Panel Reviews WHO's Ebola Response: Could More Have Been Done?

More than 50% of patients infected with the Ebola virus during the recent outbreak passed away as a result of the disease, according to a panel of independent experts that assessed the World Health Organization’s (WHO) response to the Ebola crisis that began in West Africa in 2013.

When the International Health Regulations (IHR) (2005) were revised, the aim was to better protect global health. However, the Ebola outbreak shows the failure of proper plan execution. As of July 8, 2015, a total of 11,961 Ebola cases were confirmed with 6,439 resulting in death from the current outbreak, according to the Centers for Disease Control and Prevention (CDC).

The panel detailed the shortcomings that contributed to the widespread crisis and voiced recommendations to move forward in the full report. The 29-page document is the second installment in the Report of the Ebola Interim Assessment Panel, the first report consisting of 12 pages was released in May 2015.

“Unfortunately, a great opportunity to strengthen the Regulations was lost when the 2011 recommendations of the Review Committee on the Functioning of the International Health Regulations (2005) in relation to Pandemic (H1N1) 2009 were not fully implemented,” the authors wrote.

Despite the shortcomings, the panel agrees that the WHO should be the top agency in charge of the health emergency. They also acknowledged the efforts and sacrifice of health workers in this matter. The experts addressed the integration of regulations, emergency response, and how to obtain cooperation on a global scale.

“The world simply cannot afford another period of inaction until the next health crisis,” the panel advised.

The following are 5 of the 21 organizational and financial initiatives the experts recommended:

• All levels of WHO should be strengthened in order to increase the Organization’s ability to independently identify health risks and to declare health emergencies.
• WHO should propose a prioritized and costed plan, based on independently assessed information, to develop core capacities required under the International Health Regulations (2005) for all countries. The financing of this plan is to be done in close partnership with the World Bank.
• The IHR Review Committee for Ebola should consider disincentives to discourage countries from taking measures that interfere with traffic and trade beyond those recommended by WHO.
• At the 2016 Executive Board and World Health Assembly meetings, Member States should reconsider moving from the policy of zero nominal growth to increase assessed contributions by 5%.
• WHO should establish the WHO Centre for Emergency Preparedness and Response, which will be based on the current separate outbreak control and humanitarian areas of work. This WHO Centre will need to develop new organizational structures and procedures to achieve full preparedness and response capacity.

The investigators expressed that they are “extremely concerned” about not only the health impact of Ebola, but also the social and economic backlash. Therefore, they urge improvement in WHO leadership and response. The team noted, however, that this requires a worldwide effort.

“The Panel firmly believes that this is a defining moment not only for WHO and the global health emergency response but also for the governance of the entire global health system,” the report concluded.