The Ebola outbreak that began in Guinea in December 2013, has infected about 28,000 people in Guinea, Sierra Leone and Liberia, and killed more than 11,000. The World Health Organization (WHO) declared it a global public health emergency on August 8, 2014. A UN-appointed panel of experts reported that the WHO had been too slow in its response to the outbreak, and recommended a fundamental change. Joanne Liu, the head of medical charity Doctors Without Borders (Medecins Sans Frontieres, MSF), said, "All the ingredients for the west African Ebola outbreak are still there one year after a public health emergency was declared. The Ebola epidemic in west Africa is far from under control."
Liu further added, "Cases are still reported weekly, new communities are being infected, and bodies are still being buried in secret - a major problem for a disease transmitted though direct contact with body fluids. All the ingredients that enabled last year's devastation are still with us- rainy seasons, an uncoordinated response, fear and distrust."
MSF's volunteer medical personnel were key in the international response to the Ebola epidemic. Liu said, "Fatigue and waning focus were prolonging the epidemic. The number of cases in the past three months, about 330, was more than the third largest Ebola outbreak in history."
Liberia, which was declared 'Ebola free' in May, 2015, reported six new cases in June, 2015. 20 to 27 cases have been confirmed in Guinea and Sierra Leone every week from mid-June to mid-July. Liu said, "Cases have emerged in Guinea's Boke province, on the border with Guinea-Bissau, a country with a weak health system and almost non-existent epidemiological surveillance and blood-testing capacity."
Also of concern was that governments and aid agencies had still not won the trust of local communities, causing people to hide their sick and dead. The goal is to have no new Ebola cases in the three countries for 42 days, double the incubation period of the hemorrhagic fever virus, and the cut-off for the WHO to declare the epidemic over. Liu said, "But this would require a major push. Ministries of health and aid agencies must do more to engage and empower communities and to re-establish people's trust in government officials and health workers. The surveillance systems to locate and track new Ebola cases across Sierra Leone, Guinea and Liberia need to be properly supported, including in the districts that have not had an Ebola case for months."
Liu also said, "Basic health infrastructure, left in tatters by the epidemic, must be rebuilt. We need to push through the fatigue and complacency and put everything we have learned into action to end this epidemic. We must finish the fight against Ebola."
The report is published in Nature.