http://www.huffingtonpost.com/2014/08/05/ebola-plan_n_5649563.html

Health Expert: 'No Strategic Plan' For Controlling Ebola Outbreak

Posted: 08/05/2014 4:47 pm EDT Updated: 08/06/2014 11:59 am EDT

The Ebola outbreak concentrated in West Africa is “out of control,” and the international community has no organized plan to address it, a global health expert said Tuesday.

“We’re now in a perfect storm,” Laurie Garrett, senior global health fellow for the Council on Foreign Relations, said Tuesday on a CFR conference call. “There is no strategic plan for how this epidemic will be brought under control.”

“People believe that there’s a giant World Health Organization office in Geneva stocked full of specialized equipment and talented health care workers,” she said. “Not only do we not have any such thing –- the WHO is essentially bankrupt.”

Garrett said it is telling that the largest response group in West Africa -- Médecins Sans Frontières (Doctors Without Borders), which has more than 550 staff members on the ground -- is a volunteer group. Furthermore, Garrett said, the group's tired workers have "issued plea after plea in recent days" for someone else to take over. More than 60 health care workers have been infected by the Ebola virus, including some of the most famous physicians in the battle against the disease, Garrett said.

In addition, health care workers are describing themselves as “in a state of seige -- feeling that the population despises and loathes them,” Garrett said. “Rumors are rife that they are actually deliberately infecting people, cutting off people’s arms and selling them on some alleged international market, and even that there are health care workers who are cannibals.”

Garrett said the most immediate need is an agreed-upon international leader in the fight against the epidemic. There hasn’t been an all-hands-on-deck meeting to confirm WHO leadership –- and how it can effectively take on that role with what Garrett says is a $1.2 billion deficit.

When the H1N1 virus (commonly known as swine flu) broke out in 2009, individual countries responded with their own plans because there was no international leader in the fight against the virus, Garrett said. Because there's no leadership in the current crisis, and nonprofits in West Africa have varying mandates and purposes, the region faces possible chaos, she said.

WHO spokeswoman Christy Feig confirmed to HuffPost that the WHO has a budget deficit, but did not immediately disclose the amount. On Monday, the World Bank pledged $200 million toward combating the Ebola outbreak. Feig said the WHO now needs an additional $78 million for its fight against the virus. She said the WHO currently has about 140 staff members on the ground in West Africa, and has had a total of 428 staff members who have cycled in and out of the region since the outbreak began.

Garrett criticized this week's Africa summit in Washington, D.C. –- where nearly 50 African heads of state are discussing economic development –- for not having a discussion of the Ebola outbreak added to its agenda.

“We should be taking advantage of this remarkable coincidental moment, but as far as I can tell, it’s not on the agenda,” she said. Garrett said leaders at the summit should be discussing how to mobilize more health care workers, and whether African countries should start closing their borders and canceling flights.

The WHO is convening a special summit starting Wednesday in Geneva, where experts will decide if the epidemic constitutes an international public health emergency. If they designate it as one, the international community would go full-steam ahead to try to develop vaccines, implement border checks, give instructions to flight carriers and more, Garrett said. However, she noted again, the WHO is running on a deficit.

The Ebola virus, which is contracted through bodily fluids, has killed nearly 900 people since February –- making it the largest outbreak of the virus in history -- and has no proven cure. The outbreak began in the forests of Guinea, but the epicenter has shifted to neighboring Liberia and Sierra Leone. There also have been two confirmed cases in Nigeria. The death rate of the current epidemic is about 70 percent, Garrett said.

Two Americans -- a doctor and a missionary -- contracted the Ebola virus in Liberia and have been airlifted to a special isolation ward at Emory University Hospital in Atlanta. Both saw their conditions improve by varying degrees after they received an experimental drug previously tested only on monkeys.

However, Garrett said their improved condition could be due to other factors and is certainly not enough to make a determination about the drug. There are numerous untested Ebola drugs, she said, and although some may go into safety trials this year, none would be available for widespread production for several years.

This is something I've never thought about before - where does the WHO's funding come from in the first place, and why are they now saying they're "essentially bankrupt"?

I think this goes a long way toward explaining the size of the current outbreak. Without a coordinated plan, and more importantly governments capable of implementing it, it falls to the populace to take care of themselves. In countries where the man risk factors (bush meat consumption, inherently dangerous funeral practices, refusal to seek medical help, refusal to self quarantine) have already been clearly identified, but nothing substantial is being done to remedy any of them, it's going to continue to spread. It doesn't need to be an exotic airborne virus - it just needs to be plain old garden variety Ebola thrown into a poverty stricken region of 100 million + people that have little or no idea of how to protect themselves in an outbreak of this magnitude, and the only saving grace being an underfunded and understaffed group of volunteers taking fire on the ground for trying to help.
Chuck - do you see any way that a huge chunk of Africa isn't going to go the same way as the countries already affected, because after that statement I can't imagine any organization, government or agency stepping up with what it'll take to prevent further uncontrolled spread. And I agree with what you said earlier - this could leave the way open for more conflict in countries dealing with rebel insurgencies and tribal instability, and that in turn will give the virus more opportunities.

Thanks FluMom, it does. Just makes me wonder who's not coughing up, or more significantly, what did they spend all their budget on to end up broke?
Nice time to have a budget crisis

I'm wondering how places like South and Central America would fare if it made it over there? Similar climate, dense bush, lots of animals to act as natural reservoirs and in many cases, a large portion of the population on a similar economic footing as many Africans (ie dirt poor).

All of these late breaking infectious diseases seem to be encircling the globe like a belt. Obviously that has to do with climate.