World Bank president Jim Yong Kim on Wednesday said that the international community had “failed miserably” in its response to the Ebola virus, which has killed more than 3,800 people in west Africa, and warned that the crisis now affecting Spain and the US was going to get much worse.
Amid signs yesterday that Western governments were being forced to take the risks of a global pandemic more seriously, Kim said he wanted them to back a new US$20 billion global health fund that would be able to react instantly to emergencies.
“It’s late. It’s really late,” Kim said before the Washington-based organization’s annual meeting this weekend. “We should have done so many things. Healthcare systems should have been built. There should have been monitoring when the first cases were reported. There should have been an organized response.”
Kim’s warning that the global community was still not “moving fast enough” came as the Ebola virus claimed its first victim in the US and news of a case in Spain sent shares in travel and airline companies tumbling on stock exchanges.
The WHO said the number of deaths from Ebola in west Africa now stood at 3,879, with no evidence that the epidemic was being brought under control.
Britain on Wednesday said that it was scaling up its efforts to deal with the Ebola virus that has gripped Sierra Leone, Liberia and Guinea. All of England’s major hospitals are making preparations to isolate and treat patients suspected of having Ebola if a serious outbreak occurs, while more than 750 military personnel and the medical ship RFA Argus are being sent to west Africa to help contain the outbreak.
The announcement followed a meeting of the government’s Cobra emergency committee, chaired by British Prime Minister David Cameron.
RFA Argus has a fully-equipped hospital, including critical care and high-dependency units, and is scheduled to be sent to Sierra Leone along with three Merlin helicopters.
The US has also announced that it is scaling up its efforts and is set to tighten screening procedures at airports from this weekend. Thomas Duncan, who died in a Dallas hospital on Wednesday after arriving from Liberia, lied in a questionnaire about whether he had been in contact with anyone affected by Ebola.
Kim said he welcomed the UK and the US scaling up their efforts, but said that a high price was being paid for 11 months of delay and interagency argument.
“Now that there are cases in Spain and the US, the chances of the virus going to other European countries is fairly high,” he said.
In a blunt assessment of how the international community had coped with the crisis, Kim said: “We were tested by Ebola and we failed. We failed miserably in our response.”
He urged finance ministers attending meetings of the World Bank and the IMF this weekend to provide the resources needed to treat Ebola patients in their home countries.
Under the World Bank’s plan, resources would be provided to build big specialized treatment centers and to extend care to local communities. Every developed country should be prepared to send trained medical staff to west Africa, Kim said.
“We don’t need to stop all travel from these countries. It’s going to be impossible to stop people. The way to stop the flow of patients from these countries getting to the rest of the world is to have programs that will treat people and increase survival dramatically. It’s possible. We need to have quality services in place so that the motivation to leave these countries goes away. It is a rational thing to do to get away because we don’t have the treatment in place,” he said.
Rudimentary healthcare systems in the three west African countries have encouraged people to travel abroad for treatment, thereby spreading the virus. Before the crisis, Liberia had 61 doctors and 1,000 nurses, while Sierra Leone had 327 hospital beds.
“I say to finance ministers: ‘Look at what’s happening in Spain right now. It is going to get much worse.’”
The authorities in Spain said they were dealing with the first case of Ebola that had been transmitted outside of the three west African countries — a nurse who treated a priest who had flown to Madrid for care.
The WHO said further “sporadic” cases of Ebola in Europe were now inevitable.
A World Bank study released on Wednesday showed that the economic cost of Ebola could be as high as US$33 billion over the next two years if the virus spread to neighboring countries in west Africa.
Kim said the World Bank had been having arguments with the WHO over Ebola, but that they had now stopped.
“The most important thing is to stop arguing about what is or is not possible and to get on with doing what’s needed.”
Kim said his plan involved big treatment centers being set up by the US and the UK together with attempts to provide as full a range of services as possible into local communities.
“It would be good if you could manage the treatment of people close to home. But you can’t do that without the personnel. We need to put the capacity into place so that cases are identified more quickly,” he said.
Oxfam on Wednesday criticized the World Bank for its failure to invest enough in healthcare and in its promotion of user-fees and privatization.
This has changed rhetorically under Jim Kim,” said Nicolas Mombrial, head of Oxfam in Washington. “We hope to see it play out in the World Bank’s lending and advice from now. Ebola should serve to accelerate this change.”
Kim said that countries such as Sierra Leone had used financial support from the World Bank to improve energy supplies.
However, “this has taught us that we have to be much more serious about putting health systems into place,” he added.
He contrasted health systems in the three west African countries with Rwanda, which has 55,000 health workers.
“If this had happened in Rwanda we would have had it under control,” he said.
Kim said it was fortunate Ebola was not a quick-moving virus, but the chances of a quick-moving virus in the next 10 years is high.
“This was sloppy work on even a slow-moving virus like Ebola. If we have seen this with a slow-moving virus we are not even close to being ready to deal with a fast-moving virus,” he said.
He said Ebola highlighted the need to have a speedier way of responding to health crises.
“Why don’t we have a multibillion-dollar fund of US$10 billion, US$15 billion or US$20 billion set up so that once there is a global health emergency it can be drawn down on very quickly?” he said.
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