MELISSA BLOCK, HOST:
As the World Health Organization tries to bring the Ebola outbreak under control, it's announced a plan that would cost $100 million. Promises of funding help have been flowing in. NPR's Richard Harris has this story about how the WHO will spend the money.
RICHARD HARRIS, BYLINE: It turns out that it's much more challenging to respond to the slow burn of an epidemic than it is to a typical natural disaster. When I asked WHO spokeswoman Nyka Alexander in Conakry, Guinea what's the biggest single challenge right now, she had no easy answer.
NYKA ALEXANDER: If there was just one solid large chunk that we could just slice out, we would. But it's so many little things that add up to the outbreak.
HARRIS: There's obvious needs like providing a constant stream of protective clothing for the doctors and nurses who are risking their lives in the makeshift hospitals and medical supplies - it's getting food to areas that have been placed into forced isolation - it's helping neighboring countries prepare in case the disease crosses more borders. WHO is working on all those problems. More than half of the money WHO is collecting is supposed to flow to the governments of Liberia, Sierra Leone and Guinea to bolster their teetering healthcare systems. More goes to international organizations that provide supplies and expertise. Doctor Trish Perl is chief epidemiologist at Johns Hopkins Medicine.
TRISH PERL: You need expertise from the West to support some of this, but a lot of this response is going to have to be local. You know, you may not be able to walk in and just say OK, so who in this village has Ebola? That may not be, you know, something that's culturally acceptable.
HARRIS: Advisors can train local people how to do that critical job. And in fact, some of those trainers are from the U.S. Centers for Disease Control and Prevention. Experts from the U.S., Europe and other nations in Africa can also set up the critical systems that are needed to track the epidemic. Many cases of the disease aren't being tracked at all.
PERL: A lot of these people are getting logged probably on papers and pencils, if they're getting logged at all. You know, we don't even really know the magnitude of the epidemic just because they don't have a well-defined surveillance system in place.
HARRIS: A surveillance system may seem like bean-counting while a disease is raging out of control, but Perl says it's actually essential for tracking the disease, identifying flare-ups and ultimately bringing it under control by isolating infected people. And ideally that system should stay in place after the current outbreak is finally snuffed-out because Ebola and other diseases aren't going away. Doctor Nils Daulaire, who was until recently the U.S. representative on the WHO executive board, says even in an emergency it's important to repair badly broken healthcare systems like those in West Africa.
NILS DAULAIRE: Whatever WHO does in a country needs to leave something very substantial behind so that it's not a matter of just going back and doing the same thing time and time again.
HARRIS: Of course this is more easily said than done. Doctor Fred Hartman from a nonprofit called Management Sciences for Health says not many years ago some of these West African nations got international assistance to prepare for a possible outbreak of avian flu.
FRED HARTMAN: When avian influenza ended - when the threat went away, these systems atrophied because resource-scarce countries have many demands on their resources, you know. Malaria can flare up or cholera or something else.
HARRIS: So it takes a sustained response, not just one-time aid projects to strengthen these healthcare systems, which have been crippled by civil wars and are only gradually being rebuilt. Richard Harris, NPR News.
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