WHO Director
Gives Frank Assessment Of Ebola Situation To West African Leaders
Speaking in Conakry
Guinea on August 1, WHO Director Margaret Chan pointed out the
unique features of the Ebola outbreak in West Africa and gave a
frank assessment of the actions needed to halt the outbreak.
Firsts For This
Outbreak
The outbreak is the
largest ever of Ebola virus because it has the largest number of
cases and deaths, is taking place in the largest geographical area
and this is near other areas at risk of further spread, it has
demonstrated its ability to spread via air travel, and cases are
occurring in both rural areas as well as capital cities.
Five Key Concerns
According to Chan, the Ebola outbreak is of special
concern for the following reasons:
1. The outbreak is moving
faster than efforts to control it.
According to Chan, “If the situation continues to
deteriorate, the consequences can be catastrophic in terms of lost
lives but also severe socioeconomic disruption and a high risk of
spread to other countries.
2. The outbreak is a affecting a large number of
doctors, nurses, and other health care workers. Chan told the
leaders that more than 60 health care workers have lost their lives
in helping others, including some international staff.
3. Failure to give high enough priority to
control efforts could allow the Ebola virus to circulate widely and
over a long period of time in human populations. Such a situation,
would be extremely unwise because it could allow the virus to
mutate.
Said
Chan, “we must not give this virus opportunities to deliver more
surprises.”
4. Ebola is a social problem as well as a
medical and public health problem. Cha called beliefs and cultural
practices “a significant cause of further spread and a significant
barrier to rapid and effective containment.” She called for
addressing the social dimension as part of the outbreak response.
5. Cases are being deliberately underreported or
hidden and defeat control strategies. This may make some sense
for the population because case fatality rates are high even with
treatment and so being sent to an isolation ward can be equated with
a death sentence, said Chan. She added, some people “prefer to care
for loved ones in homes or seek assistance from traditional
healers.”
6. Public attitudes can create a security threat
to response teams when fear and misunderstanding turn to anger,
hostility, or violence.
7. Work is also emotionally
very stressful
Needs Assessment
Chan called for the following needs to be tackled in
urgent fashion.
1. Accurate and detailed mapping of the outbreak is
urgently needed.
2. All affected and at-risk countries need a national
response plan, and these plans need to be regionally coordinated.
3. Facilities for isolation and supportive therapy
need to be properly equipped and adequately staffed.
4. Personal protective equipment is absolutely
essential.
5. For national staff, salaries need to be paid.
6. Dignified burial makes an essential contribution
to public trust and eases family grieving, but this must be done
safely.
7. Contact tracing is a formidable challenge, for
reasons I have mentioned. Again, more staff are needed.
8. Public awareness of the facts about this disease
needs to increase dramatically. Messages from presidents and
community and religious leaders are important, but this outbreak
needs professionally designed and implemented campaigns, again with
help from external experts.
9. Depending on the epidemiological situation, your
governments may need to impose some restrictions, for example, on
population movements and public gatherings.
10. Governments may need to use their police and
military forces to guarantee the safety and security of response
teams. Some are already doing so.
She concluded her frank assessment by reassuring the leaders that
“Ebola outbreaks can be contained. Chains of transmission can be
broken. Together, we must do so.” ■
|