88 HEALTHCARE
WHO DIRECTOR-GENERAL ADDRESSES
G7 HEALTH MINISTERS ON EBOLA
Dr Margaret Chan, Director-General of the World Health Organization
Remarks at the G7 Health Ministers Meeting. Session on
Ebola: lessons learned and the International Health Regulations.
Berlin, Germany
9 October 2015
Honourable ministers, ladies
and gentlemen, I will focus
my remarks on lessons
learned and the IHR.
Managing the global regime for
controlling the international spread
of disease is a central and historical
responsibility of WHO. In a given
year, WHO manages around 100
outbreaks of familiar diseases, like
cholera, dengue, meningitis, and
many others. This Ebola outbreak
was different. It was complex in
size and context, present in three
countries which were unfamiliar with
the disease and ill-prepared.
Since Ebola first emerged in
1976, WHO and its partners
have responded to 22 previous
outbreaks. Even the largest of these
were controlled within four to six
months.
The outbreak in West Africa has
been different. The Ebola virus is
well-equipped to take advantage of
any weaknesses in preparedness,
any gaps in control measures. The
event in West Africa was a dramatic
and tragic revelation of weaknesses
and gaps.
Clinicians had no vaccine, no
treatment, and no personal
equipment specifically designed
to protect them from one of the
deadliest pathogens known.
All responders had difficulty finding
sufficient numbers of experienced
clinicians and epidemiologists.
Much about the disease, including
its modes of transmission, natural
history, and clinical features, was
poorly understood.
This is the fear factor. Let me give
you a comparison. In the Philippines
after the typhoon, WHO coordinated
150 medical teams. For Ebola,
less than five medical teams could
be deployed. On this, I thank the
German government for mobilizing
volunteers, its Red Cross staff, and
the military. Germany was the first
country to accept non-German
Ebola patients for treatment at its
hospitals.
The virus circulated in Guinea for
three months, undetected, off every
radar screen, initially misdiagnosed
as cholera, later thought to be
Lassa fever. This tells us the early
warning system was not working.
Nor was adequate diagnostic
capacity available.
It took neighbouring Liberia and
Sierra Leone several weeks to
confirm that the virus had entered
their territories. These delays gave
the virus a head start with explosive
momentum.
In Sierra Leone, the entire health
system was overwhelmed less
than six weeks after the first case
was confirmed. National and
international responses ran behind
the virus and did not begin to catch
up until late October of last year.
This is my first point. No regime for
global governance can manage the
invisible.
The simultaneous outbreak in the
Democratic Republic of Congo
operated almost like a control
group. This was the country’s
seventh Ebola outbreak. It was
prepared.
“Since Ebola first
emerged in 1976,
WHO and its partners
have responded
to 22 previous
outbreaks. Even the
largest of these were
controlled within four
to six months.”