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| 2 Panels Advise Bolstering W.H.O. for Crises Like Ebola | 2 Panels Advise Bolstering W.H.O. for Crises Like Ebola |
| (35 minutes later) | |
| In recent months, numerous groups of health experts have gathered to debate how to prevent another crisis like the Ebola epidemic in West Africa, which jumped borders, spread fear across the globe, and directly killed more than 11,000 people. Many more died as hospitals and clinics closed for months. | In recent months, numerous groups of health experts have gathered to debate how to prevent another crisis like the Ebola epidemic in West Africa, which jumped borders, spread fear across the globe, and directly killed more than 11,000 people. Many more died as hospitals and clinics closed for months. |
| Now two of those groups — one independent and the other convened by the World Health Organization — have released specific recommendations and called for urgent action. Both concluded that the W.H.O.’s outbreak and emergency response capacities should be strengthened and consolidated, protected from political meddling and independently overseen. The health organization is a United Nations agency. | Now two of those groups — one independent and the other convened by the World Health Organization — have released specific recommendations and called for urgent action. Both concluded that the W.H.O.’s outbreak and emergency response capacities should be strengthened and consolidated, protected from political meddling and independently overseen. The health organization is a United Nations agency. |
| “There should be no question of any kind of politics around the decisions that it makes,” said Dr. David Nabarro, the chairman of the 19-member panel appointed to advise the health organization on reforms to address early missteps in its handling of the Ebola outbreak, including being overly sensitive to the wishes of some officials to play it down. The organization’s job “sometimes may mean questioning the positions taken by national authorities with regard to their people’s health and well-being,” he added. The work builds on that of an interim panel, which released its findings in July. | “There should be no question of any kind of politics around the decisions that it makes,” said Dr. David Nabarro, the chairman of the 19-member panel appointed to advise the health organization on reforms to address early missteps in its handling of the Ebola outbreak, including being overly sensitive to the wishes of some officials to play it down. The organization’s job “sometimes may mean questioning the positions taken by national authorities with regard to their people’s health and well-being,” he added. The work builds on that of an interim panel, which released its findings in July. |
| Dr. Margaret Chan, the agency’s director-general, told her staff this month that she would institute changes by merging an entity responsible for outbreaks with another concerned with emergencies, including wars and disasters. She appointed the official currently leading the agency’s Ebola response, Dr. Bruce Aylward, as interim director of the new program. | Dr. Margaret Chan, the agency’s director-general, told her staff this month that she would institute changes by merging an entity responsible for outbreaks with another concerned with emergencies, including wars and disasters. She appointed the official currently leading the agency’s Ebola response, Dr. Bruce Aylward, as interim director of the new program. |
| “I am committed to implementing the recommendations” of Dr. Nabarro’s panel, she said in an email on Sunday, adding that she had not yet seen the independent group’s report. | “I am committed to implementing the recommendations” of Dr. Nabarro’s panel, she said in an email on Sunday, adding that she had not yet seen the independent group’s report. |
| Other proposed changes may require the backing of world leaders. Both groups reaffirmed the agency’s mandate to act in emergencies, but agreed that more needed to be done to protect its ability to act independently in the interest of people’s health — even at the risk of angering some of the 194 member states that govern it. It must be able, the experts said, to freely raise international alarms about an epidemic in a country without regard to that country’s reputation. Impartiality is also important for fighting diseases in war zones, including Syria, where governments have targeted civilians. | Other proposed changes may require the backing of world leaders. Both groups reaffirmed the agency’s mandate to act in emergencies, but agreed that more needed to be done to protect its ability to act independently in the interest of people’s health — even at the risk of angering some of the 194 member states that govern it. It must be able, the experts said, to freely raise international alarms about an epidemic in a country without regard to that country’s reputation. Impartiality is also important for fighting diseases in war zones, including Syria, where governments have targeted civilians. |
| Recommendations by the independent panel addressed what one of its members, J. Stephen Morrison of the Center for Strategic and International Studies, called a “startling lack of accountability.” An inept initial response to Ebola “kicked out the pins of trust, confidence and legitimacy” at the World Health Organization, Mr. Morrison said at the Council on Foreign Relations in New York last week. “Now is the time to act.” | Recommendations by the independent panel addressed what one of its members, J. Stephen Morrison of the Center for Strategic and International Studies, called a “startling lack of accountability.” An inept initial response to Ebola “kicked out the pins of trust, confidence and legitimacy” at the World Health Organization, Mr. Morrison said at the Council on Foreign Relations in New York last week. “Now is the time to act.” |
| The panel called for sweeping changes in the way the health agency is governed, including an independent board to help insulate the new emergencies program from political pressures, and the institution of a freedom of information policy. | The panel called for sweeping changes in the way the health agency is governed, including an independent board to help insulate the new emergencies program from political pressures, and the institution of a freedom of information policy. |
| “It will represent a pretty significant shift in the culture of the organization; and the governments who call the shots on how the World Health Organization runs would need to support it and push for it,” said Suerie Moon, a research director at the Harvard Global Health Institute, which convened the panel in concert with the London School of Hygiene and Tropical Medicine. That group’s recommendations were published online Sunday in the journal The Lancet. | |
| The group also recommended that an independent committee rather than the agency’s director general be charged with declaring future international public health emergencies, and that records of its deliberations be made public. A winnowing of the W.H.O.’s priorities is also needed, the group said, noting that donors often choose to support pet projects, weakening the organization’s core functions. | The group also recommended that an independent committee rather than the agency’s director general be charged with declaring future international public health emergencies, and that records of its deliberations be made public. A winnowing of the W.H.O.’s priorities is also needed, the group said, noting that donors often choose to support pet projects, weakening the organization’s core functions. |
| Problems with outbreak preparedness reach far beyond the World Health Organization. Both groups said countries that had pledged to adhere to a set of international health regulations should no longer be allowed to rate their own level of preparedness. | Problems with outbreak preparedness reach far beyond the World Health Organization. Both groups said countries that had pledged to adhere to a set of international health regulations should no longer be allowed to rate their own level of preparedness. |
| Instead, they should be given assistance to expand their surveillance and response capacities, with incentives rather than punishment for admitting vulnerabilities and disclosing outbreaks. The independent group also called for researchers to share data during emergencies so that it can be used to help patients rather than be withheld for academic articles that might be published years later. It said standards should be established for ethical research in disasters, and to ensure more equitable distribution of experimental therapies and newly developed treatments when local resources are inadequate. | Instead, they should be given assistance to expand their surveillance and response capacities, with incentives rather than punishment for admitting vulnerabilities and disclosing outbreaks. The independent group also called for researchers to share data during emergencies so that it can be used to help patients rather than be withheld for academic articles that might be published years later. It said standards should be established for ethical research in disasters, and to ensure more equitable distribution of experimental therapies and newly developed treatments when local resources are inadequate. |
| The 19-member independent panel comprised academics, aid workers, and analysts from think tanks. Three of its members were from West Africa. Members included Chelsea Clinton, the vice chairwoman of the Clinton Foundation; Laurie Garrett, a science journalist and a fellow at the Council on Foreign Relations; and Dr. Peter Piot, who helped discover the Ebola virus in 1976. | |
| Dr. Piot recalled that world leaders had pledged in 1977 to help countries strengthen their capacities to fight emerging outbreaks, but that too little had been done. | Dr. Piot recalled that world leaders had pledged in 1977 to help countries strengthen their capacities to fight emerging outbreaks, but that too little had been done. |