Ebola: a crisis in global health leadership

In 2011, after the 2009 H1N1 influenza PHEIC, an independent Review Committee warned that "The world is ill-prepared to respond...to a global, sustained and threatening public-health emergency", with health capacities "not now on a path to timely implementation worldwide".15 Huge capacity deficits remain and, for some low-income countries, no data are even reported in WHO's global database.16 WHO itself did not implement the Review Committee's proposal for a rapid-response emergency fund.15 WHO declared Ebola a PHEIC on Aug 8, triggering temporary non-binding recommendations.17 Some countries imposed travel bans, contrary to WHO's recommendations. Affected states, moreover, could not realistically implement WHO recommendations for treatment centres, health worker compensation, and personal protective equipment.17 The delayed and fragmented response to Ebola left a vacuum, which led to an unlikely plea from Médecins Sans Frontières for military deployment--logistics, engineering, and supply-chain management.18 On Sept 16, US President Barack Obama announced a military-led response in Liberia,19 which could shore-up capacity but will not fill major governance deficits, which require UN action.