A year after WHO declared that Ebola had been found in Guinea, the agency is on the defensive over reports that it dragged its feet when raising the international alarm over the disease.
Internal communications published by The Associated Press last week documented senior agency staff discouraging the move about two months before the international alert was finally raised, citing diplomatic relations, mining interests and the Muslim pilgrimage to Mecca.
Political worries appear to loom large in the communications obtained by AP, which include emails and memoranda. A June 10 memo sent to WHO Director-General Dr. Margaret Chan says declaring an emergency or convening a committee to discuss the issue could be seen as a "hostile act" by Ebola-affected countries.
When senior African staff floated the idea of declaring an emergency on June 4, WHO official Dr. Sylvie Briand wrote that she saw such a move as a "last resort."
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Ebola was judged to have become a health emergency with international implications nearly a month earlier by the US Centers for Disease Prevention and Control.
"I activated the emergency operations center at the CDC on July 9," said Dr. Tom Frieden, CDC director, meaning the agency moved immediately to put the organization's full weight behind efforts to curb Ebola in mid-July.
Frieden said WHO's international emergency declaration should have been based mainly on health criteria.
"We need to ensure the technical issues are always the primary issues that lead to the decisions that are made," he said.
Recently drafted internal talking points seen by AP say West Africa's borders are so porous that it didn't make sense to declare an emergency despite the fact that the virus was causing an epidemic across three countries by early 2014.