As of this week, there have been over 13,000 suspected cases of, and just under 5,000 deaths caused by, Ebola. In coordinating a response, the international community has worked through the UN Mission for Ebola Emergency Response, a partnership including the World Health Organization, World Bank Group, Médecins Sans Frontières, International Federation of Red Cross and Red Crescent Societies and the United States Centers for Disease Control and Prevention. To learn more about how these global governance institutions have responded to this situation, we speak to CIGI Chair of Global Health Alan Whiteside.
CIGI: In terms of global health crises, has the global community experienced anything like this before? Have our global governance institutions improved in how they responded?
Alan Whiteside: There have been diseases but in lived memory there are just a few people still alive who experienced the flu of 1919. Probably the more important outbreak of disease that swept across the world is HIV and AIDS, which we saw from 1981 onwards. With the current crisis of Ebola, we haven’t seen an infectious disease of this magnitude for decades. It’s quite a unique experience.
Have our global governance intuitions improved in how they’ve responded? Absolutely, and there’s a mixture of things going on here. The first is science is advanced: both the response in terms of treatment and vaccinations, but also understanding epidemiology. People understand modes of transmission, why this disease is being spread and what to do about it. Second, we have global institutions that are able to mount a response. The major ones are organizations like the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC); and Médecins Sans Frontières (MSF), which is the organization that first sounded the alarm bell about the outbreak.
CIGI: Building on that question, is this experience a wakeup call for our global governance institutions?
Whiteside: It may be a wakeup call in terms of how institutions are held accountable. The particular example is WHO Afro led by an incompetent, bumbling bunch of buffoons who couldn’t fight their way out of a paper bag. They’ve really let down the global community. It doesn’t mean you shouldn’t have a WHO Africa office, but it does mean it should be more accountable not just to WHO Geneva but to the people who it’s meant to serve: the population of Africa. The is a selection going on for a new Afro director and I am encouraged by the profile of some of the candidates – but the person appointed will have an uphill battle.
CIGI: What do you think has gone right in preventing the current spread of Ebola?
Whiteside: One thing that has gone right is awareness. We know about this. There is no question about where this epidemic is. We have a pretty clear handle on how it’s spreading. And second, we’ve seen mobilization in terms of resources — the work of the World Bank for example. What’s gone wrong is we actually need people on the ground. We need health workers and we need those health workers to be treated better. You can’t have a nurse coming back from working in an Ebola area and being put into quarantine in Maine — this is absurd.
CIGI: Trust in government, institutions and our leaders seem to play a paramount role in controlling fear and preventing panic. What advice would you give leaders?
Whiteside: The first thing leaders have to know is the science. And this is part of the problem. They tend to react on a political basis to what is fundamentally an infectious disease. It’s very hard for leaders to deal with the panic we saw in Liberia’s Monrovia and Freetown if they don’t understand the science. A good political leader is somebody who knows a little about an awful lot, and they’re prepared to take advice. So, know your science; know your epidemic; know what’s going on with it; and be upfront with people — be honest.
We have got to be realistic about this global health crisis. The big challenge we face is not that we have an epidemic that is killing people. It’s the destruction to the society, the economy, and the politics. That’s a really serious issue.