WHO, worried about damage to West Africa’s economy, delayed declaring Ebola an emergency

EbolaWHO, worried about damage to West Africa’s economy, delayed declaring Ebola an emergency

Published 24 March 2015

The World Health Organization(WHO) for two months delayed labeling the Ebola outbreak a global emergency for fear of damaging the economy of Guinea and neighboring countries, according to leaked documents and memos from the organization. Beginning in April 2014, WHO’s specialists, both in the field and at the organization’s headquarters in Geneva, were raising an alarm about the spreading epidemic — but it was not until June 2014 that WHO begun seriously to consider the scope of the outbreak, and it was not until August 2014 that WHO defined the Ebola outbreak as an epidemic and declared an international emergency.

The World Health Organization (WHO) for two months delayed labeling the Ebola outbreak a global emergency for fear of damaging the economy of Guinea and neighboring countries, according to leaked documents and memos from the organization.

According to the AP, WHO’s Geneva headquarters received numerous e-mails by mid-April 2014 from staffers in Guinea calling for help with an epidemic which had already killed 100 people and was likely to spread. In an e-mail from Jean-Bosco Ndihokubwayo, an Ebola expert with WHO’s Africa office to a WHO official in Geneva, he described the situation as taking a critical turn because many health workers at Donka Hospital in Guinea’s capital, Conakry, had been exposed to the virus. “What we see is the tip of an iceberg,” he wrote, later requesting the help of six veteran outbreak responders, writing in all capitals in the email’s subject line: “WE NEED SUPPORT.”

WHO official Stella Chungong warned the Geneva office that terrified health workers might abandon Donka Hospital and that new Ebola cases were appearing out of nowhere. “We need a drastic … change (of) course if we hope to control this outbreak,” she said.

WHO eventually sent Pierre Formenty, an Ebola expert to the region, but many of the other staffers sent to Conakry “had no idea how to manage an Ebola epidemic,” according to Marc Poncin, mission chief for Doctors Without Borders (DWB), the group that led the Ebola outbreak response until WHO declared a global public health emergency in August.

Before the declaration, in early April WHO spokesman Gregory Hartl told reporters that “this outbreak isn’t different from previous outbreaks.” In a Twitterpost, Hartl wrote “You want to disrupt the economic life of a country, a region, (because) of 130 suspect and confirmed cases?”

The Guardian reports that in June 2014, WHO officials discussed whether to declare a global health emergency as such a declaration “ramps up political pressure in the countries affected” and “mobilizes foreign aid and action,” read an internal document. WHO, however, was already preoccupied with other outbreaks, including polio, which was a high political priority. There were also issues with the Guinean government, which according to WHO documents, was reporting only confirmed Ebola cases and not those suspected or probable, in an effort to downplay the dangers and avoid alarming foreign workers in the mining industry.

Dr. Sylvie Briand, head of WHO’s pandemic and epidemic diseases department acknowledged that her agency made wrong decisions, but said postponing the declaration made sense at the time because it could have had catastrophic economic consequences “What I’ve seen in general is that for developing countries, it’s sort of a death warrant you’re signing,” she told the AP.

Critics of WHO’s actions before August 2014 argue that declaring an international emergency functions as a global distress call, one that no world leader could ignore. “It’s important because it gives a clear signal that nobody can ignore the epidemic any more,” said Dr. Joanne Liu, DWB’s international president. In a meeting at WHO headquarters on 30 July, Liu told WHO chief Dr. Margaret Chan: “You have the legitimacy and the authority to label it an emergency … You need to step up to the plate.”

After WHO declared an international emergency on 8 August 2014, the United States sent 3,000 troops to west Africa to help build Ebola field hospitals, Britain and France also pledged to help build Ebola clinics, China sent a fifty-nine-person lab team, and Cuba sent more than 400 health workers. Dr. Bruce Aylward, WHO’s top Ebola official still maintains that labeling the Ebola outbreak a global emergency would not have been a magic bullet. “What you would expect is the whole world wakes up and goes: ‘Oh my gosh, this is a terrible problem, we have to deploy additional people and send money,’” he said. “Instead what happened is people thought: ‘Oh my goodness, there’s something really dangerous happening there and we need to restrict travel and the movement of people.’”

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