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Funding delays may have contributed to Ebola's spread

Study finds need for faster funding is one of many lessons public health officials mull as epidemic winds to an end

The slow deployment of international aid to countries most affected by the latest Ebola epidemic may have contributed to the virus’ spread, according to a new study, which highlights one of several lessons learned by aid organizations scrambling to contain the infectious disease.

Only one-third of the total amount of pledged aid, estimated at $2.89 billion from Aug. 1 through Dec. 31, has reached nongovernmental organizations (NGOs) or government agencies such as UNICEF or the World Health Organization (WHO), according to the study. About 11.5 percent of the total amount — or $110,000 per individual case of Ebola in Liberia, $49,000 in Sierra Leone and $86,000 in Guinea — was promised directly to the governments of Ebola-stricken countries, according to the study published by the British Medical Journal.

The remaining two-thirds of the promised funding most of it from governments, corporations and individuals, has yet to be collected let alone distributed, according to the study, "International Donations to the Ebola Virus Outbreak: Too Little Too Late?" 

"The problem has not been the generosity of the donors, but that the resources have not been deployed rapidly enough," said Karen Grépin, the study’s sole author and an assistant professor of global health policy at New York University.

Mechanisms that more quickly funnel money to beneficiaries would help curtail humanitarian emergencies such as the Ebola epidemic before they spin out of control, Grépin said.

Ebola, which has killed nearly 9,000 people during its latest and deadliest outbreak, is transmitted through direct contact with the body fluids of an infected person.

The sluggish response by donors was compounded by a widespread lack of expertise on Ebola. The NGO Doctors Without Borders — often known by the acronym MSF of its name in French, Médecins Sans Frontières — was the only aid group with Ebola field experience in the region. Training programs set up by the organization to instruct other health care professionals could not immediately make up for the global lack of expertise, according to the group.

“Speed is a key thing in the response to the epidemic,” said Brice de le Vingne, MSF's director of operations. “The delay allowed the epidemic to spread.”

The latest Ebola outbreak also killed an unprecedented number of health care workers, including several prominent Ebola experts and at least 450 local professionals. This dealt a severe blow to the region’s fragile health care systems, which were already scrambling to stem the flow of patients. The World Health Organization (WHO) estimates that only one to two doctors are available to treat every 100,000 people in the affected regions.

Those setbacks greatly hampered relief efforts, according to Jeremy Konyndyk, director of foreign disaster assistance at the United States Agency for International Development (USAID). “There was no global machine that you could deploy at scale,” he told Al Jazeera.

Several organizations such as Samaritan's Purse, the U.S. Centers for Disease Control and Prevention (CDC) and the International Red Cross have since stepped forward to help combat the virus. Some worked in the field, burying corpses in accordance with a protocol designed to reduce of the spread of the virus. Others ministered directly to the sick, some diagnosed new cases and some traced the people who had come in contact with infectious individuals.  

The result is that there is now more knowledge and more capacity to respond to the epidemic, according to Konyndyk.

One plan being considered by USAID, which took a central role in combatting the epidemic relief from the U.S., would be to fund ever-ready U.S.-based units that could be deployed within 24-hours — much like search-and-rescue teams for earthquake relief operations — to try to help mitigate any international infectious-disease threat, Konyndyk said.

But the effects of strengthened international support for local health care systems remain unclear, according to results in Grépin's study published on Feb. 3, which emphasized the lack of resources that had been directly committed to recipient governments. 

Applying the lessons learned from the Ebola outbreak will require greater coordination among agencies and countries, experts say. A good first step would be to include Ebola in governments' mandated health-screening programs, which also screen for diseases such as cholera and are monitored by national health agencies, which send alerts as needed, according to de le Vingne of MSF.

Facing intense criticism over its handling of the Ebola crisis, the WHO last week said its member states understand that a "collective defense mechanism" is needed for global health security.

Ebola has been "a mega crisis and it overwhelmed the capacity of WHO," said the organization’s director, Margaret Chan, at a Jan. 25 news briefing where she announced the creation of a contingency fund and emergency workforce for quicker responses to epidemics. 

"Member states truly understand that the world does need a collective defense mechanism for global health security," she said.

Regional coordination efforts are already underway. African Union (AU) leaders on Friday are expected to debate a proposal to establish an organization similar to the CDC, which played a key role in the efforts to stop the outbreak. The AU’s organization could be operational by mid-2015, according to AU Commissioner for Social Affairs Mustapha Sidiki Kaloko.

The AU'S proposal create a regional CDC-like organization comes amid the release of new figures that highlight numerous challenges in fighting the epidemic. For the first time in 2015, new weekly Ebola cases rose in all three Ebola-stricken countries, according to the WHO, which cited local resistance to aid workers as a "significant challenge" to ending the epidemic.

With wire services

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