From failed responses to failed health systems, we’re reading about Ebola

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NewWWREbola: Pushed to the limit and beyond: In their scathing report on the failures of the international response to the Ebola outbreak in West Africa, Médecins Sans Frontières warns that the outbreak is not yet over. “There is no room for mistakes or complacency,” the report reads. “The number of cases weekly is still higher than in any previous outbreak, and overall cases have not significantly declined since late January.” The report notes infections are rising in Guinea and in Sierra Leone, many people presenting with the virus were not previously on lists of known Ebola contacts.

The report outlines the effects of several months of inaction by the international community after MSF’s early warnings of an outbreak one year ago, resulting in the virus spreading wildly while leaving MSF staff overwhelmed by the need for more resources and healthcare workers. “By the end of August, MSF’s ELWA3 center in Monrovia was overwhelmed with patients,” the report says. “Staff were forced to turn away visibly ill people from the front gate, in the full knowledge that they would likely return to their communities and infect others.” The report quotes MSF’s general director Christopher Stokes: “For the Ebola outbreak to spiral this far out of control required many institutions to fail. And they did, with tragic and avoidable consequences.”

One year later, Ebola outbreak offers lessons for next epidemic: This New York Times article examines the shortfalls of the global response to the Ebola outbreak in West Africa, claiming that “Ebola has laid bare the inadequacy of current global mechanisms for detecting outbreaks and quickly mobilizing a response.” From the World Health Organization’s failure to respond effectively to the first cases in Guinea and Sierra Leone in March 2014, to the U.S. military’s inability to help with logistics such as transporting lab samples, inadequate responses from the world’s leading global health players may have played a part in allowing the first few cases to turn into a major outbreak, the article claims. The international community’s albeit late response did prevent the outbreak from spreading more widely to Mali, Nigeria, and Senegal, however. “Six months ago, the world was worried. There was a lot of self-interest in making sure this thing was stopped,” Dr. Bruce Aylward of the WHO is quoted saying, adding, “The biggest mistake the world could do right now is blink.”

How to Fight the Next Epidemic: In this op-ed in the New York Times, Bill Gates contends the failures of groups like the WHO or the CDC to respond wasn’t the main problem in the Ebola outbreak. “The problem isn’t so much that the system didn’t work well enough. The problem is that we hardly have a system at all,” he wrote. “In a battle against a severe epidemic, we would be taking a knife to a bazooka fight.” He says we shouldn’t count on nonprofit groups like Doctors Without Borders to mount a global response, but need to strengthen health systems in poor countries and build up disease surveillance to detect outbreaks at their source. In addition, “we need to invest far more in research on drugs, vaccines and diagnostic tests, and make it possible to accelerate the approval of new approaches in times of crisis.”

Care Differs for American and African with Ebola: While an American clinician working at a Partners in Health Ebola treatment unit in Sierra Leone was swiftly evacuated to a specialized treatment center for infected health workers run by the British Defense Ministry in Freetown before being transported to the National Institutes of Health, a Sierra Leonean health officer who showed symptoms days after his American colleague was sent to a local treatment unit instead, where half of all Ebola patients have died. The health officer’s arrival at the treatment center run by International Medical Corps “was treated with disbelief,” the New York Times article notes. The disparate treatment of American and Sierra Leonean health workers by Partners in Health raises questions about the organization’s commitments to its stated value that “people in poor countries deserve the same high standard of medical care as those in wealthy nations.”

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