Assignment on a Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

Executive Summary of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

            This proposal analyses the role of the World Health Organisation in response to the Ebola Virus outbreak in West Africa which started in 2014. The overall facts are analysed along with the response of the organisation, like what kind of actions were taken by the WHO. After analysing the situation, it is concluded that the WHO took some steps and measures to deal with the outbreak, but it is found that there response was inadequate and insufficient. The main reason for their failure was lack of financial resources, lack of communication, lack of coordination with other partners, as well as, governments. The response was also very slow, and it could not stop the spread of virus in a timely manner. The organisational structure and operational competency was questioned in this regard, because both could not do, what was expected from the WHO. To make sure that the response of the WHO is better in next virus outbreak or epidemics, they should make organisational and leadership changes, and make new departments to improve coordination and communication efforts to have quick and timely response.

A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

Background of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

            The world has been facing a variety of global health issues in the shape of the outbreak of viruses and diseases. The history has noted so many pandemics which devastated the world or any specific region of the world, and huge losses were observed. The World Health Organisation has been fighting against these diseases and pandemics throughout history, and this struggle continues even till now. It is important to mention here that the WHO has set some Sustainable Developmental Goals (SDGs) to meet by 2030. One of the goals is related to health issues such as fighting with diseases and ending several pandemics. The journey is long and hard to reach but WHO and the United Nations as a whole work at their best to deal with a variety of health issues. Some of the key SDGs are related to giving health facilities to the poor people, and another goal is to deal with all types of malnutrition. The major goal in the health category is the prevention of diseases by making sure with safe water & sanitation for everyone. The other goal is to make healthier cities along with protection diseases by promoting health practices in the best possible manner (WHO, 2018)

            The world has seen so many diseases that caused a lot of troubles in the past, and many of these diseases continue to do so. The African region has been particularly in trouble due to various pandemics and diseases. One such virus which destroyed the West African region was the Ebola outbreak. In 2014, the first case was observed in Guinea. It was observed that Ebola is a severe kind of illness, fatal in some cases for humans. The transmission of the virus was happening due to wild animals, and humans were getting infected through animals such as non-human primates, porcupines, and fruit bats (WHO, 2015a). The human to human contact of the virus was happening due to infected people’s bodily or organ fluids, direct contact with the infected person’s blood, touching surfaces such as clothing, bedding, as well as, secretions. The average fatality rate has been around 50%. It is important to mention here that the first-ever Ebola outbreak was in a village of Central Africa, but the actual large scale outbreak was observed in West Africa from 2014 to 2016. The first-ever discovery of Ebola virus was made in 1976 (WHO, 2020)

Objectives of the Stakeholder of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

            The stakeholder for this proposal to give a helping hand by giving some policy recommendations to the WHO is Médecins Sans Frontières. This organisation has its origin from France, which is a non-governmental organisation for international humanitarian medical work. The translation of the French words Médecins Sans Frontières is Doctors without Borders, which means that the organisation is working to handle the issues of humans across the globe without considering any borders. The primary focus of the organisation is to provide assistance to the affected people, who have been hit by disasters, epidemics, and conflicts, or even who are out of the healthcare facilities. The foundation of the organisation was laid in 1971, and its foundation was laid by a group of doctors and journalists. Currently, the organisation has a worldwide movement of people, which has reached the number of 67,000. The MSF has a specific charter which is followed by its people in best possible manner. The organisation has made sure that its actions are made by the forces of impartiality, neutrality, and independence. The MSF is a non-profit organisation, and its sole purpose is to serve humanity in any possible manner (MSF, 2020). Keeping these facts in view, it is evident that the MSF is very much relevant to the case of the Ebola virus outbreak because they are also working to assist humans in epidemics, diseases, and disasters. Ebola virus was one of the first epidemics of recent times. The current situation is that the Ebola outbreak happened in the Democratic Republic of Congo, and it is continuing to haunt the people of Congo, and the MSF is working to deal with the DRC Ebola outbreak. The organisation is working since 2018 to help people of Congo to deal with it, which shows that the MSF is very much relevant to the cause the WHO to fight with Ebola virus (MSF, 2019)

The Actions Taken of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

            It is important to mention here that an Ebola Response Roadmap draft was developed by the World Health Organisation to deal with the Ebola outbreak in 2014. It was observed that the outbreak of Ebola was unprecedented in so many ways, so this response roadmap was made to deal with it in an effective manner. The primary purpose of the strategy was to assist partners, as well as, governments in the resourcing and revision of operational plans as specific to the countries being affected by Ebola. The strategy was focused on those specific areas, where intense transmission was happening. The exponential increase was the biggest issue along with managing the burial of dead patients, as well as, making any behavioural changes to stop the spread (Cenciarelli et al., 2015). The first report by the WHO was launched in March 2014, which gave an idea of dealing with the disease in a variety of manners. The WHO was providing support to the Ministry of Health of Guinea. A collaborative laboratory as immediately formed by the WHO in Lyon, France, which coordinated with the laboratories in Kenema, Senegal, Dakar, Guinea, and Donka. The WHO Global Outbreak Alert and Response Network (GORAN) was the first team sent to Guinea, and they made a report after investigation, which revealed the fact that “one of the most challenging Ebola outbreaks that we have ever faced.” In just one month's time, there were more than 168 cases in Guinea, and 108 deaths were also observed in six prefectures. Liberia also started to report new cases. In 3rd week of April, the WHO mobilised a new team of physicians with the help of GORAN, and this team was an expert in dealing with infectious disease prevention & controls, and teams were deployed to Guinea’s principal hospital and Donka Hospital. Till the 1st week of May, more than 112 health experts of the WHO were deployed in different parts of West Africa. These were some of the actions and steps taken, which continued for the next period, which will be discussed in the next section with its success of failures (WHO, 2015)

Key Successes and Failures of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

            After the outbreak of the Ebola virus in West Africa, the health emergency was declared due to the severity of the situation, and similarly, a great response was needed to deal with the situation. As per the WHO, they came with a good and immediate response, but in reality, the situation was quite different. Once the severe situation of the Ebola outbreak passed, and when the success and failures of the WHO were analysed, then it was found that the WHO was failed to fulfill its responsibilities. It was evident that the WHO was not successful in completing its leadership responsibilities to deal with the Ebola Virus in an effective manner. It is true that some kind of normative leadership and support was provided and few measures were taken to handle the virus outbreak, but by looking at the serious situation with so many deaths, the WHO response was inadequate. Especially, the operational response of the WHO was very disappointing. The world looks to the WHO for a better and great response in such health emergencies, but their actual response was way lower than the expectations. It was revealed that the WHO has many organisational, as well as, financial constraints. The world community expected a lot from the WHO to perform a great role in dealing with health emergencies, but they were not able to do so, which damaged their reputation as a first-line defense to manage diseases, pandemics, epidemics, and virus outbreaks (Wenham, 2017)

Recommendations of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

            After looking at the disappointing response of the WHO in the Ebola outbreak, here are some of the recommendations for them to consider for the future:

·         It was admitted by the WHO that their response to the Ebola outbreak did not only slow, but insufficient as well. So, it is recommended to the WHO that they should develop a response strategy or framework, which comes with a quick response to such outbreaks. They need to develop a comprehensive strategy by making any possible structural changes in their organisation so that they can come up with an aggressive response. The slow response in outbreaks of viruses can be deadly because a slow response means the spread of the virus rapidly, which means by the time response comes, it’s too late in so many ways (Wenham, 2017)

·         The coordination of the WHO was also at fault during this breakout. So, it is recommended for them to make a new department, whose sole response is to work for the coordination of the WHO with other countries and partners. The new department should be made because the old structure is not good enough to deal with coordination problems. The WHO was confused with its roles and responsibilities, and there was a lack of risk communication. The new department will have no other responsibility so they will focus on coordination and cooperation to deal with any miscommunication, lack of communication, misunderstandings, etc.

·         It is also important for the WHO to review its operational capacity by looking at the existing operational processes, which have many loopholes. The Ebola outbreak can be instrumental to identify those loopholes and gaps in the strategy so that a new process is developed with better operational excellence and capabilities (Wenham, 2017)

·         It was found that the WHO had many organisational and financial constraints, so it is recommended that they should also revise their overall financial model along with revisiting organizational structure to see, where they lacked in responding to the outbreaks. They should develop a new post-epidemic research department, which holds research on the outbreak after it is gone so that all the good and bad learning elements are identified so that when such kind of outbreak comes again, then they are able to give a better response in a timely manner. They need to increase their funds' availability for global epidemics and outbreaks so that they help poor countries in a better manner (Cenciarelli et al., 2015)

·         The leadership structure should also be changed with the required changes. It is recommended that the leaders should be given more training and development on situational awareness. The leadership of the Who was lacking in an adequate response, and they did not acknowledge the severity of the situation. More experts should be given the leadership role, setting political influences aside.

            It is vital to understand that if the WHO is ready to learn from their mistakes, and they accept the negligence, then it is time for them to implement above-mentioned recommendations in a best possible manner to repair their damaged image. It can be said that the WHO has a great capability and capacity to do things, which no other organisation can do, so they should look to improve their processes and work on their loopholes, as their role will always be a critical one in responding to global pandemics, diseases, viruses, and epidemics.

References of A Proposal for Reforming the World Health Organisation (for Médecins sans FronDères) in response to the Ebola Crisis in West Africa

1.       Cenciarelli, , Pietropaoli, , Malizia, , Carestia, , D’Amico, F., Sassolini, , Giovanni, , , Rea, , Gabbarini, , Palombi, and Bellecci, (2015) 'Ebola Virus Disease 2013-2014 Outbreak in West Africa: An Analysis of the Epidemic Spread and Response', International Journal of Microbiology.

2.       MSF (2019) Ebola: In the Democratic Republic of Congo, we are currently responding to the second-worst Ebola outbreak in history, [Online], Available: https://www.msf.org.uk/issues/ebola [4 April 2020].

3.       MSF (2020) We are Médecins Sans Frontières, [Online], Available: https://www.msf.org/who-we-are [4 April 2020].

4.       Wenham, (2017) 'What we have learnt about the World Health Organization from the Ebola outbreak', Philos Trans R Soc Lond B Biol Sci, vol. 372, no. 1721.

5.       WHO (2015) Key events in the WHO response to the Ebola outbreak, [Online], Available: https://www.who.int/csr/disease/ebola/one-year-report/who-response/en/ [4 April 2020].

6.       WHO (2015a) 2015 WHO Strategic Response Plan: West Africa Ebola, [Online], Available: https://apps.who.int/iris/bitstream/handle/10665/163360/9789241508698_eng.pdf?sequence=1 [4 April 2020].

7.       WHO (2018) Strategy 2018-2023: Building the science of solutions, [Online], Available: https://apps.who.int/iris/bitstream/handle/10665/255777/9789241512756-eng.pdf;jsessionid=D9A77454992824527EA95E957B2372ED?sequence=1 [4 April 2020].

8.       WHO (2020) Ebola virus disease, [Online], Available: https://www.who.int/health-topics/ebola/#tab=tab_1 [4 April 2020].