"Together we will ensure that WHO is reformed and well positioned to play its rightful role in disease outbreaks, humanitarian emergencies and in global health security," write the WHO directors.
The statement from the World Health Organization (WHO) Director-General, Deputy Director-General and Regional Directors outlines eight valuable lessons that WHO have learned while dealing with the Ebola crisis.
- That new diseases and old diseases in new contexts "must be treated with humility and an ability to respond quickly to surprises"
- That health gains such as fewer child deaths, control over malaria and more women surviving childbirth "are all too easily reversed when built on fragile health systems"
- That current national and international capacities and systems cannot cope with large-scale outbreaks
- That WHO's engagement with affected communities and cultures was inadequate. "This is not simply about getting the right messages across; we must learn to listen if we want to be heard," the directors write. "Empowering communities must be an action, not a cliché"
- That the global surveillance and response system "is only as strong as its weakest links" and that "a disease threat in one country is a threat to us all"
- Recognizing the need to coordinate with other organizations and work in partnership when WHO lacks capacity
- That incentives are needed "to encourage the development of new medical products for diseases that disproportionately affect the poor"
- The importance of communication - "of communicating risks early, of communicating more clearly what is needed, and of involving communities and their leaders in the messaging."
How will WHO improve their disease outbreak response?
Taking onboard constructive criticism of the WHO response, the directors also use the statement to make a series of promises concerning improvements to their emergency response.
One such improvement will be to develop "a directing and coordinating mechanism" to bring together the world's resources for rapid and effective response to disease outbreaks and humanitarian emergencies, as well as expanding WHO's core staff working on disease outbreaks.
WHO will also combine the expertise of public health scientists, health workers, logisticians, project managers, social scientists, communication experts and community workers with the creation of a Global Health Emergency Workforce. Teams working as part of the Global Health Emergency Workforce will be trained and certified responders available immediately in the event of an emergency.
To ensure that adequate domestic and international resources are available before the next outbreak, WHO will establish a Contingency Fund to allow the organization to respond more rapidly to disease outbreaks.
The directors write that they will boost support to countries to develop the minimum core capacities to implement the International Health Regulations. These regulations are "the international framework for preparedness, surveillance and response for disease outbreaks and other health threats."
Recommendations for world leaders
Finally, the WHO directors urge world leaders to take the following steps:
- Take disease threats more seriously - invest in prevention and essential public health systems. "We do not know when the next major outbreak will come or what will cause it. But history tells us it will come"
- Remain vigilant, as the Ebola outbreak is far from over and support to the affected countries must be sustained. Ebola could easily spread again
- Re-establish the services, systems and infrastructure that have been devastated in Guinea, Liberia and Sierra Leone. "This recovery must be country-led, community-based and inclusive"
- Be transparent in reporting. "Speedy detection facilitates speedy response and prevents escalation"
- Invest in research and development for diagnostics, drugs and vaccines related to neglected diseases with outbreak potential.
"The Ebola outbreak that started in December 2013 became a public health, humanitarian and socioeconomic crisis with a devastating impact on families, communities and affected countries," write the WHO leaders. "It also served as a reminder that the world, including WHO, is ill-prepared for a large and sustained disease outbreak."
"This is our commitment; together we will ensure that WHO is reformed and well positioned to play its rightful role in disease outbreaks, humanitarian emergencies and in global health security."