The Ebola outbreak that has stricken Sierra Leone, Liberia and Guinea since March 2014 has had a devastating effect on the region. By 2 December 2014, more than 17,500 cases and 6,000 deaths had been reported. Ebola has had wider damaging consequences for local economies, food security, institutional stability and the broader health system. The House of Commons International Development Committee says DfID and the World Health Organisation initially failed to recognise the scale and severity of the Ebola crisis and were too slow to respond. This is in part due the WHO's member states, who have cut its funding and failed to emphasise building sustainable health systems in developing countries, leaving the global health system "dangerously inadequate" for responding to health emergencies. It recommends that DfID press for a review of the international approach to health emergencies, incorporating the function, structure and funding of the World Health Organisation and the role and expectations of major donors.

The deadliest outbreak of Ebola virus disease in history, and the first to hit epidemic levels, struck the West African countries of Guinea, Liberia and Sierra Leone in 2014, killing 11,315 people. Despite being diagnosed in March 2014, there was a slow initial response to the epidemic. This was attributed by many witnesses to our inquiry to delays in WHO sounding the alarm and declaring a Public Health Emergency of International Concern (PHEIC), something which WHO must carry primary responsibility for. As a result, the international community did not fully mobilise until September, in the wake of the World Health Organization's designation of the outbreak as a Public Health Emergency of International Concern in August. We praise those who risked their lives to bring the epidemic under control and pay tribute to all those who lost their lives in the fight against Ebola.

Ebola is a rare and deadly disease. Since late 2013, West Africa has experienced the largest Ebola outbreak ever recorded. We pay tribute to all those who worked tirelessly to tackle this outbreak, some of whom gave evidence to this inquiry, and many of whom continue working to avert similar crises in the future. We also commend the Government on its leading contribution to the fight against Ebola, and the financial, and personnel, commitments that it made, from constructing and staffing Ebola treatment centres in Sierra Leone to deploying troops, helicopters, aircrew and an aviation support ship to provide much needed logistical support. Examples of UK successes in tackling Ebola, however, must not allow complacency to set in. Despite this impressive deployment of resources to combat Ebola in Sierra Leone, the UK response - like the international response - was undermined by systemic delay. The biggest lesson that must be learnt from this outbreak of Ebola is that even minor delays in responding cost lives. Yet delays were evident at every stage of our response, from escalating Public Health England's disease surveillance data to those with the capacity to act, to convening a Scientific Advisory Group for Emergencies which failed to be established until October 2014, three months after 'Cobra', the Government's emergency response committee, first met. In the absence of established mechanisms, ad hoc approaches emerged to fill the gaps. Inevitably, these were not as effective, or as targeted, as they should have been.

A Choice Outstanding Academic Title of the Year “A critical, poignant postmortem of the epidemic.” —Washington Post “Forceful and instructive...Sabeti and Salahi uncover competition, sabotage, fear, blame, and disorganization bordering on chaos, features that are seen in just about any lethal epidemic.” —Paul Farmer, cofounder of Partners in Health “The central theme of the book...is that common threads of dysfunction run through responses to epidemics...The power of Outbreak Culture is its universality.” —Nature “Sabeti and Salahi present a wealth of evidence supporting the imperative that outbreak response must operate in a coordinated, real-time manner.” —Science As we saw with the Ebola outbreak—and the disastrous early handling of the COVID-19 coronavirus pandemic—a lack of preparedness, delays, and system-wide problems with the distribution of critical medical supplies can have deadly consequences. Yet after every outbreak, the systems put in place to coordinate emergency responses are generally dismantled. One of America’s top biomedical researchers, Dr. Pardis Sabeti, and her Pulitzer Prize–winning collaborator, Lara Salahi, argue that these problems are built into the ecosystem of our emergency responses. With an understanding of the path of disease and insight into political psychology, they show how secrecy, competition, and poor coordination plague nearly every major public health crisis and reveal how much more could be done to safeguard the well-being of caregivers, patients, and vulnerable communities. A work of fearless integrity and unassailable authority, Outbreak Culture seeks to ensure that we make some urgently needed changes before the next pandemic.

In March 2014, an Ebola Virus Disease (EVD) outbreak was reported in Guinea, West Africa. The outbreak is the first in West Africa and has caused an unprecedented number of cases and deaths. The outbreak is continuing to spread in Guinea, Sierra Leone, and Liberia (the "affected countries"); it has been contained in Nigeria and Senegal, and has been detected in Mali. As of October 22, 2014, more than 10,000 people have contracted EVD, more than half of whom have died.

The 2014-2015 Ebola epidemic in West Africa was an unprecedented medical and political emergency that cast an unflattering light on multiple corners of government and international response. Fear, not rational planning, appeared to drive many decisions made at population and leadership levels, which in turn brought about a response that was as uneven as it was unprecedented: entire populations were decimated or destroyed, vaccine trials were fast-tracked, health staff died, untested medications were used (or not used) in controversial ways, humanitarian workers returned home to enforced isolation, and military was employed to sometimes disturbing ends. The epidemic revealed serious fault lines at all levels of theory and practice of global public health: national governments were shown to be helpless and unprepared for calamity at this scale; the World Health Organization was roundly condemned for its ineffectiveness; the US quietly created its own African CDC a year after the epidemic began. Amid such chaos, Médecins sans Frontières was forced to act with unprecdented autonomy -- and amid great criticism -- in responding to the disease, taking unprecedented steps in deploying services and advocating for international aid. The Politics of Fear provides a primary documentary resource for recounting and learning from the Ebola epidemic. Comprising eleven topic-based chapters and four eyewitness vignettes from both MSF- and non-MSF-affiliated contributors (all of whom have been given access to MSF Ebola archives from Guinea, Sierra Leone, and Liberia for research), it aims to provide a politically agnostic account of the defining health event of the 21st century so far, one that will hopefully inform current opinions and future responses.

The 2014â€"2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Republic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014â€"2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak. Integrating Clinical Research into Epidemic Response: The Ebola Experience assesses the value of the clinical trials held during the 2014â€"2015 epidemic and makes recommendations about how the conduct of trials could be improved in the context of a future international emerging or re-emerging infectious disease events.