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Ebola crisis points to wider global threat on a par with al-Qaida, warns UK medic Ebola crisis points to wider global threat on a par with al-Qaida, warns UK medic
(about 5 hours later)
Ebola should be seen as an early warning to world leaders of the potential for an international health disaster on the scale of 9/11, a leading British medic in Sierra Leone has warned. Ebola should be seen as an early wake-up call to world leaders of the potential for an international health disaster in the same way that the 1998 US embassy bombings highlighted the possibility of further attacks by al-Qaida, a leading British medic in Sierra Leone has warned.
Dr Oliver Johnson has called for “a big political shakeup” at the World Health Organisation and says Britain’s Department for International Development must decide whether to “nationalise” aid and deploy the army the next time a humanitarian emergency hits.Dr Oliver Johnson has called for “a big political shakeup” at the World Health Organisation and says Britain’s Department for International Development must decide whether to “nationalise” aid and deploy the army the next time a humanitarian emergency hits.
“I hope this Ebola outbreak is as bad as it gets, I hope this is a one-off,” he said. “But it could be that it’s much more like the US embassy bombings [in Nairobi and Dar es Salaam in 1998].“I hope this Ebola outbreak is as bad as it gets, I hope this is a one-off,” he said. “But it could be that it’s much more like the US embassy bombings [in Nairobi and Dar es Salaam in 1998].
Related: Ebola upsurge could undo progress in blink of an eye, warns expertRelated: Ebola upsurge could undo progress in blink of an eye, warns expert
“They were a warning to us. At the time, we thought: ‘This is as bad as it can get – this organisation, al-Qaida, can you believe they’ve just demolished a US embassy?’“They were a warning to us. At the time, we thought: ‘This is as bad as it can get – this organisation, al-Qaida, can you believe they’ve just demolished a US embassy?’
“Actually, it was a warning sign for 9/11 … there was an emerging threat, and we – and the US – were not in a position to respond effectively to that.”“Actually, it was a warning sign for 9/11 … there was an emerging threat, and we – and the US – were not in a position to respond effectively to that.”
Johnson has been a leading figure in health policy in Freetown for the past two years, heading a partnership between the UK’s King’s Health Partners and key health institutions in Sierra Leone, including the Connaught hospital. He was previously policy director for the Parliamentary Group on Global Health.Johnson has been a leading figure in health policy in Freetown for the past two years, heading a partnership between the UK’s King’s Health Partners and key health institutions in Sierra Leone, including the Connaught hospital. He was previously policy director for the Parliamentary Group on Global Health.
But Johnson said the issues raised by Ebola go beyond Africa, highlighting the world’s vulnerability and “how incredibly limited our capacity is to identify and respond to emergencies”.But Johnson said the issues raised by Ebola go beyond Africa, highlighting the world’s vulnerability and “how incredibly limited our capacity is to identify and respond to emergencies”.
He said the UK has to ask itself why it has no domestic agency, no equivalent of Médecins Sans Frontières (MSF) to deploy health workers in a humanitarian emergency, be it Ebola or the Haitian earthquake.He said the UK has to ask itself why it has no domestic agency, no equivalent of Médecins Sans Frontières (MSF) to deploy health workers in a humanitarian emergency, be it Ebola or the Haitian earthquake.
“This was a market failure. DfID, in September, said: ‘We have a blank cheque we need NGOs to go.’ Deafening silence. They had to strong-arm Save the Children into [running] Kerry Town, the Freetown Ebola hospital built by the British army.“This was a market failure. DfID, in September, said: ‘We have a blank cheque we need NGOs to go.’ Deafening silence. They had to strong-arm Save the Children into [running] Kerry Town, the Freetown Ebola hospital built by the British army.
“We are the second largest donor in the world. MSF Spain deployed, MSF Swiss, Brussels deployed, the German Red Cross, the Americans deployed, Goal in Ireland deployed; we’re about the only country that didn’t have their own domestic NGO that was able to deploy to a health emergency, that had the right relationships with DfID,” he said.“We are the second largest donor in the world. MSF Spain deployed, MSF Swiss, Brussels deployed, the German Red Cross, the Americans deployed, Goal in Ireland deployed; we’re about the only country that didn’t have their own domestic NGO that was able to deploy to a health emergency, that had the right relationships with DfID,” he said.
The closest the UK had to MSF was Merlin, but it merged with Save the Children.The closest the UK had to MSF was Merlin, but it merged with Save the Children.
Johnson said the UK government must grasp the nettle, either nationalising its response to emergencies by sending in the army or keeping it private but making sure Save the Children or the Red Cross have access to NHS workers to deploy.Johnson said the UK government must grasp the nettle, either nationalising its response to emergencies by sending in the army or keeping it private but making sure Save the Children or the Red Cross have access to NHS workers to deploy.
The government should also look at establishing the equivalent of America’s Centers for Disease Control and Prevention, a federal agency that currently has 80 staff stationed in Freetown alone.The government should also look at establishing the equivalent of America’s Centers for Disease Control and Prevention, a federal agency that currently has 80 staff stationed in Freetown alone.
Johnson agrees this is a politically fraught challenge, but says: “You can be on the left and say we are doing this to save Africans, and you can be on the right and say we are doing this as national security to save ourselves.”Johnson agrees this is a politically fraught challenge, but says: “You can be on the left and say we are doing this to save Africans, and you can be on the right and say we are doing this as national security to save ourselves.”
However you look at the problem, it has to be addressed, he added.However you look at the problem, it has to be addressed, he added.
Related: Ebola crisis brutally exposed failures of the aid system, says MSF | Lisa O'CarrollRelated: Ebola crisis brutally exposed failures of the aid system, says MSF | Lisa O'Carroll
Johnson also called for the world’s largest nations to restructure the WHO as a matter of urgency.Johnson also called for the world’s largest nations to restructure the WHO as a matter of urgency.
He fears that, with Ebola in retreat – and because it hasn’t really threatened the safety and the security of people in the west – there “isn’t the appetite for addressing those failings”.He fears that, with Ebola in retreat – and because it hasn’t really threatened the safety and the security of people in the west – there “isn’t the appetite for addressing those failings”.
The WHO’s director general, Margaret Chan, has been heavily criticised for the organisation’s delayed response to the Ebola epidemic, which has claimed more than 10,000 lives.The WHO’s director general, Margaret Chan, has been heavily criticised for the organisation’s delayed response to the Ebola epidemic, which has claimed more than 10,000 lives.
Johnson says the repeated budget cuts emasculated the WHO and sent it into a “negative spiral” that blunted its ability to respond to the Ebola crisis when it first hit in December 2013.Johnson says the repeated budget cuts emasculated the WHO and sent it into a “negative spiral” that blunted its ability to respond to the Ebola crisis when it first hit in December 2013.
But, he says, the answer is not more money or a new WHO leader.But, he says, the answer is not more money or a new WHO leader.
“Learning from Ebola shouldn’t just be about learnings about Africa or Ebola, I think it’s much more about the WHO – and the problems with the WHO are not small.“Learning from Ebola shouldn’t just be about learnings about Africa or Ebola, I think it’s much more about the WHO – and the problems with the WHO are not small.
“When I raise the WHO issue with national governments, they say: ‘Oh, we know, we know, we’re working on it,’ and I keep saying: ‘Guys, you’re not working on it on the level you need to be working on it.’“When I raise the WHO issue with national governments, they say: ‘Oh, we know, we know, we’re working on it,’ and I keep saying: ‘Guys, you’re not working on it on the level you need to be working on it.’
“This has got to be a G7 summit issue. There’s a structural problem with the agency that a little bit of change of leadership or change of structure is not going to solve.“This has got to be a G7 summit issue. There’s a structural problem with the agency that a little bit of change of leadership or change of structure is not going to solve.
“There’s something fundamental about the WHO. This director general, when she became DG, said very clearly that she saw her role as supporting national governments and she wasn’t going to do anything that national governments weren’t going to be happy with.”“There’s something fundamental about the WHO. This director general, when she became DG, said very clearly that she saw her role as supporting national governments and she wasn’t going to do anything that national governments weren’t going to be happy with.”
Johnson said this meant “cover-ups” at the African regional level were just left to run, with Geneva failing to intervene until eight months into the outbreak. Johnson said this meant challenges at the African regional level went unaddressed, with Geneva failing to intervene until eight months into the outbreak.
His comments chime with those in a recent report by MSF that said WHO had initially stood on the sidelines offering nothing but advisory support.His comments chime with those in a recent report by MSF that said WHO had initially stood on the sidelines offering nothing but advisory support.
“We need a WHO which has a mandate to be more autonomous, to say to a country: ‘We don’t agree with you’ … That goes to the very constitution of the WHO,” said Johnson.“We need a WHO which has a mandate to be more autonomous, to say to a country: ‘We don’t agree with you’ … That goes to the very constitution of the WHO,” said Johnson.
He is now concerned that, with Ebola in retreat, global leaders and the media will “let it slip from public consciousness and wait for something worse to happen”.He is now concerned that, with Ebola in retreat, global leaders and the media will “let it slip from public consciousness and wait for something worse to happen”.