The United Nations Ebola chief said on Wednesday his top priority now that the deadly Ebola epidemic appears to be nearing an end is helping more than 15 000 survivors who need medical and psychological support.
Dr David Nabarro told a press conference that the survivors are distressed, not trusted, and are subjected to a lot of stigma in addition to facing medical problems including diminised vision and "terrible joint pains".
"They really need to be treated as the heroes of the outbreak," he said, not as outcasts.
The outbreak caused its first deaths in December 2013, made headlines in March 2014 in Guinea and soon spreading to Liberia and Sierra Leone. By early June 2014, the Ebola epidemic was the deadliest ever recorded, but WHO resisted sounding the international alarm until August, a delay that some argue may have cost lives.
Nabarro spoke a day after Guinea reported that its last known Ebola case ? a baby whose mother died ? tested negative for a second time, starting a 42-day countdown for the country to be declared free of the deadly virus. "We're hoping she will be the last case in Guinea," he said.
Comprehensive package of care
Liberia and Sierra Leone, the two other hardest-hit countries, already have reached the 42-day benchmark ? representing two incubation periods of 21 days for new cases to emerge ? and are now "in a 90-day period of enhanced surveillance, which means a high level of vigilance", Nabarro said.
But he cautioned that "the outbreak is not completely over" even though the number of new cases is approaching zero because there could be flare-ups, as happened in Liberia after it was declared Ebola-free for the first time in May.
Nabarro said survivors need a comprehensive package of care to maintain good hygiene, practice safe sex and ensure that they get psychological and medical support, and in some cases economic help.
In May, the World Health Organisation updated guidelines for male survivors because of the "strong possibility" that the Ebola virus could be spread through sex months later.
Nabarro said his other priorities are to ensure that countries have the capacity to detect and respond to any resurgence of Ebola and to honour the more than 11 300 people who died by making sure the world can better deal with such deadly diseases in the future.
Global health emergency work force
As part of that commitment, Nabarro is chairing a 19-member advisory group on reforming WHO which issued its first report earlier this week. The group has been criticised not only for its slow response, but for weak leadership, shoddy supplies and infighting that worsened the battle against the virus.
Nabarro said the advisory board had three key recommendations for WHO:
? Ensuring "that it is always neutral, independent, free of any kind of political control when it is making judgments about health risks and sharing those with the rest of the world."
? WHO needs a single programme to deal with health emergencies which must include "a global health emergency work force" and contingency funds to get people into the field quickly.
? An independent oversight group should be set up to help ensure that the agency and its director-general are performing "in the way the world needs."
Nabarro said Dr Margaret Chan, WHO director-general, has accepted the recommendations.