In the face of massive budget cuts at the World Health Organization (WHO), the US has stepped into the breach, providing USD 100 million and sending 3,000 military personnel to help stem the Ebola outbreak – but this may not be enough. According to WHO, the disease has killed nearly 3,000 people so far. The figure is climbing at a frightening rate. WHO’s budget problems began after the 2008 financial collapse, when it had to cut nearly USD 1 billion from its proposed two-year budget, which today stands at almost USD 4 billion. This leaves it unable to fund its emergency response to bring the outbreak under control, which may now cost as much as USD 1 billion.
In contrast, the US Center for Disease Control (CDC) in Atlanta had a USD 6 billion budget for 2013 alone. President Obama is asking the US Congress to approve the release of an extra USD 88 million to fight Ebola.
UN member nations contribute only 20% of WHO’s budget. The rest, according to a New York Times interview with WHO director general Margaret Chan, comes from outside donors, and “when the money stops coming in, then all the staff you recruited to do the response, you have to terminate their contracts”. According to Chan, Ebola is a global issue that must have a global solution. The problem is that emergency responders like Médecins Sans Frontières (MSF) rely on WHO, not only for funding but to coordinate the international response. In the face of the WHO leadership vacuum, the US and the CDC have moved swiftly and generously. Following a call on 12 September by Chan for at least 1,000 medical workers to be sent to West Africa, Cuba quickly offered to send 165. Several days later, the White House announced its planned military contingent, including doctors and other healthcare providers to build 17 new Ebola treatment units.
At a recent news conference in Geneva, Chan said more laboratories and health facilities are needed in the fight against Ebola where “the biggest obstacle is a lack of trained health care workers”. But she said that money alone cannot stop the spread of Ebola. “Human resources are important, especially the need for compassionate doctors and nurses who will know how to comfort patients despite the barrier of wearing a PPG (Personal Protective Gear) suit and working in very demanding conditions.”
But for numerous health workers, money, logistical support and ethics are the issue. “We are willing to go but they are asking for (unpaid) volunteers and how many will agree to that?” said a former WHO employee speaking off the record. The WHO epidemic response department was never well funded and those offices now stand empty, she said. For UN employees, including many who are not even trained for the job, there is pressure that if you do not volunteer, your career could be penalized. And finally, up till now, neither the UN nor WHO is able to guarantee evacuation for anyone who falls sick or has an accident, even if not with the Ebola virus.