Weekly Ebola infections in west Africa have dropped to below 100 for the first time in more than six months, figures showed yesterday, raising hopes the worst-ever outbreak of the virus is coming to an end.
The World Health Organisation said it had now shifted its efforts in Guinea, Liberia and Sierra Leone - the countries worst-hit by the epidemic - from slowing the spread to stamping it out completely.
The UN’s Ebola co-ordinator, David Nabarro, nevertheless cautioned that the epidemic was still not totally contained.
With 710 new cases confirmed in the past 21 days, this epidemic is far from over. But now that health experts are easing back from crisis mode, this is a good time for an assessment of what went wrong and how to address the problem more effectively the next time.
There will be a next time. Ebola has surfaced in different strains multiple times since its discovery in 1976, and the fact that the current epidemic got so wildly out of control, with more than 8,600 deaths, indicates ample room for improvement in how the world responds.
WHO’s executive board met in Geneva this week to examine what went wrong. As Dr Margaret Chan, director general of WHO, told the board, the epidemic “delivered some horrific shocks and surprises. The world, including WHO, was too slow to see what was unfolding before us.”
Some of the problems that exacerbated Ebola’s spread were beyond the medical community’s control. War and political upheaval weakened local governments’ ability to identify and contain the early outbreak.
Cultural factors, such as traditions calling for corpses to be washed before burial, also proved difficult to change. Myths and rumours spread rapidly, putting medical personnel at risk when villagers became convinced the health workers were there not to save them but to infect them.
First among many top international priorities should be expanded public education. In schools, mosques and churches across Africa, the WHO and other UN bodies should redouble efforts to explain how to properly handle corpses and avoid contact with people showing disease symptoms. The best time to educate the public is not in the throes of crisis but rather in calmer times when people are better able to absorb the message.
West Africa’s medical community has been hit hard by the Ebola deaths of 499 health workers. Vulnerability to new epidemics increases dramatically in the absence of qualified health workers to treat the ill. International organisations such as Doctors Without Borders and Samaritan’s Purse can lead the way to helping fill this gap as west Africa works to rebuild its medical corps.
Finally, WHO officials should consider more nimble responses. While poor African countries certainly benefit from having more hospitals and clinics, nearly a third of the 64 Ebola treatment centres planned for West Africa still remain under construction today. A better approach might emphasis on mobile facilities that can be deployed quickly when Ebola hot spots develop.
The executive board’s lessons-learned examination is a healthy one. As Chan noted, “Never again should the world be caught by surprise, unprepared.”

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