Adam Kamradt-Scott, Sophie Harman, Joao Nunes, Anne Roehmer-Mahler, and Clare Wenham
The 2014 Ebola outbreak in west Africa has demonstrated again the urgent need for strong leadership and coordination in responding to global health challenges. As members of the global health scholarly community, we call upon all WHO Member States to recommit themselves to strengthening global outbreak alert and response by sustainably investing in the WHO, its departments, and personnel.
As members of the WHO secretariat have admitted, mistakes were made in how the organisation initially responded to the 2014 Ebola outbreak.
Ahead of the 68th World Health Assembly in May, 2015, the temptation will be to point fingers and use the extreme case of Ebola to justify further erosion of the WHO. The temptation might also be to divert voluntary contributions to other institutions. We firmly believe that any such measures must be approached with extreme care.
In international forums, a proposal is being discussed to establish a new “first responder” UN agency, which will provide emergency operational assistance in humanitarian crises by rapidly deploying trained personnel, equipment, and supplies. While an enhanced rapid response would be beneficial, a new agency would be subject to the same vagaries of institutional funding and Member State interests in delivering its mandate. Even more importantly, these are functions that the WHO already fulfils via the Global Outbreak Alert and Response Network (GOARN), which maintains a roster of experts that can be deployed to assist in humanitarian disasters. The resources to create an entirely new agency would therefore be better served by strengthening the WHO’s emergency response division rather than duplicating existing functions. Resources could also be more effectively used to help Member States implement the International Health Regulations (2005) via health system strengthening.
An independent investigation of the WHO’s handling of the 2014 Ebola outbreak is both appropriate and warranted. The investigation should focus on the structural and procedural elements of institutional practice, consider how recent funding cuts affected the WHO’s ability to respond, and identify pathways to sustainable funding of the institution.
The WHO can provide global health leadership that is technically informed and representative. The organisation remains a fundamental element of global health governance, and provides an indispensable service as the lead technical agency in global health. While mistakes have been made, rather than engage in the further dismantling of the WHO we call on all Member States and the international community to give the organisation the resources it needs to serve its members and the populations they represent.
Adam Kamradt-Scott, Sophie Harman, Joao Nunes, Anne Roehmer-Mahler, and Clare Wenham, on behalf of 95 signatories.
Find the original letter and the full list of signatories in The Lancet.
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