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WHO leadership admits failings over Ebola, promises reform

REUTERS   by Tom MIles                                                                     April 19, 2015

GENEVA--The World Health Organization has admitted serious failings in its handling of the Ebola crisis and pledged reforms to enable it to do better next time, its leadership said in a statement seen by Reuters on Sunday.

"We have learned lessons of humility. We have seen that old diseases in new contexts consistently spring new surprises," said the statement, attributed to the WHO Director-General Margaret Chan and the deputy director-general and regional directors.

"We have taken serious note of the criticisms of the Organization that, inter alia, the initial WHO response was slow and insufficient, we were not aggressive in alerting the world ... we did not work effectively in coordination with other partners, there were shortcomings in risk communications and there was confusion of roles and responsibilities...," it said.

The statement listed eight lessons learned, including areas where the WHO's response to Ebola could have been better, such as information sharing and communication....

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Rebuilding after Ebola will require the world’s help

WASHINGTON POST EDITORIAL                             Aug. 18, 2015

THE RAVAGING of populations in Liberia, Sierra Leone and Guinea by the Ebola virus over the past year has been devastating. The virus killed 10,702 people and left behind vast economic and emotional tolls. The rest of the world responded slowly to the outbreak but eventually rallied. Now it is time to do the same with the aftermath and extend a hand for rebuilding...

The outbreak has receded, but weak local health-care systems proved inadequate when the virus began to spread last year, and improvements are vital in all three countries, especially a much-strengthened system of surveillance to spot any resurgence. Trained health-care workers are in short supply. A small but important step was taken recently in the announcement that the Centers for Disease Control and Prevention will help set up an African CDC that could keep the continent one step ahead of another scourge. But the rest of the world also has a stake in making sure that the region builds a better firewall against infectious disease....

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Paper and Phones Could Soon Diagnose Ebola and HIV for $1

NEWSWEEK  by Conner Gaffey                               April 16, 2015
Diseases such as HIV and Ebola are on the verge of being diagnosed almost instantly using paper-based technology costing less than $1.

                                       Diseases may soon be tested for via paper and smartphones Getty

The devices, known as biosensing platforms, are made from cheap materials including plastic film and cellulose paper. Results are captured using a smartphone camera and sent back to hospitals or clinics for immediate diagnosis.

Current HIV diagnosis can cost up $48 (45) for a negative test and $64 (60) for a positive test. Checks for Ebola cost some $100 (95), take up to six hours to produce a result and require sophisticated diagnostic equipment, the type of which is often unavailable in western Africa where the disease is especially prevalent.

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CDC announces smartphone coaching app for Ebola workers

CGN                                                    April 17, 2015

(Scroll down for underlying press release.)

The Centers for Disease Control and Prevention announced a free smartphone application that provides intuitive coaching on CDC's guidelines for proper use of personal protective equipment (PPE) to prevent transmission of Ebola.

Powered by 22otters, a mobile patient engagement platform, CDC's PPE app is an animated, speech-enabled, step-by-step mobile coaching tool to help healthcare workers access easy-to-follow directions for putting on and removing PPE and respirators in accordance with CDC guidelines to prevent transmission of Ebola. Following the initial Ebola app release, 22otters will release a variant of the app allowing training progress tracking and content modules customized for providers.

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Evaluating Clinical Trial Designs for Investigational Treatments of Ebola Virus Disease

PLOS MEDICINE   by Ben Cooper and others                                                             April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

Read complete study.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815

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Ebola: World Bank Group Provides New Financing to Help Guinea, Liberia and Sierra Leone Recover from Ebola Emergency

THE WORLD BANK                                                                           April 17, 2015

New GDP Estimates Show International Support Vital to Speed Recovery

WASHINGTON--The World Bank Group (WBG) announced today that it would provide at least US$650 million during the next 12 to 18 months to help Guinea, Liberia and Sierra Leone recover from the devastating social and economic impact of the Ebola crisis and advance their longer-term development needs. The new WBG pledge brings the organization’s total financing for Ebola response and recovery efforts to date to US$1.62 billion.

The additional funding announcement comes as the WBG releases new GDP estimates showing that the Ebola epidemic continues to cripple the economies of Guinea, Liberia and Sierra Leone. Estimated GDP losses for the three countries in 2015 rose to US$2.2 billion: US$240 million for Liberia, US$535 million for Guinea and US$1.4 billion for Sierra Leone. In addition to the severe effects of Ebola, the economic downturn in the three countries is aggravated by the sharp decline in global iron ore prices, as well as the collapse of the mining sector in Sierra Leone...

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Dramatic’ progress in fighting Ebola must be followed by long-term recovery efforts

UNITED NATIONS NEWS CENTRE                                                      April 16, 2015

WASHINGTON  --Intense efforts to control the Ebola outbreak in the three most-affected West African countries in will continue, the United Nations health chief said in Washington, DC today, adding that the international community is also looking for ways to build on dramatic recent progress by aiding with efforts aimed at recovery from the outbreak.

Tuesday 14 April 2015 was a happy day in Sierra Leone as children returned to school after many months             away, due to the Ebola outbreak. Photo: WHO/N. Alexander

“The goal is to help people and their communities to return to a normal life again,” said Margaret Chan, Director-General of the World Health Organization (WHO). “It means that children are going back to school, women can once again shop in their local markets, and livelihoods are restored.”

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Ebola Fighters Say Now Is Not the Time to Let Up

 Cases may be nearing zero in certain areas, but the threat of the disease lingers

 TIME MAGAZINE  by Maya Rhodan                                                   April 16, 2015

There were only 37 confirmed cases of Ebola last week, just a year after the deadly virus was spreading quickly across Western Africa. But key stakeholders in the effort to reduce the number of cases to zero said Thursday that success is not guaranteed.

President Barack Obama, flanked by Liberian President Ellen Johnson Sirleaf, left, and Guinean President Alpha Condé, speaks in the Cabinet Room of the White House in Washington, Wednesday, April 15, 2015, to discuss the progress made in the international Ebola response. Manuel Balce Ceneta—AP

“We are dealing now with the most difficult areas,” said Bruce Aylward, the assistant director-general of polio and emergencies at the World Health Organization. “We’re dealing with issues of fear, of trust with communities that have been marginalized. That have not been fully engaged.”

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Turning the Page on Ebola

Joint Statement by Presidents Alpha Condé  of Guinea, Ernest Bai Koroma  of Sierra Leone. and Ellen Johnson Sirleaf of Liberia 

 PROJECT SYNDICATE   COMMENTARY                                                                                       April 16, 2015

....The uncontrolled spread of the disease exposed the shortcomings of our national health care systems, as well as regional and global institutions’ weak capacity for coordination and effective response. Simply put, we were ill prepared to cope with, much less prevent, an outbreak on this scale.

We bear a collective responsibility for the thousands of lives lost to Ebola and the tens of thousands affected by the disease. And, today, thanks to institutional improvement and adaptation, we are closer to winning the fight against Ebola. Although the disease has not been contained and eradicated throughout the region, its spread has slowed; now we have to start planning our recovery, which must include strengthening the national, regional, and international systems that protect our people’s lives and futures....

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Challenges in Guinea spur increase in Ebola cases

CENTER FOR INFECTIOUS DISEASE RESEARCH AND POLICY    by Lisa Schnirring                       April 15, 2015
(Scroll down for full WHO report.)
Ebola progress held steady in Sierra Leone and Liberia last week, but the number of confirmed cases in Guinea increased, with the country's response indicators showing a mixed picture amid sparks of community resistance, the World Health Organization (WHO) said today in its weekly epidemiologic update.

The outbreak region registered 37 confirmed cases last week, up from 30 reported the week before, the WHO said. Guinea's cases increased from 21 to 28, with Sierra Leone reporting 9 lab-confirmed cases, the same as the week before. Liberia hasn't reported any new cases since the middle of March.

Meanwhile, the geographic scope of the outbreak shrank a bit last week, with 8 districts in Guinea and Sierra Leone reporting cases, down from 10 the week before. The hot spots are still located in western Guinea, especially Forecariah district near the border with Sierra Leone. The few cases in Sierra Leone are coming mainly from three western districts in an area that includes the capital city, Freetown.

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