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By Alice Park
February 3, 2015
TIME Health
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Of all the money pledged by well-intentioned individuals, organizations and nations, only 40% has actually reached the countries hardest hit by the Ebola epidemic in West Africa—Guinea, Liberia and Sierra Leone.

The new calculation comes from Karen Grepin, an assistant professor of global health policy at New York University, in a report published in the BMJ. Using data collected by the United Nations Office for the Coordination of Humanitarian Affairs, Grepin looked back and found that the World Health Organization’s requests for aid changed constantly since the Ministry of Health in Guinea first reported the 49 cases and 29 deaths that launched the current Ebola outbreak. From an early ask of $4.8 million in April, the agency, along with the governments of the three affected nations, revised that need to $71 million in August and to $600 million soon afterward to contain the epidemic. By the end of 2014, the UN was requesting $1.5 billion.

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The global community responded, pledging nearly $2.9 billion by December. Only $1.09 billion of this support has actually been paid, however, and Ebola-stricken countries only began receiving some of this aid in October, a full seven months after the first cases were reported. The U.S. has been the largest donor, pledging more than $900 million, of which 95% has been funded, followed by the U.K., with $307 million, and the World Bank at $230 million. (Only half of the World Bank pledge has been funded.)

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The delay in dispatching resources to West Africa may have contributed to the spread of the virus and further increases in the financial needs of those countries, whose health systems have been strained by the volume of Ebola cases, Grepin argues. “We need a mechanism to enable more rapid disbursement of funds to fight public health threats such as Ebola, such as a dedicated fund that could be rapidly deployed for any emergency,” she writes. “Although quantity of funding is important, so is the quality of the response.” Learning from what worked to support the nations affected by Ebola, and which strategies proved too inefficient, could help to streamline and optimize efforts for the next public health threat.

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