. World Health Organisation is 'unfit to deal with global emergencies', says damning new report into its handling of the Ebola epidemic

. Experts have called for an overhaul of the UN agency, in the wake of crisis

. Panel severely critiscised its failure to deal with the disaster last year

. Epidemic was not declared a public health emergency until August 2014, despite its outbreak in Guinea in December 2013

. Disease ravaged Guinea, Liberia and Sierra Leone killing more than 11,000 

 

The World Health Organisation is ‘culturally’ unfit to deal with global emergencies, an independent review has found in the wake of the Ebola crisis. Experts called for a fundamental overhaul of the body, a branch of the United Nations, which was severely criticised for its failure to deal with the disaster last year. A panel chaired by Dame Barbara Stocking, former CEO of Oxfam GB, found that the episode exposed serious problems within the structure of the WHO and the actions of those it employed.

 

The epidemic, which broke out in West Africa in December 2013, was not declared a public health emergency by WHO until August 2014 - which has been partly blamed for its rapid spread throughout the region, resulting in more than 11,000 deaths.

 

In a damning report published yesterday, the independent board commissioned to investigate the disaster said: ‘The panel considers that WHO does not currently possess the capacity or organisational culture to deliver a full emergency public health response. ‘The organisation’s capacity for emergency preparedness and response must be strengthened and properly resourced at headquarters, regional and country levels.’ They called for sweeping changes to the organisation, which employs 7,000 people around the world.

 

‘The world simply cannot afford another period of inaction until the next health crisis,’ the authors said. Other findings included a lack of a ‘culture of rapid decision-making’, with staff reacting to events rather than making proactive decisions. The report said the agency must make changes in terms of leadership and decision-making processes.

 

‘The WHO does not have an organisational culture that supports open and critical dialogue between senior leaders and staff or that permits risk-taking or critical approaches to decision-making,’ the authors wrote. ‘There seems to have been a hope that the crisis could be managed by good diplomacy rather than by scaling up emergency action,’ they added.

 

World leaders and charities also came under criticism.

‘The panel considers that during the Ebola crisis, the engagement of the wider humanitarian system came very late in the response,’ they wrote. ‘The panel was surprised that many donors, governments, the United Nations and international non-governmental organisations understood only either the health emergency or the humanitarian system.’

 

More than 27,000 people were diagnosed with Ebola during the outbreak, which peaked last summer, most of them in Liberia, Sierra Leone and Guinea. The epidemic was considered to have ended two months ago - but last week the virus re-emerged in Liberia, which announced three new cases of the virus.

 

Dame Barbara’s team wrote: ‘Widespread and intense transmission has devastated families and communities, compromised essential civic and health services, weakened economies and isolated affected populations. ‘The outbreak also put enormous strain on national and international response capacities, including WHO’s outbreak and emergency response structures.

 

Doctors Without Borders: A look at West African Ebola

GUINEA, LIBERIA AND SIERRA LEONE STILL NEED $700 MILLION IN THE NEXT TWO YEARS TO REBUILD THEIR BATTERED HEALTH SERVICES 

 

The West African nations ravaged by the deadly Ebola virus need a further $700 million to rebuild their batter health services, experts have said. The funding is needed in the next two years to help Guinea, Liberia and Sierra Leone recover from the epidemic, that claimed more than 11,000 lives. So far donors across the world have pledged $1.4 billion of an estimated $2.1 billion required by the three nations, according to WHO assistant director general for health systems and innovation, Marie-Paule Kieny.

 

UN secretary-general Ban Ki-moon will host an international Ebola recovery conference in New York on Friday to raise additional funds for reconstruction. 

'Full recovery in the three countries will not happen if we don't strengthen the health system,' Ms Kieny told Reuters. She said additional funding would also be required after 2017. 

 

Even before Ebola struck, Guinea, Liberia and Sierra Leone had some of the poorest healthcare systems in the world, but the damage inflicted by the outbreak has left them more vulnerable than ever, officials say.  In Guinea, WHO officials have reported a drastic increase in deaths from malaria and measles. Before the crisis, the country's annual healthcare spending stood at just $7 per person in 2013, one of the lowest rates in the world. 

 

Pre-Ebola healthcare expenditure in Liberia and Sierra Leone was little better at $14 and $11 per person respectively, well below the WHO's recommended minimum of $84 per person per year.  The re-emergence of Ebola in Liberia last week, nearly two months after it was declared free of the virus, has stoked fears that it may take longer than expected to defeat the epidemic.

 

Kieny said it was too soon to say how the three new cases in Liberia - one of whom has died - became infected.  Tests are being carried out by the Liberian government and international health agencies. 

 

The European Union on Monday approved 1.15 billion euros in aid for West Africa through to 2020, nearly doubling its previous commitment to a region that is a major source of migrants seeking to enter Europe.

 

‘The panel remains extremely concerned about the grave health, social and economic costs of the Ebola outbreak. In light of the unpredictable nature of outbreaks and other health crises - and the mounting scale of ecological changes that may trigger them - improving WHO’s leadership and response to events such as these is critical.’

 

WHO director-general Margaret Chan, who has led the agency since January 2007, admitted in May it had been ‘overwhelmed’ by the Ebola epidemic and ‘ought to have reacted far earlier’.

 

The WHO said in a statement yesterday: ‘WHO is already moving forward on some of the panel’s recommendations including the development of the global health emergency workforce and the contingency fund to ensure the necessary resources are available to mount an initial response. The current Ebola outbreak is still ongoing and improved methods of working are incorporated into the response as they are developed. But it will take many more months of continued hard work to end the outbreak and to prevent it from spreading to other countries.’

 

The report was last night welcomed by health charities. 

Dr Jeremy Farrar, director of the Wellcome Trust, said: ‘The recommendations outlined by the independent panel should give WHO the mandate it needs to lead the global response to future health crises. The support of the global community is also crucial if we are to avert another catastrophe on the scale of Ebola.’ 

 

The report also criticised Britain’s contribution to the humanitarian response. The UK sent more than 800 troops to Sierra Leone help battle the outbreak, as well as hundreds of NHS and aid workers. Military engineers built six treatment centres which were then handed over to civilian aid agencies. But the report authors said the UK military inappropriately tried to take control of the situation - and instead should have assisted local leaders.

 

They wrote: ‘There may be a place for military support for emergencies - for example, in construction and transport - but as agreed in civil/military guidelines, this must be under civilian control.’  

 

By BEN SPENCER MEDICAL CORRESPONDENT and LIZZIE PARRY 

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