The Ebola crisis in west Africa could have been averted if governments and health agencies had acted on the recommendations of a 2011 World Health Organisation (WHO) Commission on global health emergencies, according to a new Comment, published in The Lancet.
The Comment, written by Professor Lawrence Gostin, Faculty Director of the O'Neill Institute for National & Global Health Law at Georgetown University, USA, calls for renewed international commitment to a health systems contingency fund to prevent another infectious disease crisis, together with long-term funding for enduring health systems development.
Although WHO has now implemented a plan for dealing with Ebola - five months after the virus first began to spread internationally - implementation will be further delayed while US$490 million are raised to meet the cost of tackling the epidemic. In the meantime, Ebola continues to spread amongst health workers and the general population, in countries where health resources were already strained before the outbreak.
The 2011 WHO Review Committee proposed a Global Health Emergency Workforce, backed by a US$100 million contingency fund, which would have enabled the rapid initial response needed to contain the Ebola outbreak, but the Commission was not acted upon by WHO, lacking sufficient financial commitment from governments in high-income countries.
According to Professor Gostin, "How could this Ebola outbreak have been averted and what could states and the international community do to prevent the next epidemic? The answer is not untested drugs, mass quarantines, or even humanitarian relief. If the real reasons the outbreak turned into a tragedy of these proportions are human resource shortages and fragile health systems, the solution is to fix these inherent structural deficiencies."
"A dedicated International Health Systems Fund at WHO would rebuild broken trust, with the returns of longer, healthier lives and economic development far exceeding the costs. This fund would encompass both emergency response capabilities and enduring health-system development."
"The west African Ebola epidemic could spark a badly needed global course correction that would favour strong health infrastructure. Sustainable funding scalable to needs for enduring health systems is a wise and affordable investment. It is in all states' interests to contain health hazards that may eventually travel to their shores. But beyond self-interest are the imperatives of health and social justice--a humanitarian response that would work, now and for the future."