More than $430 million will be needed to bring the worst Ebola outbreak on record under control, according to a draft document laying out the World Health Organization's battle strategy. The plan sets a goal of reversing the trend in new cases within two months, and stopping all transmission in six to nine months. It requires funding by governments, development banks, the private sector and in-kind contributions, according to the document obtained by Bloomberg News. Protecting Against Ebola The current outbreak, which has killed 1,427 people in Liberia, Guinea, Sierra Leone and Nigeria, may soon exceed all previous Ebola outbreaks combined. The sum now being sought is six times more than the $71 million the WHO suggested was needed in a plan published less than a month ago. There is reason to be concerned "about whether the proposed resources would be adequate," said Barry Bloom, a public health professor at Harvard University who also questioned whether the funds would be made available fast enough, and whether the organization's latest plan "would ensure the expertise from WHO that is needed." The WHO plans to publish the plan by the end of this week at the earliest and details may change, said Fadela Chaib, a spokeswoman for the Geneva-based agency. United Nations Secretary-General Ban Ki-Moon this month appointed health crisis expert David Nabarro to coordinate the UN response. WHO Criticized The European Commission and aid groups including Doctors Without Borders have criticized the WHO for a lack of leadership in coordinating the fight against the outbreak. "Clearly WHO didn't foresee this outbreak and while the Ebola crisis was clear in March, it didn't act until August to declare an emergency," Bloom said in an e-mail. J. Stephen Morrison, director of the global health policy center at the Center for Strategic and International Studies in Washington, had a different view. The scale of the disease's devastation goes far beyond what health officials had seen previously, he said in a telephone interview. It's not "a question of incompetence or complacency," according to Morrison, who said the WHO should be able to raise the money needed. "It's the fact we're catching up with the unknown, and it's way ahead of us." Treatment Centers More than half the cost will be needed for the treatment, isolation and referral centers that are bearing the brunt of the epidemic, according to the WHO plan. Guinea, Liberia and Sierra Leone are among the world's poorest countries, and weak health systems combined with a lack of experienced health-care workers has contributed to the epidemic, the WHO has said. "The response at the beginning wasn't robust enough," David Heymann, a professor of infectious diseases at the London School of Hygiene and Tropical Medicine who worked on the first recorded Ebola outbreak in 1976. "It's a step forward that they've made the plans and I'm glad they're emphasizing rapid containment as a start." The WHO this month declared Ebola in West Africa a public health emergency of international concern. A separate outbreak in the Democratic Republic of Congo has killed as many as 13 people, the government in that country said yesterday. In West Africa, more than 240 health care workers have been infected and 120 have died, the agency said in a statement yesterday. Among them is Abraham Borbor, the deputy chief medical officer of Liberia's John F. Kennedy Medical Center, who died despite being treated with Mapp Biopharmaceutical Inc.'s experimental ZMapp medicine, the nation's information minister said. Experimental Drug Borbor was one of three Liberian health-care workers being treated with ZMapp, the same drug that was used on two American aid workers who were evacuated to the U.S. after being infected in Liberia. Closely held Mapp, based in San Diego, has said its supply of the drug is exhausted. A British health worker, William Pooley, was flown home for treatment at London's Royal Free hospital after being infected in Sierra Leone, Public Health England said in a statement yesterday. Pooley is receiving "excellent care," his family said in a statement on the hospital's website, as it asked "everyone to remember those in other parts of the world suffering with Ebola who do not have access to the same health-care facilities as Will." A Senegalese disease-tracker working with the WHO in Sierra Leone also became infected, making him the first of the agency's 400 workers in the affected countries to fall ill with the deadly virus, the WHO said. Evolving Epidemic The epidemic "continues to evolve in alarming ways, with the severely affected countries, Guinea, Liberia, and Sierra Leone, struggling to control the escalating outbreak against a backdrop of severely compromised health systems, significant deficits in capacity and rampant fear," according to the draft of the WHO's so-called road map. "Clearly a massively scaled and coordinated international response is needed to support affected and at-risk countries." The document has been shared with the WHO's partners for comment and will be published once their feedback has been received, Chaib said. The final document will include a country-by-country plan for dealing with the outbreak, she said. Source: Bloomberg
