Ebola

Now that there is a person in the US with Ebola following up on people from the US getting it in Africa (such as), the US now cares much more about it. There are many reasons it has spread so much this time. Here’s one:

The W.H.O. had to cut nearly $1 billion from its proposed two-year budget, which today stands at $3.98 billion. (By contrast, the budget of the Centers for Disease Control and Prevention for 2013 alone was about $6 billion.) The cuts forced difficult choices. More emphasis was placed on efforts like fighting chronic global ailments, including heart disease and diabetes. The whims of donor countries, foundations and individuals also greatly influenced the W.H.O.’s agenda, with gifts, often to advance specific causes, far surpassing dues from member nations, which account for only 20 percent of its budget.

At the agency’s Geneva headquarters, outbreak and emergency response, which was never especially well funded, suffered particularly deep losses, leaving offices that look, one consultant said, like a ghost town. The W.H.O.’s epidemic and pandemic response department — including a network of anthropologists to help overcome cultural differences during outbreaks — was dissolved, its duties split among other departments. Some of the main outbreak pioneers moved on.

“That shaping of the budget did affect the area of responding to big outbreaks and pandemics,” said Dr. Fukuda, who estimated that he now had 35 percent fewer employees than during the 2009 H1N1 flu pandemic — more than double the cuts for the organization as a whole.

“You have to wonder are we making the right strategic choices?” he said. “Are we ready for what’s coming down the pike?”

The entire W.H.O. unit devoted to the science of pandemic and epidemic diseases — responsible for more than a dozen killers, including flu, cholera, yellow fever and bubonic plague — has only 52 regular employees, including secretaries, according to its director, Dr. Sylvie Briand, who said that could be increased during outbreaks. Before the Ebola epidemic, her department had just one technical expert on Ebola and other hemorrhagic diseases.

The W.H.O. hoped to balance its budget cuts by strengthening the ability of countries to respond to public health threats on their own. It put out new regulations for nations to follow to help contain outbreaks. But by 2012, the deadline it set, only 20 percent of nations had enacted them all. In Africa, fewer than a third of countries had programs to detect and stop infectious diseases at their borders. The W.H.O.’s strategy was often more theory than reality.

An organization that has to trust that the countries in West Africa will be able to fund these programs is an organization that is going to fail. One thing that needs to happen is for the countries of the world to step up to help, which means that whatever you feel about Cuba you should cheer this:

On Thursday, 165 health professionals from the country arrived in Freetown, Sierra Leone, to join the fight against Ebola – the largest medical team of any single foreign nation, according to the World Health Organization (WHO). And after being trained to deal with Ebola, a further 296 Cuban doctors and nurses will go to Liberia and Guinea, the other two countries worst hit by the crisis.

In some ways, this is the reason we have a UN. Countries need to organize against outbreaks such as this (Ebola doesn’t abide by borders or the system of government), it’s hoped that by working together for the common good the countries will better get along with each other–so far that has not been realized.

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