Medical establishment also a casualty of Ebola crisis

Richard Ingham and Elisabeth Zingg
A newspaper vendor sells copies of the New York Post in front of the entrance to Bellevue Hospital October 24, 2014 in New York (AFP Photo/Timothy A. Clary)

A newspaper vendor sells copies of the New York Post in front of the entrance to Bellevue Hospital October 24, 2014 in New York

A newspaper vendor sells copies of the New York Post in front of the entrance to Bellevue Hospital October 24, 2014 in New York (AFP Photo/Timothy A. Clary)

Paris (AFP) - Beyond the human tragedy of the Ebola epidemic unfolding in west Africa, the crisis is claiming a collateral victim: trust in the medical order.

The biggest casualty is the reputation of the UN's World Health Organization (WHO), which analysts fault for foot-dragging and misjudgements.

Also under assault are Big Pharma, the West's aid policies in Africa and public faith in the rich world's lavishly funded health systems.

"Failures in leadership have allowed a preventable disease to spin out of control, with vast harms to social order and human dignity," a commentary carried by The Lancet said on October 7.

"If the Ebola epidemic does not spur major reforms, it will undermine the credibility of (the) WHO and the UN, and enable the conditions for future crises to persist."

Patrick Zylberman, a historian of medicine at France's National Centre for Scientific Research (CNRS), said the WHO had been slow to heed warnings from frontline groups such as Medecins Sans Frontieres (MSF, Doctors Without Borders).

"Everyone agrees there was a delayed response, which is partly responsible for the scale of the epidemic today," Zylberman said.

It took the WHO until August 8 to press the global alarm button, when it declared the outbreak to be a Public Health Emergency of International Concern, or PHEIC.

That was 20 weeks after the first suspected cases emerged in the world's worst outbreak of haemorrhagic fever -- "a terrible delay," Zylberman said.

Always running to catch up, the WHO in April estimated needs to tackle Ebola at $4.8 million, which in July it raised to $71 million before hiking it to $490 million in August. A few weeks later, the UN launched an appeal for $988 million.

Zylberman said the WHO could plead mitigating circumstances -- it is just the sum of the nation-states that oversee it.

Staffing in its infectious diseases department has fallen from 95 to 30 people, partly because of a decision to shift resources to non-transmissible diseases such as cancer, he said.

Its operational budget is just a third of that of the US Centers for Disease Control and Prevention (CDC). And just 30 percent of the funds are controlled by the WHO itself.

In 2011, the budget was cut by nearly $600 million, causing a reduction in the WHO's emergency response units, and some of its epidemic control experts left.

The WHO has promised to carry out a full review of its handling of the Ebola crisis after the epidemic is under control.

Another failure, say critics, has been priorities for drug research.

Big Pharma pours billions into exploring cures for obesity, diabetes, heart disease, cholesterol, Alzheimer's, impotence and even baldness.

But, with the exception of military-funded projects, there was negligible interest in Ebola, which struck rarely and claimed few lives -- all of them in poor tropical Africa.

"Ebola Vaccine At Least 50 White People Away," the satirical US news site The Onion headlined on July 30.

Vaccines are now being rushed into trials at unprecedented speed and will be rolled out if they are deemed safe and effective. If things go wrong, the medical establishment may have another nightmare on its hands.

- Dud strategy? -

Public health experts also say Ebola spread in part because of inadequate or misdirected aid.

Lacking basic resources -- even gowns, masks and latex gloves -- Liberia, Sierra Leone and Guinea were sitting ducks.

Because of porous borders and jet travel, Ebola became a global scare. The final bill may far outstrip what it would have cost to stop the outbreak at the onset.

"In the last decade, less than two percent of international aid dedicated to health in Liberia has been provided for basic health infrastructure, training health workers and public health education," said Sebastian Taylor at Britain's University of East Anglia.

"Stronger investments in building basic health capacity in countries like Liberia will be key to containing the risk of similar outbreaks in the future."

In Europe and North America, only a handful of Ebola cases have surfaced.

Yet several fumbles and dread of the disease have chipped away at public confidence.

A Pew Research poll conducted among more than 2,000 US adults between October 15 and 20 found that 54 percent had little or no concern about getting Ebola. In early October, that figure was 58 percent.

Seeking to shore up confidence, US President Barack Obama has appointed an Ebola "czar," hugged a nurse who recovered from the disease, and urged the public to remain calm and be "guided by the science -- the facts, not fear."