Across the world, people have responded to the Ebola epidemic with great generosity, pledging around $2.89 billion in donations as of December 31st, 2014. However, a new report has found that only $1.09 billion of this total has reached the countries affected by the outbreak.
The report, published in The BMJ, suggests that the speed in which donations have been received by the affected West African region could have played a part in how the epidemic has progressed.
“These delays in disbursements of funding may have contributed to spread of the virus and could have increased the financial needs,” states study author Karen Grépin.
Grépin, an assistant professor of global health policy at New York University, analyzed donations recorded by the UN Office for the Coordination of Humanitarian Affairs (OCHA). She looked specifically at the level and speed at which donations were made, and how these measured up to the consistently changing estimates of funding requirements.
News of the Ebola outbreak first came to the World Health Organization (WHO) on March 23rd, 2014, when Guinea’s Ministry of Health reported a “rapidly evolving outbreak” of the virus involving 49 cases and 29 deaths.
Although the WHO donated protective equipment and medical supplies to Guinea within a week of this notification, it was only on August 8th that the outbreak was declared a public health emergency of international concern.
At this point, the WHO and presidents of Guinea, Liberia and Sierra Leone all called for international donors to pledge $71 million to help control the outbreak.
However, estimates for required funds kept evolving. In late August, the WHO estimated that $490 million would be required to implement a proposed response plan. Less than a week later, this figure was revised to around $600 million by the director general of the WHO and other UN leaders.
After the creation of the United National Mission for Ebola Emergency Response in November, the official request for funding stood at an estimated $1.5 billion. “Clearly, international leaders have found it challenging to estimate the financial requirements to tackle this rapidly spreading outbreak,” Grépin says.
It is likely that the WHO would suggest the dramatically changing estimates were a result of the rapid spread of Ebola virus disease. On August 28th, they reported that nearly 40% of the total number of reported cases had occurred within the previous 3 weeks.
“Substantial donor support did not reach affected countries until October, more than 6 months after WHO was alerted to the outbreak,” Grépin argues. “The problem has not been the generosity of donors but that the resources have not been deployed rapidly enough.”
While a total of $2.89 billion has been pledged by international donors, it is estimated that it took until mid-October for $500 million to be received by the affected countries, and until at least December for $1 billion to be received.
The data analyzed by Grépin do not lend themselves to a comparison of the speed of the response to the Ebola outbreak and that for other humanitarian crises, but they do indicate that existing mechanisms for fund disbursement may be too slow.
One potential solution could be a dedicated fund that could be rapidly deployed in the event of a similar crisis, the report suggests. Monitoring and tracking donor responses and how the donations are spent is crucial to being able to improve the way public health threats are dealt with.
“Although quantity of funding is important, so is the quality of the response,” concludes Grépin. “Learning from this experience will help us to understand what worked and what did not in this epidemic and will also help us better assess funding needs in the future.”
Last week, the WHO stated that efforts against the disease were shifting from slowing transmission to ending the epidemic.