Ebola offers another lesson for WHO: It’s not over until it’s over

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NIHEbolaAt the press conference Thursday announcing the latest official end of Ebola in Liberia and with it the end of all known chains of virus transmission in West Africa, representatives of the World Health Organization did emphasize that, as the virus has turned out to be more persistent than previously realized, further transmissions and infections, or, as they put it, “flare-ups,” are expected.

As ten such “flare-ups” already had taken place, that emphasis reflected an apparent resolution on the part of the international health agency to anticipate likely developments — a definite improvement over ignoring ongoing developments — and it was certainly a step in the right direction. Today, with the announcement that another case of Ebola has been confirmed in Sierra Leone, which celebrated its last end of transmission in November, WHO seized the opportunity to remind us that it had, in fact, “stressed in a statement yesterday that Guinea, Liberia and Sierra Leone remain at high risk of additional small outbreaks of Ebola in the coming months . . .”

During the press conference Thursday, however, WHO Emergency Risk Management and Humanitarian Response Director Dr. Rick Brennan seemed less interested in reminders of other harsh realities, when he responded to a question regarding criticisms of the agency’s failure over months to respond and lead action against the outbreak as it worsened exponentially and spread across the capitals of three countries. On that occasion, his emphasis was on the word “and” as he referred to a “general acknowledgement that WHO and the international community were slow at the start,” missing a valuable opportunity to initiate and demonstrate a new trend on the part of the agency toward accountability and responsibility. Because, while it’s true the “international community” of governments and many other purported global health leaders were egregiously and unforgettably negligent as the outbreak swept across three West African countries, the responsibility for leadership, through assessing the situation and its needs, declaring the crisis a Public Health Emergency of International Concern, and coordinating responses rested on WHO.

WHO has another valuable opportunity to show leadership now and in the months that follow, as efforts to meet the needs of more than ten thousand survivors with health care, testing and counseling, as well as the needs of their family members and intimate partners, including with anti-Ebola vaccinations, proceed in countries with shattered health systems and economies. One way to do it would be to replace announcements of what representatives Thursday called “a good day, an important day,” with announcements of the realities that continue, the needs that remain unmet, and of the work to be done before the real crisis, of accountability, of equity, of functional health systems, that led to the deaths of more than 11,300 people is over.

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