WHO has a second chance on Ebola – POLITICO

Nobody wants a deadly epidemic of 39; Ebola Tedros Adhanom Ghebreyesus, of the World Health Organization, said this month the end of an Ebola outbreak that began in May in the Democratic Republic of Congo, four years ago. after the start of the Ebola outbreak. This is a notable victory for an organization struggling to regain momentum following major institutional failures in the management of epidemics – from the Ebola virus to bird flu to SARS from the respiratory virus. After waiting months to act, the US agency lacked the funds and capabilities to deal with the 2014 and 2015 Ebola crisis, which killed more than 11,300 people in some of the world's most poor of the world. This time, 33 people died.

While its member countries and in particular the United States take an increasingly isolationist approach to global health, the Geneva-based agency is desperately trying to prove that it is still worthy of funding . was at stake … not getting this correct answer was really a risk as the world starts to question our ability to manage the risk and impact of epidemics, "said Ryan Morhard, chief project in global health at the World Economic Forum. "What Dr. Tedros and the WHO have shown, is that it is an organization worthy of our support and our commitment."

"A different thing is that the WHO is better prepared now" – Tedros Adhanom Ghebreyesus

The response to Ebola virus disease in the DRC is considered proof that the WHO learns from the mistakes of the past and that international collaboration on global epidemics is strong. But it remains to be seen whether the Director General has solved the institutional problems of WHO and can apply the same manual to future outbreaks.

"This can be reproduced," Tedros said in a telephone interview with the Republic of Congo. "One thing that is different from before is that the WHO is better prepared now," he said. Last week, the head of the WHO took a ferry from Kinshasa to Brazzaville after visiting the area to declare it free of Ebola.

Other health experts say that it takes longer to judge the return of the WHO. read too much in one victory. The list of priority diseases of the agency includes Ebola fever, Zika and Lbada, which are constantly changing. Last week, researchers in Sierra Leone discovered a new strain of Ebola in bats, but it is not clear yet if it can make humans sick. "We should not be too confident," said Ashish Jha, director of Harvard Global Health. Institute and co-chair of a burning independent review that cataloged the failures of the WHO Ebola response in 2014.

The DRC's effort has been a clear success – and has shown the potential of the new Ebola vaccine used to stop the epidemic – but it should not to be taken "as evidence that in one way or another the problems of the overall response have been solved," said Jha. "See for what it is, which is a success story under really very ideal circumstances."

But he admits that Tedros is on the right track, especially after a decade of lukewarm leadership at the WHO under his former general manager Margaret Chan

"Dr. Tedos has a program, has a plan and is trying to convince the member countries to follow this plan, "said Jha.

A man with a plan

A few hours after the declaration of the Ebola epidemic in the DRC in May 8, Tedros authorized $ 2 million from the WHO reserve fund for emergency situations. Four days later, arrived in Kinshasa and then went to Bikoro to badess the situation alongside the DRC government.

Tedros attributes this quick response in part to his willingness to reform the flow of information that the WHO receives about global disease outbreaks. When the former Ethiopian Minister of Health began working at the WHO last July, he was receiving an email update once a week – he quickly decided not to delete it.

Dashboard, which Tedros says that he regularly refreshes from his iPad wherever he is. "In order to make the world really safe or safer, that kind of mentality is very important – it's 24 hours a day, 7 days a week," he said. help identify the challenges we have and improve the system continually. "

" They call him "the director of the WHO" because he's trying to stay in place with people in the field. Devi Sridhar

Tedros also pushed to reshape the WHO's financial and tactical response to epidemics, although he says many of these structural reforms began under his predecessor Chan in the wake of the 39 Agency delayed response to Ebola in Sierra Leone, Liberia and Guinea.

"She left a very good reform program, which we have just built," Tedros said of Chan. "You can take this as a relay – a switch to the other and that's why we have a better system now."

Tedros' mantra for his tenure has been that the people who need the most from WHO should play a role. He sought to involve local communities in disease issues to help small island countries build better health infrastructure to cope with extreme weather conditions. At the beginning of the epidemic in the DRC, about 30 Guinean health workers with experience of the outbreak in West Africa were brought to teach local teams how to administer the vaccine against the Ebola virus, said Tedros. Director "because he's trying to be up with people on the ground and not staying in Geneva," said Devi Sridhar, professor of global public health at the University of New York. Edinburgh, which co-chaired the review of the Ebola outbreak.

However, after witnessing eight outbreaks of Ebola, the DRC was better prepared than any country in West Africa that had never experienced Ebola before .

"The WHO has not yet been implicated as such." Larry Gostin, director of the O'Neill Institute of National and World Health Law and Health WHO advisor, wrote in an email. "The jury is still on the verge of whether in the long run, the WHO is up to the task. But the first indicators are very favorable. "

One of those indicators is Tedros 'ability to raise funds, WHO relies on its members' contributions to the wealth and size of the population, but relies more and more on voluntary contributions from countries or large nonprofit organizations, which can be badigned to specific projects.Why WHO is fighting because there may not be enough money.I would would say that the reason they do not have enough money is because they struggle often, "said Jha de Harvard. "Money follows success."

The success of the confinement was also due in part to the widespread deployment of an Ebola vaccine by Merck & Co in the United States, tested by WHO and organizations such as Wellcome Trust and GAVI . after the research efforts mobilized around Ebola. More than 3,300 people have been vaccinated in the DRC, including health workers and family members of those infected with the deadly virus.

WHO has raised $ 63 million for its response to the Ebola virus in the DRC

Tedros attributes this to its success in the rapid establishment of the field organization

" People will believe you if you say OK, I'm here in the middle of the epicenter of the epidemic and that's what's happening and that's the kind of support we need, "he said." This was not hypothetical, it was just the actual situation we were reporting … I think the donors have convinced. "

The United States has pledged up to $ 8 million, despite previous appeals by President Donald Trump.

"Expectations are high for a real move on this subject and it will not happen again. there is no movement, I think that it certainly has the potential to harm the WHO "- Ashish Jha, director of the Harvard Global Health Institute

While the victory of Ebola es t extremely symbolic, Tedros says that it is a small piece of a larger agenda that he built last year to ensure universal health coverage and combat noncommunicable diseases and the impacts of climate change on health. Universal coverage was one of the topics discussed with health officials in the DRC and the Republic of Congo during his recent visit.

But all of these areas may put the WHO in conflict with recent Trump administration messages on global health. . The United States has lobbied for international badfeeding declarations to change and use IP flexibilities to reduce drug prices, as well as pressure for sugar taxes to be removed from the United States. WHO recommendations on noncommunicable diseases. The success of the emergency response to the Ebola virus may not translate directly into the success of some of Tedros' more general problems, says Harvard's Jha, observing that achieving universal health coverage rests with individual governments.

"There is some risk here given WHO's gamble on universal health coverage," said Jha. "Expectations are high for a real movement on this and if there is no movement, I think it certainly has the potential to harm the WHO."

Sridhar of the University of Edinburgh pointed out the National Security Council of the United States. House has not yet filled a vacant position for the head of global health security. "It is becoming difficult to consider the United States as a reliable partner," she said. "You still have very good people [working for the U.S. government] .It's just a question at the highest level that will make a difference in key negotiations."

Tedros himself says that he's not Not worried about the threat of a broken commitment from the Trump administration. "What I do know is that I met with the president last year and he swore that the United States will continue to support the WHO," Tedros said. [19659089] Sarah Wheaton contributed to the report. ] [ad_2]
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