Via The New York Times: Cuts at W.H.O. Hurt Response to Ebola Crisis. Excerpt:
With treatment centers overflowing, and alarmingly little being done to stop Ebola from sweeping through West African villages and towns, Dr. Joanne Liu, the president of Doctors Without Borders, knew that the epidemic had spun out of control.
The only person she could think of with the authority to intensify the global effort was Dr. Margaret Chan, the director general of the World Health Organization, which has a long history of fighting outbreaks. If the W.H.O., the main United Nations health agency, could not quickly muster an army of experts and health workers to combat an outbreak overtaking some of the world’s poorest countries, then what entity in the world would do it?
“I wish I could do that,” Dr. Chan said when the two met at the W.H.O.'s headquarters in Geneva this summer, months after the outbreak burgeoned in a Guinean rain forest and spilled into packed capital cities. The W.H.O. simply did not have the staffing or ability to flood the Ebola zone with help, said Dr. Chan, who recounted the conversation. It was a fantasy, she argued, to think of the W.H.O. as a first responder ready to lead the fight against deadly outbreaks around the world.
The Ebola epidemic has exposed gaping holes in the ability to tackle outbreaks in an increasingly interconnected world, where diseases can quickly spread from remote villages to cities housing millions of people.
The W.H.O., the United Nations agency assigned in its constitution to direct international health efforts, tackle epidemics and help in emergencies, has been badly weakened by budget cuts in recent years, hobbling its ability to respond in parts of the world that need it most. Its outbreak and emergency response units have been slashed, veterans who led previous fights against Ebola and other diseases have left, and scores of positions have been eliminated — precisely the kind of people and efforts that might have helped blunt the outbreak in West Africa before it ballooned into the worst Ebola epidemic ever recorded.
Unlike the SARS crisis of 2003, which struck countries in Asia and elsewhere that had strong governments and ample money to spring to action, the Ebola outbreak has waylaid nations that often lack basic health care, much less the ability to mount big campaigns to stamp out epidemics.
The disease spread for months before being detected because much of the work of spotting outbreaks was left to desperately poor countries ill prepared for the task. Once the W.H.O. learned of the outbreak, its efforts to help track and contain it were poorly led and limited, according to some doctors who participated, contributing to a sense that the problem was not as bad as it actually was.
Then, as the extent of the epidemic became obvious, critics say the agency was slow to declare its severity and come up with plans, and has still not marshaled the people and supplies needed to help defeat the disease and treat its victims.
“There’s no doubt we’ve not been as quick and as powerful as we might have been,” said Dr. Marie-Paule Kieny, a W.H.O. assistant director general.
Another W.H.O. leader agreed. “Of course in retrospect I really wish that we had jumped much higher much earlier,” said Dr. Keiji Fukuda, the assistant director general in charge of outbreak response. “Of course I wish we’d poured in more and more earlier.”
But, he added, “if this outbreak had been a typical outbreak, nobody would be saying we did too little, too late.”