The doctor of the world gets a second chance on Ebola – POLITICO

Tedros Adhanom Ghebreyesus, of the World Health Organization, said the end of an Ebola outbreak that began in May in the Democratic Republic. Republic of Congo, four years after the high-profile failure of the agency to stem the spread of the virus in West Africa.

This is a remarkable victory for an organization struggling to regain its momentum after serious institutional failures in the treatment of epidemics. Avian Influenza to SARS 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, are adopting 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 the Ebola virus disease in the DRC is seen as evidence that the WHO is learning from past mistakes and 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 Lassa, 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 this can make humans sick. "We should not have too much faith in ourselves," 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.

Tedros maintains with the medical staff of the World Health Organization. an Ebola treatment center in Itipo, DRC | Junior D. Kannah / AFP via Getty Images

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 what it is, what 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 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

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 assess the situation alongside the DRC government.

Tedros attributes this quick response in part to his reform of the flow of information that the WHO receives about global disease outbreaks. When the former Ethiopian health minister started at the WHO last July, he was receiving an email update once a week – he quickly decided not to cut 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 up with people on field. Devi Sridhar

Tedros also pushed to reshape the WHO's financial and tactical response to outbreaks, 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, some 30 Guinean health workers benefiting from the outbreak experience in West Africa were led 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. "

Tedros' mantra for his tenure has been that the people who need the most WHO should play a bigger role in his operations | Fabrice Coffrini / AFP via Getty Images

L & # 39; One of these indicators is Tedros' ability to raise funds.The WHO relies on the contributions of its members to the wealth and size of the population, but it is increasingly dependent on voluntary contributions from from countries or large nonprofit organizations, which can be assigned to specific projects, why is WHO fighting because there may not be enough money. I would say that the reason they do not have enough money is because they struggle often, "said Jha de Harvard. "Money follows success."

The successful containment was also partly due to the widespread deployment of an Ebola vaccine by US pharmacist Merck & Co, which had been tested by WHO and organizations including the 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 raised $ 63 million for its response to the Ebola virus in the DRC.

Tedros attributes this to his success in setting up the organization quickly on the ground

"People will believe you if you say" OK, I'm here in the middle of the world. " 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 pledged up to $ 8 million, despite previous calls from the president Donald Trump

"The expectations are great for a real movement on this and if there is no movement, I think it certainly has the potential to harm the "WHO" – Ashish Jha, Director of the Harvard Global Health Institute

While the Ebola victory is extremely symbolic, Tedros says that it is a small piece of a diary more impo as it built last year to ensure universal health coverage and fight against 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 US is lobbying for international breastfeeding declarations to change and use IP flexibilities to reduce drug prices, as well as pressure for sugar taxes to be removed from recommendations of the WHO on noncommunicable diseases. The success of the emergency response to the Ebola virus may not translate directly into success on 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 the gamble that the WHO has made on universal health coverage," said Jha. "Expectations are high for real movement 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 only a question at the highest level that this is going to make a difference in key negotiations?"

Tedros himself says that 39, he is 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.

Sarah Wheaton contributed to the report. ] [ad_2]
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