WHO incapable of effective response to Ebola outbreak-like health crises
Published 8 July 2015
The World Health Organization (WHO) does not have the capacity and internal culture to launch and manage an effective response to an epidemic such as the Ebola outbreak in West Africa, according to a scathing WHO-commissioned report, which also blames governments for not offering more support for the organization. The report says the organization was too slow in its response to the Ebola epidemic, which killed more than 11,000 people.
The World Health Organization (WHO) does not have the capacity and internal culture to launch and manage an effective response to an epidemic such as the Ebola outbreak in West Africa, according to a scathing report, which also blames governments for not offering more support for the organization.
The panel of experts writing the WHO-commissioned report was led by Dame Barbara Stocking, a former head of Oxfam.
The report says the organization was too slow in its response to the Ebola epidemic and that it was under-funded. More than 11,000 people have died in the latest outbreak of Ebola, which began spreading in late 2013.
The panel stresses that it believes examining the lessons which should be drawn from the response to the Ebola outbreak is a defining moment for the health of the global community. “WHO must reestablish its preeminence as the guardian of global public health; this will require significant changes throughout WHO with the understanding that this includes both the secretariat and the member states.”
The panel says that at each of its three levels, the secretariat must undergo significant transformation in order to better perform its core function of protecting global health. For their part, member states must provide, at their highest political levels, the required political and financial support to WHO. While WHO has already accepted the need for transformation of its organizational culture and delivery, it will need to be held accountable to ensure that this transformation is achieved, the panel notes.
The report says that the Ebola crisis not only exposed organizational failings in the functioning of WHO, but it also demonstrated shortcomings in the International Health Regulations (2005). “If the world is to successfully manage the health threats, especially infectious diseases that can affect us all, then the Regulations need to be strengthened,” the panel says. “We ask that the full Review Committee under the International Health Regulations (2005) to examine the role of the Regulations in the Ebola outbreak (the IHR Review Committee for Ebola), which follows our Panel, consider and take forward the implementation of our recommendations.”
The panel states that had the recommendations for revision made in 2011 by the Review Committee in relation to Pandemic (H1N1) 2009 been implemented, the global community would have been in a far better position to face the Ebola crisis. “The world simply cannot afford another period of inaction until the next health crisis,” the report says.
Among the panel’s comments and recommendations:
- “The panel considers that WHO does not currently possess the capacity or organizational culture to deliver a full emergency public health response,” the report says.
- Member states share at least part of the blame for the inadequate response because they have not fulfilled their responsibilities under the WHO’s international health regulations. They are required to collect data and carry out surveillance to pick up infectious disease outbreaks at an early stage but they failed, the report says.
- Other member states violated the regulations by imposing bans on travel to the affected West African nations — Sierra Leone, Liberia, and Guinea. These and other measures “significantly interfered with international travel, causing negative political, economic and social consequences for the affected countries,” the report says.
- The WHO itself is criticized for “significant and unjustifiable delays” in declaring a public health emergency, which belatedly fired the starting gun for the international response to Ebola.
- The report says that the general flouting of the rules put in place to keep the world safe from infectious disease cannot continue. “The panel considers this situation, in which the global community does not take seriously its obligations under the international health regulations (2005) – a legally binding document – to be untenable.”
- Organizational and financial issues must be addressed immediately. Less than 25 percent of the WHO’s budget comes from core funds contributed by member states and there are no core funds for emergency response. “The longstanding policy of zero nominal growth policy for assessed contributions has dangerously eroded the purchasing power of WHO’s resources, further diminishing the organization’s emergency capacity,” the report says. It recommends a 5 percent increase.
- There should be incentives for countries to declare an emergency — at the moment many would be unwilling because of the damaging impact on trade and the economy — and disincentives to countries imposing travel bans and other measures that interfere with trade.
- There be a WHO center for emergency preparedness and response which can take the lead in avoiding and dealing with outbreaks, overseen by an independent board, and that the independence of WHO’s country officers be reinforced.
- “At country level, the WHO representative must have an independent voice and be assured of the full support of the regional director and the director-general, if challenged by governments,” the report says.
“It’s essential that this new body is accountable and can show leadership in the face of emerging health threats, with the authority and independence to act quickly when needed. The support of the global community is also crucial if we are to avert another catastrophe on the scale of Ebola.”
— Read more in Report of the Ebola Interim Assessment Panel - July 2015
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