WHO has published Report by the Director-General to the Special Session of the Executive Board on Ebola. This is a long review of the response to Ebola, and it's worth reading Dr. Chan's whole speech. Excerpt:
The Ebola outbreak revealed some inadequacies and shortcomings in this Organization’s administrative, managerial, and technical infrastructures. I am proposing a package of reforms, but want to highlight a few in this address to you.
The proposals before you repeat the need for a dedicated contingency fund to support rapid responses to outbreaks and emergencies.
Our standard recruitment procedures are too slow for use in emergencies. We need streamlined procedures for this purpose. We need to apply the “one WHO” approach, whereby all three levels of the Organization use the same standard operating procedures, tools, and frameworks for risk assessment, monitoring, and accountability during emergencies.
The severity of the outbreak underscores the need to enhance crisis management and field experience during emergencies in WHO country offices.
WHO’s regional structure has advantages, for example, in tailoring the implementation of global strategies and guidelines to local cultures and conditions (and we learned from the Ebola outbreak how important culture is), in shaping the response of neighbouring countries to shared threats, like polio or malaria, and in helping countries to build and certify the core capacities set out in the International Health Regulations to be better prepared for the next emergency.
As events since the start of this century have shown, outbreaks rarely have only local or regional consequences in our highly interconnected and interdependent world.
The International Health Regulations need more teeth. They provide the principal line of collective defence against the threat from emerging and epidemic-prone diseases. The world will never reach true health security until more countries, and eventually all countries, have core capacities in place.
We need a far more rigorous methodology for evaluating these capacities than self-assessments in a questionnaire. And we need to treat the importance of getting these capacities in place like the emergency that it is.
We need to stop thinking about core capacities as something that should be tacked onto a country’s health systems, like an extra arm. No.
The capacities needed to undertake sensitive surveillance, provide laboratory support, manage data collection and reporting, and mount a response need to be an integral part of the health system.
Health systems also need adequate numbers of well-trained health care workers and these people need to be appropriately paid.
This is one of the biggest lessons the world learned last year. Well-functioning health systems are not a luxury. Well-functioning health systems are the cushion that keeps sudden shocks from reverberating throughout the fabric that holds societies together, ripping them apart. As we learned control depends on community engagement and community leadership at every stage.
In West Africa, what began as a health crisis quickly escalated into a humanitarian, social, economic, and security crisis. Schools, markets, businesses, airline and shipping routes, and borders closed. Tourism shut down, further deepening the blow to struggling economies. Countries resorted to using their defence and military forces for the command and control of containment measures.