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Editorial

Who will meet the Ebola threat?

As Ebola kills, a budget-strapped WHO comes up short

The United Nations warns that the intensive global medical effort needed to contain the Ebola virus sweeping through parts of West Africa could cost as much as $600 million. Ebola has killed 1,900 people so far — about half of those who have become infected — and has recently crossed from Guinea, Liberia and Sierra Leone into two more nations. U.N. officials estimate that 20,000 people could die in the next six months, and that the situation could worsen after that without a prompt and generous international response of money, equipment and skilled personnel.

But deep budget cuts have crippled the ability of the World Health Organization, the U.N. agency that should be leading the response to the outbreak, to handle these kinds of emergencies. As the Montreal-based Center for Research on Globalization reported last week, "Since the financial collapse of 2008, the WHO budget has been slashed by at least $1 billion, leading to layoffs of veteran medical staff and a 35% reduction of the agency's emergency response staff."

With the undermining of WHO's ability to be the first responder in global medical crises, the United Nations should have quickly figured out a new scenario — perhaps one under which nations agreed to apportion donations of staff, medicines and other resources, while WHO's role was limited to organizing the international response. It did not do so. The respected nonprofit Doctors Without Borders also has been swamped by the crisis. The director of the U.S. Centers for Disease Control and Prevention said last week that the epidemic was "spiraling out of control."

The United States has moved swiftly and generously to help. The Obama administration has asked Congress to allocate $58 million toward research and production of an experimental drug that was used on two U.S. missionaries who were infected in Africa. They survived, but it's not known whether the medication, ZMapp, was the reason. The money also would be used for testing two promising experimental vaccines. In addition, the U.S. Agency for International Development has committed to spending nearly $100 million on protective suits for medical personnel, beds for patients and food aid; the U.S. will also recruit U.S. medical staff and employ the military to help on the ground.

At this point, the U.S. appears to be in a better position to organize and lead the international response than WHO, perhaps in coordination with that agency. But the U.S. shouldn't have to pick up most of the $600 million tab itself. Doctors Without Borders last week criticized what it perceived to be a lackluster global response and called on governments around the world to mobilize military and civilian biological disaster teams. Developed nations should be answering the call, right away. And once WHO has been helped through this humanitarian crisis, the United Nations must determine a workable new plan for WHO's role in future international medical disasters.

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