The Inefficiencies of the World Health Organization: H1N1 and Ebola Management

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Table of Contents

Abstract
Introduction
H1N1 Management Errors
Ebola Outbreak Management Errors
Conclusion
Recommendations
References

Abstract

Overall aims and specific objectives: To examine the management of health emergencies by the World Health Organization (WHO) as a UN agent to establish its inefficiency in coordinating international cooperation. The paper analyzes structural and administrative shortcomings that led to poor communication, messaging, coordination, and cooperation during the 2009 influenza A (H1N1) and the 2014 Ebola disease outbreak health emergencies.
Method/procedure: The paper analyzes evidence presented in the existing literature on the 2009 H1N1 and 2014 Ebola outbreaks.
Key findings: During the H1N1 crisis, the WHO made communication and messaging mistakes that led to pigs’ mass slaughter. Simultaneously, the WHO erroneously declared a pandemic costing countries millions of dollars invested into vaccines that were never used. During the Ebola outbreak, the WHO’s coordination failed between the Geneva and African secretariats, delaying interventions. Additionally, the WHO accepted misleading official reports from governments and NGOs, giving the disease time to get out of control.
Main conclusions and recommendations: The WHO needs to undergo policy and human resource reforms.

Introduction

The World Health Organization (WHO) has been existing for several decades now, serving the world to coordinate health responses to outbreaks and pandemics. Nevertheless, the organization receives criticisms from time to time due to its mishandling of disease outbreaks and resource management. Civil society organizations, member states, and non-governmental organizations have questioned the WHO’s relevance. This report uses a simple structure to examine the lack of coordination, appropriate communication, and international cooperation in the WHO’s Ebola and H1N1 management.

When H1N1 influenza was reported to the WHO in 2009, the world was confident that it was ready for the first 21^st-century pandemic. The virus originated from a rural village in Mexico called La Gloria. In a few weeks, influenza spread across 200 locations in the world (Kamradt-Scott, 2018). Governments worldwide joined the WHO to prepare for the next pandemic following the bird flu reemergence, also known as H5N1. During and after the H1N1 flu, the WHO was criticized for mismanagement of the event. Following the criticisms, three investigations were conducted to establish the causes of the organization’s crisis in H1N1 management (Kamradt-Scott, 2018). Although the inquiry failed to establish inappropriate conduct, they recommended changes to the organization’s emergency response strategies.

H1N1 Management Errors

The WHO’s mistakes during H1N1 include labeling the flu as “swine flu,” removing influenza guidelines from their website and declaring the flu as a pandemic. The 20^th-century influenza pandemics were named after the places of origin, such as the 1968 Hong Kong flu, the 1957 Asian flu, and the 1918 Spanish flu, adversely affecting these regions’ economies (Kamradt-Scott, 2018). The WHO attempted to change the trend by naming the flu concerning the animal linked closely to influenza, preventing it from being called the ‘Mexican flu.’ Since the flu was linked to pigs, the WHO named it the swine flu, making its first big mistake in H1N1 management.

International media houses described influenza as swine flu during its first few weeks. In the following weeks, 20 percent of the WHO’s member states deviated from international norms to protect their citizens from pigs as a swine flu source (Kamradt-Scott, 2018). Although Egypt did not report infections, the government implemented a preventative measure that saw over 400,000 pigs culled countrywide (Kamradt-Scott, 2018). A few days later, Iraq slaughtered three zoo boars to eliminate the fear of contracting the flu from visitors. Around the same time, over 20 countries banned importing pork and its products and live pigs to prevent the flu’s introduction within their borders (Kamradt-Scott, 2018). The mass slaughter of pigs was a consequence of miscommunication from the WHO.

The WHO realized that the swine flu needed immediate rebranding to prevent further damage. The secretariat began renaming the flu Influenza A (H1N1) and sought other intergovernmental organizations’ help to lift the bans on pork products and pigs importation. Towards the end of April 2009, the WHO made press releases and advisories to remedy the situation, explaining that well-cooked pork products could not spread the flu. Although the WHO continually issued such messages jointly with the Food and Agriculture Organization (FAO) and the World Organization for Animal Health, several countries did not lift their bans (Kamradt-Scott, 2018).

The WHO failed to recognize how powerful its messages would be on member states and the world. The organization did not establish a scientific transmission of the flu between humans and pigs (Rathore, 2017). Nevertheless, it named influenza swine flu and caused damage to trade practices and animal malpractices.

The WHO made its second mistake when it removed pandemic guidelines from its site. With the uncertainties surrounding new diseases, many governments rely on the WHO website’s information to guide their responses and emergency committees. The measures included the development of vaccine manufacturing ability, creation of response committees, and antiviral stockpiling. The complete policies were posted on the website a few months before the outset of H1N1, and governments were yet to internalize them (Kamradt-Scott, 2018). Therefore, the removal of these guidelines left most countries unprepared to handle the pandemic.

The third mistake the WHO committed was prematurely declaring H1N1 influenza as a pandemic. A few weeks after the H1N1 flu was reported, Mexico reported around 84 deaths and 1300 infections (Rathore, 2017). In the following days, laboratories confirmed that nine countries reported illnesses, but the figure rose to 30 countries with 5000 infections by the middle of May 2009 (Kamradt-Scott, 2018). The International Health Regulations emergency committee established to support the WHO advised that the flu be escalated to Phase 5 (sustained community transmission) to signify that a pandemic was unavoidable (Kamradt-Scott, 2018).

However, the alert was immediately criticized since infections did not cause severe symptoms. The secretariat declined to provide the IHR emergency committee members’ names who advised on declaring a pandemic, leading to allegations of conflicts of interest.

Ebola Outbreak Management Errors

While transparency improved after the H1N1 emergency, the WHO failed its member states and the world in 2014 when Ebola was reported in West Africa. The organization made two critical errors: slow response due to reliance on ‘official reports’ and inadequate coordination. The Ebola virus disease (EVD) outbreak started in December 2013 in Guinea but was not reported to the WHO until March 2014, during which it spread to Sierra Leone and Liberia (Ostergard, 2020).

Although the WHO mobilized immediate response, it relied on official reports from NGOs and governments, providing insufficient data for resource allocation. In May 2014, Guinean data showed that Ebola was nearing its end, and its health minister supported the idea (Ostergard, 2020). However, an NGO called Medecins Sans Frontieres (MSF) disputed the claim while the WHO accepted it (Ostergard, 2020). Two weeks later, the outbreak got out of control, revealing poor judgment on the WHO’s side for accepting official reports without probing further.

The WHO’s response to the EVD outbreak involved insufficient coordination between the Geneva office and Africa’s regional offices. The regional secretariat approved a response plan in March 2014 that declared the outbreak as WHO Grade 2 Emergency, requiring a regional support team (Ostergard, 2020). However, the Geneva secretariat responded in May by sending 90 workers to Guinea, one to Sierra Leone, 20 to Liberia, and four to the Africa office (Wenham, 2017). These staff allocations revealed a disparity in how regional and Geneva offices treated the situation. The WHO regional secretariat also took three months to begin a coordination process in the region. The lack of proper coordination attributed to the spread of Ebola, which was severe enough to attract the UN secretariat and several countries around the world.

Conclusion

The WHO failed in managing the H1N1 pandemic and Ebola outbreak. Labeling H1N1 as Swine flu caused animal welfare issues as pigs were culled in various countries and created trade barriers as some countries banned pork products in some countries. When the secretariat declared the flu a pandemic and was criticized, it acted on the wrong media strategy of removing pandemic guidelines from its website; during the Ebola outbreak, the WHO trusted the affected governments’ reports, knowing that they lacked experience with Ebola outbreak. The outbreak went out of control and was contained through a global effort. As a UN agent, the WHO has shown much inefficiency in handling pandemics and outbreaks.

Recommendations

The WHO requires both policy and human changes to ensure a smooth response to health emergencies. Although funding is a big challenge for the organization, most of the mistakes described in this paper require policy and human resources. The WHO can formulate policies that create speed and eliminate unpredictability in emergency handling. The policies should support collective action, eliminate bureaucracy, and promote member states’ preparedness and readiness. The WHO may include a broader skillset among its staff and increase resource allocation to developing countries.

References

Kamradt-Scott, A. (2018). What went wrong? The World Health Organization from swine flu to Ebola. In A. Kruck, K. Oppermann, & A. Spencer (Eds.). Political mistakes and policy failures in international relations (pp. 193-215). Palgrave Macmillan.

Ostergard Jr, R. L. (2020). The West Africa Ebola outbreak (2014-2016): A health intelligence failure?Intelligence and National Security, 35(4), 477-492. Web.

Rathore, I. (2017). Swine flu (H1N1 Influenza A): A recent pandemic and future threat. Asian Journal of Nursing Education and Research, 7(2), 239-242. Web.

Wenham, C. (2017). What we have learnt about the World Health Organization from the Ebola outbreak. Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1721). Web.

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