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Libya gunmen attack Corinthia Hotel in Tripoli

Corinthia Hotel,

car bomb exploded near the premises

Discouraged, scared and furious, Sierra Leoneans are taking matters into their own hands. Laid-off teachers (all schools in this country are closed) race around on motorbikes, monitoring the sick.

Sierra Leone has an elaborate Ebola response system — on paper. It starts with a call to 117, the toll-free number for central dispatch. A surveillance team is sent out, then an ambulance takes a patient to a holding center, then blood tests and a proper treatment center where the patient might receive intravenous fluids or other special care.

“You can have as many helicopters, ships and kit here as you’d like,” said Lt. Colonel Matt Petersen, a British adviser. “But unless you change behavior, it’s not going to stop transmission.”

The Economic Community of West Africa (ECOWAS) created a ‘solidarity fund’ to contain and manage the outbreak, [17] and the World Health Organisation convened an emergency meeting of regional health ministers in Accra to strengthen surveillance operations and facilitate cross-border consultations. [18] The World Health Organisation also opened a Sub-Regional Outbreak Coordinating Center in Conakry. [19] Doctors Without Borders has deployed 300 personnel to assist in health care facilities, and both the US Centers for Disease Control and Prevention and the European Union have provided scientific personnel and resources to assist with laboratory testing and government coordination. [20]

The World Health Organisation fulfilled its coordinating mission by organising a meeting of regional health officials in Accra in early July—but that was three-and-a-half months after the first report of the disease. WHO’s Sub-Regional Outbreak Coordination Center has the potential to be a useful resource, but it took nearly four months from the outbreak’s beginning until WHO began such operations. Given how quickly Ebola spreads and its virulence, such a delay helped the disease gain a foothold in the region. Arresting the spread of infectious diseases requires quicker action.

First, the current response needs to be ratcheted up. Opening sub-regional command centers, deploying personnel from governmental and nongovernmental sources, and providing financial resources are all important—but they need to be done in greater number and with greater urgency. The initial efforts are not necessarily failures; they are just too small and slow in response to the overwhelming nature of this unprecedented outbreak.

The W.H.O.’s goal is what it calls “70-70-60” — safe burials for 70 percent of victims, and 70 percent of suspected cases isolated, within 60 days of the date it set this goal.