GENEVA – The World Health Organization has proposed reforms that could overhaul its structure after botching the response to the biggest-ever Ebola outbreak, a sluggish performance that experts say cost thousands of lives.
On Sunday, several dozen of WHO’s member countries approved a resolution that could transform the U.N. health agency in response to sharp criticism over its handling of the West Africa epidemic.
“The WHO we have is not the WHO we need,” said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. He said decisions at WHO were often made for political rather than scientific reasons.
WHO’s chief, Dr. Margaret Chan, acknowledged Sunday that the agency was too slow to grasp the significance of the Ebola outbreak, which is estimated to have killed more than 8,600 people, mainly in Guinea, Liberia and Sierra Leone.
Critics say the kinds of reform being adopted are long overdue, though it is unclear what concrete changes will actually result.
“The groundswell of dissatisfaction and lack of trust in WHO over Ebola has reached such a crescendo that unless there is fundamental reform, I think we might lose confidence in WHO for a generation,” said Lawrence Gostin, director of the WHO Collaborating Center on Public Health Law and Human Rights at Georgetown University.
“Ebola revealed all of WHO’s inherent weaknesses and the international community saw painfully what it was like to see WHO not being able to lead. That resulted in thousands of deaths that were completely avoidable,” he said. “If that doesn’t light a fire for reform, I don’t know what will.”
In a resolution adopted by WHO’s executive board, nearly 60 countries called on the agency to take “immediately necessary steps” to enact measures, including the creation of an emergency fund to respond to health crises.
Britain’s chief medical officer, Dr. Sally Davies, announced the U.K. would donate $10 million to the proposed fund.
The resolution also called for the establishment of a reserve of health workers ready to battle epidemics, but didn’t specify how large this workforce would be. WHO conceded that, despite public expectations that it can respond quickly to health emergencies, it simply is not designed to do that.
WHO declared Ebola to be a global emergency in August. But it wasn’t until Jan. 12 that Chan officially assigned Bruce Aylward, the agency’s lead official on Ebola, to work full time on the outbreak, according to an internal memo sent to WHO staff.
Previous calls for reform were made after the 2009 swine flu pandemic but little changed despite similar recommendations and vows to change.
Gostin said no other agency has a mandate to protect public health that could easily replace WHO.
“If we didn’t have a WHO, we would need to create one,” he said. “But we need to make them politically accountable for their failures and force them to be leaders.”