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Containing Ebola: Better late than never

A Liberian woman watches as health workers wearing protective clothing prepare to carry an abandoned dead body presenting with Ebola symptoms in Monrovia Aug. 17.REUTERS/2Tango

The international response to the Ebola outbreak in West Africa has been weak, and it’s been slow — a symptom of many world leaders’ inability to recognize a disease outbreak in a troubled part of the world not just as a humanitarian crisis, but as a threat to global security.

Six months into the outbreak, there isn’t even a central place where individuals can donate to help. Doctors Without Borders, an organization that has warned that the world is “losing the battle” to contain Ebola, has shouldered the lion’s share of the burden of caring for victims. Meanwhile, Boston-based Partners in Health should be commended for channeling support to two local organizations, Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone.

And yet these voluntary efforts cannot substitute for a concerted multinational response. President Obama’s decision to dispatch 3,000 soldiers to set up 17 field hospitals in Liberia, each with 100 beds, offers some measure of relief. No one does logistics like the US military, and the effort will help bring in supplies and doctors to Liberia, Sierra Leone, and Guinea — affected countries largely abandoned by commercial airlines.


Even so, the United States and other powers are still playing catch-up. The delayed response has already allowed the virus to spread exponentially. Although there are only about 4,200 confirmed cases so far, including 2,400 deaths, global health officials estimate that 20,000 people will be infected with the virus by the end of October. In that context, the 1,700 hospital beds are a step in the right direction, but insufficient to meet the need.

The efforts of the British and French in their former colonies are even more modest. Britain has reportedly agreed to set up a 62-bed treatment center. So far, it’s donated $40 million. Meanwhile, France is sending 20 specialists in biological disasters and has made a donation to the French Red Cross. Other countries, such as Cuba and India, have stepped in to some degree — sending in doctors and giving money to the World Health Organization’s efforts to contain Ebola.

Such gifts are sorely needed, since the World Health Organization’s budget has been shrinking in recent years. About 80 percent of the agency’s funding comes from voluntary contributions, rather than member dues. Such gifts dried up after the financial crisis of 2008. Its most recent two-year budget came to a total of about $4 billion — for a planet that has 7 billion people and counting. And even when money was flowing, much of it was earmarked for donors’ pet causes, making it unavailable for unforeseen disasters like Ebola. The shortsightedness of that patchwork approach to funding the agency is now becoming evident; the military mobilization that Obama announced last week carries a price tag estimated at $750 million.


With more predictable funding and a more forceful attitude, the World Health Organization could play a more effective role in summoning international assistance early on. Internal reform may be necessary, too. The agency is widely perceived as overly bureaucratic, its headquarters in Geneva are far removed from the grim realities of the field. These factors hamper the agency’s ability to serve as the first line of defense against such epidemics. After this Ebola outbreak is contained, world leaders and public health officials should remember this failure and figure out how to improve the agency.

In West Africa, infected patients are dying due to lack of treatment, and fear is grinding fragile economies to a halt. The economic fallout, just like the disease, is something that can be anticipated and mitigated — but only if the United States and other powers recognize the value of promoting public health up front, in a world where the rapid movement of people also allows the rapid transmission of deadly viruses.