This is the conclusion of Dr. Joanne Liu, MD, president of Doctors Without Borders (Medicins Sans Frontieres-MSF). Her interview in the New York Times is a compelling must-read for those watching Ebola and West Africa. Far from echoing the cautious optimism that the disease may be coming under control in certain areas, she says, “no one yet has the full measure of the magnitude of this crisis. We don’t have good data collection. We don’t have enough surveillance.”
Dr. Liu ought to know. MSF has been on the front lines of the struggle against Ebola in West Africa. In the three countries most effected by Ebola, Guinea, Sierra Leone, and Liberia, the public health systems had already largely collapsed before the appearance of the disease, the result of civil war. Hence, MSF, a non-governmental organization (NGO) that is supported by private contributions and staffed by volunteers, has taken the lead in many places. But, Dr. Liu says, MSF is overwhelmed. In her interview she calls for greater involvement on the ground by public agencies such as the World Health Organization and the Center for Disease Control, as well as other NGO’s and government agencies.
She makes the chilling point that the closing of hospitals due to the fear of Ebola is allowing diseases such as malaria, pneumonia and diarrhea to kill children who otherwise would have lived.
The experience of Ebola in West Africa indicates that devastating pandemic diseases cannot be addressed by weak states with collapsing health systems. It’s time to reconsider the mandate of the World Health Organization, its staffing and its funding, as a possible way to fill the void.