The response to the Ebola epidemic: negligence, improvisation and authoritarianism
Jean-Hervé Bradol
Medical doctor, specialized in tropical medicine, emergency medicine and epidemiology. In 1989 he went on mission with Médecins sans Frontières for the first time, and undertook long-term missions in Uganda, Somalia and Thailand. He returned to the Paris headquarters in 1994 as a programs director. Between 1996 and 1998, he served as the director of communications, and later as director of operations until May 2000 when he was elected president of the French section of Médecins sans Frontières. He was re-elected in May 2003 and in May 2006. From 2000 to 2008, he was a member of the International Council of MSF and a member of the Board of MSF USA. He is the co-editor of "Medical innovations in humanitarian situations" (MSF, 2009) and Humanitarian Aid, Genocide and Mass Killings: Médecins Sans Frontiéres, The Rwandan Experience, 1982–97 (Manchester University Press, 2017).
This article was first published in the inaugural issue of the new review Humanitarian Alternatives, on February 2016
If MSF has held a preponderant position in the response to the Ebola crisis, it owes it just as much to its intervention capacities as to its capacity for criticism. The following article by Jean-Hervé Bradol embodies perfectly the latter in pointing to the issues that appeared on the occasion of this epidemic.
For the first time in history, since the discovery of the virus in 1976, medical institutions had to organise the response to an Ebola epidemic on a grand scale. As for any answer to a particularly murderous epidemic, the scrutiny of the result obtained can be carried out by discussing the impact of two types of actions on the number of deaths: those aiming at diminishing the number of new cases (incidence) and those aiming to reduce the number of deaths amongst people already infected (lethality). Between the beginning of 2014 and June 2015WHO, Ebola Situation Reports, http://apps.who.int/ebola/ebola-situation-reports, June 2015. , 27 550 cases were reported, mainly in three countries (Guinea, Sierra Leone and Liberia), with 11 235 leading to the patient's death.
Let's state it to begin with, such a result of around 41% of deaths amongst the cases reported, was not obvious at the start. Effectively, out of the 2 387 cases reported during the preceding epidemics (from 1976 in Zaire to 2012 in Uganda), 1 590 deaths were reportedIbid.. In reality, for these epidemics, in which cases were counted by hundreds instead of thousands, the proportion of deceased patients amongst the people registered as Ebola cases was subject to ample variations, the extremes being: 90% of deaths in the Democratic Republic of the Congo (2003) and 25.1% in Uganda (2007).
READ THE ARTICLE ON HUMANITARIAN ALTERNATIVES WEBSITE
To cite this content :
Jean-Hervé Bradol, “The response to the Ebola epidemic: negligence, improvisation and authoritarianism”, 8 février 2016, URL : https://msf-crash.org/en/blog/medicine-and-public-health/response-ebola-epidemic-negligence-improvisation-and
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