When it first began at the end of December 2013 in a rural village in Guinea, the Ebola virus had been restricted to a few neighboring villages. By March 2014, it had spread to Liberia and Sierra Leone, and in the coming months it would spread to at least 8 other countries around the world. Yet, the World Health Organization (WHO) did not declare a Public Health Emergency (PHE) until August 2014. By September, global concern had risen to such a degree that travel restrictions from the three most severely impacted countries were imposed by dozens of countries.
The WHO was widely, and justifiably, criticized for its failure to swiftly sound the alarm about the global spread of the Ebola virus. The Global Health Institute and London School of Hygiene and Tropical Medicine, which analyzed the WHO’s response to the Ebola epidemic, concluded that the WHO should be stripped of its role in declaring disease outbreaks to be an international emergency following its failure to warn the world of the dangers of Ebola in West Africa. This raises disturbing questions more generally about the strength (and weakness) of the global health regime currently in place, and whether conflicts of interest and politicization of issues related to the issuance of declaring a health emergency are preventing a more robust response.
The WHO, which includes virtually all countries in the world as members, is prevented from being nimble because of its size, as responsive as it might be by virtue of its multilateral decision-making protocol, and ultimately, more effective by virtue of the manner in which it operates. Sometimes what is needed is a firm hand to rise above the chatter of the decision-making process – in other words, a strong leadership that will say, “this is the right thing to do, and it is urgent”.