake to attribute full responsibility for the dysfunctional response to just one agency. Instead, the age-old failures of the humanitarian aid system have also been laid bare for the world to see, rather than buried in under-reported crises like those in Central African Republic and South Sudan,” the report says.
MSF has taken a lead role in Ebola outbreaks for years, setting up and staffing treatment units. But as case numbers exploded across Guinea, Sierra Leone and Liberia, the organization virtually begged other non-governmental organizations to help, eventually even asking countries to send military hospitals. It was months before the world began to respond in significant ways.
“In the end, we did not know what words to use that would make the world wake up and realize how out of control the outbreak had truly become,” says Dr. Bart Janssens, director of operations for MSF.
The organization also criticized its own response. Though MSF had helped contain numerous Ebola outbreaks over the past 20 years, its hemorrhagic fevers team was small, comprising about 40 “Ebola veterans.” Others in the operation were initially reluctant to divert more of MSF’s people to the Ebola fight, and MSF says it should have been faster to mobilize the full capacity of the organization.
The MSF report also questions if it might have been able to do more to improve communications in Guinea earlier in the outbreak. Deep distrust of the foreign aid responders persists in some Guinean villages to this day and still hampers containment efforts.
MSF says the outbreak has produced a number of tragic firsts for it, including:
— It was the first outbreak in which MSF lost so many patients, 2,547 at the time the report was written.
— It was also the first time MSF staff became infected with Ebola. So far 28 have been infected and 14 have died.
— For the first time ever, MSF was forced to turn patients away from Ebola treatment units. At one point, a major treatment centre in Monrovia, Liberia opened its gates for 30 minutes a day — just long enough to fill the beds emptied by the previous night’s deaths.
Nearly 25,000 people have been infected since this outbreak began and more than 10,000 of them have died.
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More dirty laundry from Médecins Sans Frontières on Ebola below.
Guinea and Sierra Leone tried to cover up Ebola crisis, says Medecins Sans Frontieres
Report by MSF also accuses US biotech company of failing to spot cases in Sierra Leone
By Colin Freeman6:30AM GMT 23 Mar 2015
http://www.telegraph.co.uk/news/worldnews/ebola/11488726/Guinea-and-Sierra-Leone-tried-to-cover-up-Ebola-crisis-says-Medecins-Sans-Frontieres.html
Médecins Sans Frontières has accused the governments of Guinea and Sierra Leone and a leading US biotech firm of obstructing its early efforts to bring the Ebola outbreak under control.
A new report by the aid agency says the governments deliberately underplayed the initial spread of the outbreak last year, and that when MSF warned it could be “unprecedented”, it was criticised for “scaremongering”.
The accusation of scaremongering - also wrongly voiced by the World Health Organisation - slowed the international response to the crisis, which has now claimed nearly 10,200 lives.
The report, compiled as a “lessons learned” exercise, also questions the conduct of a US medical firm, Metabiota, that was monitoring suspected Ebola cases on behalf of the Sierra Leonean health ministry.
Not only did Metabiota apparently fail to detect any cases of the virus in Sierra Leone during the early months of the outbreak, it later refused to co-operate with MSF in providing details of “contact lists” of potentially infected people, forcing the agency to work “in the dark.”
“For the Ebola outbreak to spiral this far out of control required many institutions to fail,” said Christopher Stokes, MSF’s general director. “And they did, with tragic and avoidable consequences.”
MSF, whose medics handled most of the early frontline response to the outbreak, compiled the report to coincide with the anniversary of its own staff being alerted to the crisis. In mid-March last year, doctors in its Geneva office were informed of a “mysterious disease” in Guinea that had killed several people and had baffled the country’s ministry of health.
Dr Michael Van Herp, a senior MSF epidemiologist, was struck by reports that suffers had hiccups - a typical symptom of Ebola - and warned colleagues that they should be “prepared” for an outbreak, even though one had never occurred in west Africa before.
By the end of that month, MSF warned that Guinea was facing an Ebola epidemic “of a magnitude never before seen”, only to be directly slapped down the next day by the WHO, which said there had been only “sporadic cases”.
In early May, meanwhile, the President of Guinea, Alpha Conde, accused MSF of talking up the threat from Ebola to raise extra funds, the report said. And in Sierra Leone, the government instructed the WHO to report only laboratory-confirmed deaths, hiding the scale of the outbreak by excluding the large number of cases of people who died before ever reaching a clinic.
“Needless obstacles made responding more difficult for MSF teams, who were refused access to contact lists and had to start from scratch in determining which villages were affected and where and how to respond,” the report said.
In similar vein, the report criticised Metabiota, which, along with staff from Tulane University in New Orleans, was working as a partner of Kenema Hospital in eastern Sierra Leone in investigating suspected cases for the ministry of health.
The report said that as early as March of last year, health officials in Guinea were seeing Ebola-infected people coming in from over the porous border with Sierra Leone, but that Metabiota and Tulane continued to report no cases at all in Sierra Leone. “Their ongoing surveillance activities seem to have missed the cases of Ebola that had emerged in the country,” MSF said.
It was not until May 26 that a case was first confirmed in Sierra Leone, at which point the government asked for MSF’s help. By then, though, “the hidden outbreak in Sierra Leone mushroomed and reignited the outbreak for its neighbours.”
To make matters worse, MSF said that when it then started operating in Kailahun - the first major infected area in Sierra Leone - neither Metabiota nor Tulane would share information with them.
“The Ministry of Health and the partners of Kenema hospital refused to share data or lists of contacts with us,” said Anja Wolz, an MSF emergency coordinator. “So we were working in the dark while cases just kept coming in.”
The WHO has already acknowledging failings over its response to the Ebola crisis, and that it did not recognise “fairly plain writing on the wall’.
Metabiota, a San Francisco-based firm that describes itself as a “global leader in pandemic threat management”, was already in Sierra Leone prior the Ebola outbreak working on other disease control projects. In December, it received a grant from the European Commission to work on testing and treatment programs for Ebola.
Tulane was not available to comment. But Metabiota defended their work.
“We play a supportive role to governments and we do not conduct independent investigations or surveillance in Sierra Leone,” said a spokesperson.
“Metabiota adheres to international and national agreements and regulations and, in respect of these, is not authorised to share any results in Sierra Leone to parties other than official health authorities.”