Wednesday 8 July - An independent panel of experts tasked with assessing all aspects of the World Health Organisation’s response to the Ebola outbreak, released its preliminary report and recommendations during a press conference lead by panel chair Dame Barbara Stocking in London yesterday.
The report delivered a stern verdict for the world’s international coordinating health body, in particular its Director General Margaret Chan, finding that “the Ebola crisis not only exposed organizational failings in the functioning of WHO, but also demonstrated shortcomings in the International Health Regulations… WHO does not currently possess the capacity or organizational culture to deliver a full emergency public health response.”
The panel reviewed 3 areas: International Health Regulations (IHR), WHO’s health emergency response capacity and WHO’s role and cooperation with the wider health and humanitarian systems, and requested a full Review Committee to look at the role of the Regulations in the Ebola outbreak, as well as consider and implement the report’s recommendations.
The concluding discussion will be on the agenda for next year’s 68th World Health Assembly.
Doctors Without Borders (MSF), which repeatedly raised the alarm since March 2014 on the failing WHO and global response to Ebola and was interviewed by the panel, has questioned how the investigation will transform into much needed structural and practical changes in the world’s governing health body as well as on the ground action.
The following statement from Dr Joanne Liu, MSF’s International President outlines MSF’s response to the report:
“MSF has repeatedly raised the alarm on the WHO and global response to Ebola and was also interviewed by the panel. On paper, there are a lot of strong points in the report that reflect many issues MSF is concerned about, but the question how will this translate into real action on the ground in future outbreaks and epidemics and what will Member States do to make sure this really happens?
We have seen so many reports calling for change, with everyone focused on how to improve future response and meanwhile, with 20-25 new Ebola cases per week in the region, we still don`t have the current epidemic under control. On Ebola, we went from global indifference, to global fear, to global response and now to global fatigue. We must finish the job.”
On International Health Regulations (IHR) – “On the positive side, the report includes the idea of setting up an intermediate level of alert, so before declaring a Public Health Emergency of International Concern. Our main concern is that the trigger for an international response should be the health needs of people in an outbreak, and not a perceived “security risk” by other countries.
As the report shows, IHR started in 2005 and was never really adopted or followed by countries. Now because Member States were not able to do the self- reporting, the idea is to police IHR.
“The real question is why didn’t countries implement these international health regulations? For many they are too much of a long complicated shopping list - instead they need a minimum spec and help to set it up - so for example to identify three clear things countries need to do: like stronger surveillance, a national lab and clear lines of reporting to declare an outbreak.”
Community engagement and R&D - “A big milestone in the report is the recognition of the need for community engagement – we also welcome the emphasis on research and development and the need for flexibility in emergencies on trade agreements and the use of new medicines, diagnostics and vaccines, to ensure that patients do get treated.”
The report calls for organizational change within WHO and for the creation of a WHO Centre for Emergency Preparedness and Response.
“For patients and health workers to see the benefit, countries need to push for real change and the cultural changes needed within WHO go beyond just creating another emergency response department. You can build an emergency room, but if you do not have an emergency physician in there it will not run - you cannot staff it with say a rheumatologist and if there is no culture of emergency within WHO, this will not be the magic wand. Today they are telling us they don`t have the organisational culture or competence - it is not by building an emergency room that you become an emergency physician. We need to see if the political will for change is really there. ”
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