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Offline: A pervasive failure to learn the lessons of Ebola

THE LANCET by Richard Horton                         Sept. 12, 2015

LONDON-- Post-Ebola reverie has given birth to a plethora of expert panels to consider what went wrong. The latest parade of global health specialists appointed to learn lessons gathered at the Wellcome Trust in London last week.
 Under the auspices of the US Institute of Medicine (IOM), a Commission to “deliberate and evaluate options to strengthen global, regional, and local systems to better prepare, detect, and respond to epidemic diseases” spent 2 days amassing evidence.

 There was no shortage of experience brought to bear on these important matters. Here were Margaret Chan, Jeremy Farrar, Ilona Kickbusch, David Heymann, Larry Gostin, Joy Phumaphi, Joanne Liu, and Peter Piot all wrestling with a seemingly intractable challenge. The statements offered to the Commission were arresting. But  the purpose of the meeting was not to talk. It was to identify the best system for an epidemic response....
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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2900152-X/fulltext

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WHO Director-General addresses the Review Committee of the International Health Regulations focused on the Ebola response

Opening remarks at the Review Committee on the role of the International Health Regulations in the Ebola outbreak and response Geneva, Switzerland by Dr. Margaret Chen Director-General of the World Health Organization
24 August 2015

....Since Ebola first emerged in 1976, WHO and its partners have responded to 22 previous outbreaks of this disease. Even the largest were contained within four to six months....

In West Africa, WHO, and many others, were late in recognizing the potential of the outbreak to grow so explosively. Some warning signals were missed. Why?

Our challenge now is to look for improvements that leave the world better prepared for the next inevitable outbreak.

Managing the global regime for controlling the international spread of disease is a central and historical responsibility of the World Health Organization. We need to pinpoint the reasons why the response fell short,. We need to learn the lessons. We need to put in place corrective strategies just as quickly as possible....

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http://www.who.int/dg/speeches/2015/review-committee-ihr-ebola/en/

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Ebola: What Happened

COUNCIL ON FOREIGN RELATIONS  BY John Campbell
(Scroll down for Laurie Garett's essay "Ebola's Lessons.")

With a rapidly growing and urbanizing population, persistent poverty, and weak governance, Sub-Saharan Africa is likely to be the source of new epidemics that potentially could spread around the world. Understanding the disastrous response of African governments, international institutions, and donor governments to the Ebola epidemic is essential if history is not to be repeated yet again. That makes Laurie Garrett’s essay, “Ebola’s Lessons,” in the September/October 2015 issue of Foreign Affairs, essential reading.

The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. (Courtesy Reuters/James Giahyue)

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How The Department of Defense Helped Confront Ebola

GEORGETOWN PUBLIC POICY REVIEW by Col.Russell E. Coleman   Aug. 12, 2015
WASHNGTON -- More than 10,000 people have died of Ebola virus disease (EVD) since the outbreak in West Africa began in December 2013. An epidemic of this magnitude, whether naturally occurring or caused by a biowarfare agent, could compromise both the U.S. health care system and the U.S. military’s ability to defend this country and its allies.


This possibility, long recognized by the Department of Defense (DoD), drives the department’s development of medical countermeasures. The response to the current Ebola outbreak demonstrates how DoD prepares for a medical threat without knowing (1) where it will happen, (2) when it might happen, (3) what the disease will be, and (4) what local resources will be immediately available.

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http://gppreview.com/2015/08/12/how-the-department-of-defense-helped-confront-ebola/

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Handwashing in W.African schools protects children, families from Ebola: UN

REUTERS by Monica MacSwan                                                                     Aug. 12, 2015

LONDON -- Handwashing and giving out soap in schools in Guinea, Liberia and Sierra Leone have helped to keep classrooms Ebola-free this year but schools need to remain vigilant after the summer holidays, the U.N. children's agency said on Wednesday.

UNICEF said there had been no reported cases of students or teachers contracting Ebola at a school this year in the three worst-hit countries in West Africa, where the virus has killed nearly 11,300 people since the outbreak began in late 2013.

In Liberia, where there have been as many as 4,800 deaths, two schools were decontaminated as a precaution after one student died in June and another became infected in July.

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Proposed Ebola biobank would strengthen African science

NATURE by Erika Check Hayden                                                                             Aug. 10, 2015
As West Africa’s Ebola outbreak winds down, an effort is under way to make the best use of the tens of thousands of patient samples collected by public-health agencies fighting the epidemic.  Samples from the Ebola epidemic in West Africa are held by public-health agencies in the region and abroad. Daniel Berehulak/NYT/Redux/Eyevine

On 6–7 August, the World Health Organization (WHO) convened a meeting in Freetown, Sierra Leone, to discuss how to establish a biobank for up to 100,000 samples of blood, semen, urine and breast milk from confirmed and suspected Ebola patients, as well as swabs taken from the bodies of people who died from the virus. Held by health agencies in both West Africa and the West, the samples could be valuable in understanding how the current Ebola crisis evolved, preparing for future outbreaks and developing public-health research capacity in a region that depends on outside experts.

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Only two Ebola cases reported in past week, but risks remain: WHO

REUTERS  by Stephanie Nebehay                           Aug. 4, 2015

Guinea and Sierra Leone each recorded a single cases of Ebola in the past week, putting a year-end goal of ending the deadly epidemic within reach, although risks remain, the World Health Organization (WHO) said on Tuesday.

Tight surveillance and tracing contacts of infected people remain crucial, WHO Assistant-Director Bruce Aylward said. They are especially challenging during the heavy rains in August.

In the previous week to July 26, the two countries had seven confirmed cases, which was the lowest in the past year up until then, according to the WHO.

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http://www.reuters.com/article/2015/08/04/us-health-ebola-who-idUSKCN0Q91JM20150804

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UN Ebola mission winds down, WHO takes reins in West Africa

ASSOCIATED PRESS by MARIA CHENG and RAPHAEL SATTER   July 31, 2015

LONDON — The United Nations Mission for Ebola Emergency Response is officially winding down Friday, handing its leadership role and senior staff to the Geneva-based World Health Organization as efforts to contain the deadly virus continue.

"We have reached an important milestone in the global Ebola response," U.N. Secretary-General Ban Ki-moon said in a statement Friday, while noting that that crisis "is not yet over."

The Ebola mission, also called UNMEER, was established last year as WHO struggled to get a handle on an outbreak that has killed more than 11,000 people, mainly in Guinea, Sierra Leone and Liberia. WHO had been strongly criticized for fumbling its response to the epidemic, and the creation of UNMEER was widely seen as a rebuke to its leadership.

Speaking to reporters Friday, UNMEER chief David Nabarro said he had seen signs that WHO had already absorbed some of the lessons of the Ebola disaster, recovering its coordination role in West Africa and deploying more 1,000 staffers to the field.

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http://www.seattlepi.com/news/medical/article/WHO-works-to-reform-itself-after-fumbling-Ebola-6416880.php

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Ebola cases ebb a bit, with Conakry, Freetown as hot spots

CENTER FOR INFECIOUS DISEASE AND POLICY  by Lisa Schnirring     July 22, 2015

The number of new Ebola cases in Guinea and Sierra Leone declined a bit last week, with much of the disease activity centered in the two capital cities for the second week in a row, the World Health Organization (WHO) said in its weekly epidemiologic update today.

Tests confirmed 26 Ebola cases among the two countries, 22 in Guinea and 4 in Sierra Leone. The total is down from 30 reported the previous week, but progress against the disease has been stagnant over the past several weeks, hovering around 25 to 30 cases. Officials, however, said they saw more hopeful signs in contact tracing.

No new cases were reported in Liberia.

Overall, the total in the three countries has reached 27,705 confirmed, probable, and suspected cases, including 11,269 deaths, according to the WHO.

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http://www.cidrap.umn.edu/news-perspective/2015/07/ebola-cases-ebb-bit-conakry-freetown-hot-spots

WHO:  Ebola Situation Report - 22 July 2015

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Ebola showed aid delivery desperately needs an overhaul

REUTERS  by Stella Dawson                                                          JUNE 18, 2015

WASHINGTON -- The Ebola epidemic exposed long-standing holes in aid delivery,  which desperately needs an overhaul before the next international emergency hits, aid experts said on Thursday.

Supplies for the Ebola zone in West Africa wait to be loaded at New York's John F. Kennedy International Airport September 20, 2014. REUTERS/Carlo Allegri

Many of the shortcomings seen during the Haiti earthquake of slow responses and uncoordinated relief efforts were repeated during the Ebola crisis that erupted in West Africa a year ago, they said.

With Sierra Leone and Guinea continuing to report cases of the deadly virus, the international community must act urgently, said Carolyn Reynolds, external relations manager at the World Bank.

"We need to think outside the box," she said at a panel on global health preparedness held on Capitol Hill.

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www.trust.org/item/20150618215202-ilvea/?source=fiOtherNews2

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