Ebola outbreak shows weaknesses in current international health delivery systems

Ebola outbreak shows weaknesses in current international health delivery systems
Ebola outbreak shows weaknesses in current international health delivery systems
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Chitra Subramaniam | The News Minute | October 15, 2014 | 2.51 pm IST

News coming out of the World Health Organisation (WHO) about Ebola is grim. Bruce Aylward, the WHO’s point person on the outbreak says there are 1000 new cases every week, 4,447 people have died and the spread of the disease from Liberia, Sierra Leone and Guinea has not been stemmed. Aylward has described his figures as a working forecast adding that the epidemic “could reach 5000 to 10,000 cases per week by the first week of December.” This is the worst-known outbreak of Ebola and the three countries severely touched are Liberia, Sierra Leone and Guinea. 

Even grimmer is the response of the international health community that working under the United Nations (UN) system, struggling with the public health emergency on the one hand and what appears to be internal squabbling about who is in charge, on the other. In this system of multiple mandates conflicting agencies and clashing egos are common, sometimes even to the detriment of the problem that needs solving. While that may not be the case yet, Aylward has said crisis management and “getting a common operational plan” is urgent in an obvious reference to who’s in charge. Health agencies and donor organizations tend to brief the media separately adding to the confusion and in this case, fear as we watch body bags being trundled around and airports issuing alerts. 

On paper, however, everything looks good. The first-ever UN emergency health mission, the UN Mission for Ebola Emergency Response (UNMEER) has been set-up as a temporary response to the outbreak under the strategic guidance of the UN Secretary General. A key remit of this group is to harness capabilities across the UN system to stop the spread, treat the infected and ensure essential services for which advance teams have been sent. The European Union (EU), the African Union as well as a host of bilateral and multilateral donor agencies have been roped in. 

According to UNMEER, the WHO will be responsible for overall health strategy advice within it – in other words, the global effort is being led from New York and not Geneva where the UN’s health body the WHO is situated. The WHO is an advisory (policy-setting) and not an operational body and it has proposed a 70-70-60 strategy – 70 percent of safe burials and 70 percent of suspected cases isolated in 60 days. 

This leaves a lot of questions unanswered including the most important one about money. Materials and manpower is available, but WHO says there is no cash just like the head of the World Bank Jim Kim who said last week that the international community had “failed miserably” to rise to the challenge posed by the disease. The Bank has asked the world to donate $20 billion. 

“It’s late. It’s really late…we should have done so many things. Healthcare systems should have been built. There should have been monitoring when the cases were first reported. There should have been an organized response,” he told The Guardian. Earlier, one of the co-discoverers of the Ebola virus Dr. Peter Piot – currently head of the London School of Tropical Medicine and Internal Hygiene - had also told The Guardian about the dangers including an “apocalypse” if the virus was not stopped immediately. 

Who is to organize this response, for whom? All indications show that the world is far from ensuring that future generations remain healthy and free of disease. 

There have been Ebola deaths in the United States (US), Spain and Germany. Every death is a tragedy. Is the international aid effort also aimed at trying to keep people within a certain area so they don’t travel to Europe and the US? Is this even possible? 

The world will never have the resources – manpower, materials and money – to cope with all the diseases it seeks to contain and eradicate. We have not beenable to find a vaccine for malaria, beaten every single time by a mosquito. That should tell us something about the way we approach diseases in a world that is increasingly connected through technology and disconnected with human beings. 

Postcript: News reports say a Las Vegas (US) company called Blue String Ventures is looking to sell the domain name Ebola.com for $150,000. The firm said it also owns the domain name for other diseases such as Birdflu.com and Chikungunya.com. A partner for the company was quoted as saying Ebola.com was an especially hot internet property.

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