WHO reform: bring back GOARN and Task Force ‘Scorpio’

W HO's Director-General recently put the so-called failure of WHO to respond rapidly and adequately to the Ebola epidemic squarely on the shoulders of the member states, who year after year have restricted WHO's budget options and never contributed to the emergency fund that was called for after the H1N1 influenza scare in 2009. WHO has GOARN, a Global Outbreak Alert and Response Network, which 'ensures that the right technical expertise and skills are on the ground where and when they are needed most'. This has been emasculated by budget redistribution demanded by its member states. Twenty-five years ago, during the first Gulf War, the Swiss government presented the UN Secretary General Javier Perez de Cuellar with an outfit called Task Force 'Scorpio', a fully trained and equipped team of international experts with Swiss passports and its own aircraft, capable of deploying within 24 h and 'parachuting' in to investigate the presence of nuclear, chemical, biological, or highly explosive material anywhere in the world. It was never deployed and was disbanded after the war. A proposal in 2003 to revive it as a Swiss/European WMD Task Force went nowhere. It is essential for proper functioning that team members train together wearing personal protective equipment to get accustomed to the essential team discipline and to the constraints of wearing personal protective equipment with its limitations to communication. WHO was on the ground a week from first confirmation of the disease and is still there for the long haul after the UN Mission for Ebola Emergency Response (UNMEER) has declared victory, packed up, and gone home without waiting for the last case to leave the hospital , with hundreds of contacts still in quarantine and many, many contacts lost to follow-up. But I am certainly not disputing the fact that the UN contribution of air transport and logistics was essential to success in the field. WHO is expected to take care of the world's health on a budget of $3 billion Á the same as that of the 2,500-bed New York Presbyterian Hospital! Á with most of it earmarked for health issues other than outbreaks of infectious diseases. This at the express directive of its member states. WHO is not the world health police. It cannot order a country to turn its national soccer stadium in the middle of its capital into an Ebola treatment center, over the objection of neighboring residents, …