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WHO Politics Interfered With Ebola Response, Panel Says

TIME Health
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An advisory panel selected to assess the response of the World Health Organization (WHO) to the Ebola outbreak blamed the agency's politics and rigid culture for the poor response to the epidemic. The outbreak has infected more than 27,500 people and killed more than 11,200 in West Africa.

In a report published Tuesday, the panel blamed the organization as a whole for being late in activating emergency procedures, despite early warnings from other groups like Doctors Without Borders/Médecins Sans Frontières. The panel concluded that the agency made noise about the outbreak with little action and poor preparation: "Although WHO drew attention to the 'unprecedented outbreak' at a press conference in April 2014, this was not followed by international mobilization and a consistent communication strategy," the authors write.

The panel argues that the culture at the WHO greatly prohibited action, writing:

"WHO does not have a culture of rapid decision-making and tends to adopt a reactive, rather than a proactive, approach to emergencies. In the early stages of the Ebola crisis, messages were sent by experienced staff at headquarters and the Regional Office for Africa, including after deployments in the field, about the seriousness of the crisis. Either these did not reach senior leaders or senior leaders did not recognize their significance. WHO does not have an organizational culture that supports open and critical dialogue between senior leaders and staff or that permits risk-taking or critical approaches to decision-making. There seems to have been a hope that the crisis could be managed by good diplomacy rather than by scaling up emergency action."

The panel says that a number of factors were responsible for the delay in declaring the outbreak a pubic health emergency of international concern, including a late understanding of the gravity of the situation, denial among country authorities, culture problems within the WHO and a failure of the international community as a whole to take notice.

The report suggests instituting a variety of reforms and priorities, including focusing on fast-tracking vaccines and drugs and calling upon WHO member states and partners to immediately contribute $100 million in voluntary contributions for an emergency fund.

Response to the report has been mixed. As the Associated Press reports, some members of the public health community involved were disappointed that individuals were not called out by name and that the agency was already focusing on lessons learned, when the outbreak is still ongoing.

Inside the Ebola Crisis: The Images that Moved them Most

Ebola in Sierra Leone for the Washington Post
Pete Muller, Aug. 26, 2014. Sengema, Sierra Leone."The rain started shortly after a small team of Red Cross burial workers approached the body. The deceased man, reportedly in his mid-sixties, collapsed and died outside his remote home more than a day before the burial team arrived. Having received instructions from officials that bodies of Ebola victims are extremely contagious, his family members placed a sheet over his body, marked a cordon in the sand, and called the Red Cross. With approximately 20 burial workers serving all of Kailahun district, an area the size of Rhode Island and rife with Ebola, the team had a backlog of cases. His family endured the presence of his body, laying prone and exposed to the elements, for more than 24 hours. As the team removed the sheet, the stench of death filled the air. The white cloth around the man’s head was crimson with blood. As burial workers sprayed him with chlorine, family members erupted with emotion. I was moved imagining how I might respond if I were in the situation. To me, this picture represents the range of Ebola’s emotional impact. In the two women, we see the devastation and loss that the virus causes. In the faces of the men, we see a sense of despondence, disbelief and suspicion that also defines the response. It was a difficult but necessary picture to make."Pete Muller—Prime for the Washington Post
Ebola in Sierra Leone for the Washington Post
Body removal team preps a body to be removed from the West Pont facility.
Idrissa-koruma, a 35 year old man, the husband of Baindu-koruma a 28 year old woman, grives her death of Ebola deadly virus.
Liberia Battles Spreading Ebola Epidemic
Benedicte Kurzen, September 2014."From early morning till late in the afternoon, we followed the Liberian Red Cross. They have a list of people who died and they go to their communities to collect the bodies. Every time the Red Cross workers do the same thing: they wear protective clothing, interview the family, spray the perimeter and the room, and the body. They carefully open the body bag, carry the body outside for pick up — sprayers and volunteers facing each other — and later remove their protective clothing as carefully as they can. Their work is measured, slow: any direct contact with the dead person's body can be dangerous. In this photo, it is all about the gesture. In this chlorinated, silent corridor, there is little else that can convey humanity besides this gesture. This is one human helping another."
Dominique Faget, Aug. 26, 2014. Bandor, near Monrovia, Liberia. "I went with a team from the Liberian Red Cross to Bandor from Monrovia to pick up five dead people who had been infected with the Ebola virus. After photographing the removal of three bodies, including a young pregnant woman, I followed the team to a small cottage house where we had heard the bodies of a dead couple were. Once there, one of the Red Cross team responsible for the removal of their bodies gestured to me, patting his heart — indicating that these people were still alive. I then approached and photographed this man lying silently in the doorway of his home. I wondered how many days this poor sick man, like hundreds of others, had been waiting alone?
Ahmed Jallanzo, Aug. 20, 2014. Monrovia, Liberia."Violence had broken out in the slum township of West Point as the government tried to quarantine tens of thousands of residents in order to stop the spread of the deadly Ebola virus. As I walked through the town to cover the reactions of residents towards security forces, I saw 15-year-old Shakie Kamara bleeding profusely, a pool of blood forming around him, with his right hand placed underneath his broken leg to keep it in balance. He was caught in clashes with police and had been shot. The ambulance service was somewhat slow to respond as he repeatedly cried for help. The tragic irony is that no one dared try to help for fear of contracting the Ebola virus from his blood and bodily fluids, as avoiding contact is one of the measures of preventing the disease from spreading.
Tommy Trenchard, Aug. 20, 2014. Monrovia, Liberia.
EBOLASTAFFING
Sylvain Cherkaoui, April 19, 2014. Gueckedou, Guinea."Doctors Without Borders sent me to Guekedou Forest in Guinea to cover the current Ebola crisis. After receiving an alert a team of doctors went to look for a woman who was exhibiting symptoms of the Ebola virus. When one doctor took her temperature, it was confirmed: she was infected and had to be admitted to the care center. After donning protective gear, I followed her into the field hospital and took this picture when health care workers told Finda that she had Ebola. What I did not know was that she had an extremely high viral concentration. The next morning, members of her family came to visit. Not long after, maybe minutes later, a nurse told me that Finda had died during the night. It happened so fast, I was shocked and deeply moved."
Pete Muller, Aug. 26, 2014. Sengema, Sierra Leone."The rain started shortly after a small team of Red Cross burial worke
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Pete Muller—Prime for the Washington Post
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