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Why WHO treated 2014 Ebola as a neglected disease

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Honigsbaum argues WHO’s slow 2014 PHEIC reflected Ebola’s demotion from hot biothreat to neglected African fever inside pandemic triage, not only a Geneva leadership vacuum.

Source

Between Securitisation and Neglect: Managing Ebola at the Borders of Global Health

Honigsbaum M · Medical history · 2017

doi.org/10.1017/mdh.2017.6Read the full paper ↗14 citationscc by

What they did

Drawing on internal WHO documents and interviews with responders, he traces Ebola’s identities from 1990s biosecurity (Reston, The Hot Zone) through IHR (2005) algorithms, then follows 2014 West African events, rumours, and the 8 August PHEIC.

What they found

Unlike smallpox, polio, novel flu, or SARS, Ebola needed a multi-step “serious/unusual/international” test. Officials still said urban outbreaks “don’t happen.” Misleading case dips, distrust of ETUs, and neglect of community methods delayed alarm until Sawyer, US evacuations, and Monrovia street deaths securitised the virus again.

The limits

What it doesn't show

It does not adjudicate every Stocking-panel governance reform or quantify how many deaths the delay caused; rumour analysis is illustrative, not a full ethnography of every district.

Key terms

PHEIC
Public health emergency of international concern under the International Health Regulations.
IHR (2005)
Revised regulations that auto-notify some diseases but put Ebola through a risk algorithm.
Neglected tropical disease
The identity Ebola had acquired by 2014 in Geneva, as a rare central-African haemorrhagic fever.
Dog that didn’t bark
Sprecher’s label for the April 2014 dip in visible cases that hid a worsening outbreak.
UNMEER
UN Mission for Ebola Emergency Response, created 19 September 2014.

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Quiz yourself

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By 2014 Honigsbaum says Ebola was treated as:

Common questions

When did Chan declare a PHEIC?

8 August 2014.

Which diseases required automatic WHO notification?

Smallpox, wild-type polio, new-subtype human influenza, and SARS—not Ebola.

What did officials tell Oliver Johnson in Freetown?

There had never been a major urban Ebola outbreak.

How large was Muyembe’s 2014 DRC outbreak as cited?

Sixty-six cases, ended in three months with community engagement.

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