A health worker checks the temperature of a woman leaving Guinea at the border with Mali in Kouremale,
A health worker checks the temperature of a woman leaving Guinea at the border with Mali in KouremaleREUTERS/Joe Penney

A war of words has broken out between aid agency Medecins Sans Frontieres (Doctors Without Borders, MSF) and the World Health Organization (WHO) over who is to blame for the slow response to the Ebola epidemic that killed 10,299 across West Africa.

A Twitter war erupted between a Geneva-based WHO spokesperson and MSF employees -before MSF released a highly critical report exposing the "age-old failures" of the humanitarian aid system on Sunday 22 March.

MSF is accusing the WHO of having delayed calling Ebola a public health emergency of international concern (PHEIC).

The WHO, the only agency with the authority to lead a global response to health crises by diverting financial, human and logistical resources to epidemic response, says it was aware of how dire the situation was and stuck to its legal framework regarding a PHEIC declaration.

WHO is an easy target

"MSF has produced a report that makes a lot of claims (...) It's very interesting that this narrative has been established: the idea that we should have declared something earlier when the conditions were not there to declare it in legal terms," WHO spokesperson Margaret Harris told IBTimes UK.

The UN agency also hinted MSF could be playing a blame game by using the Twitter spat to back up its claims.

"Unfortunately this has been elevated to the status of official WHO statements in the MSF report, even if the statements were made on a private Twitter account," Harris said. "When a (WHO) representative sends a private tweet that doesn't represent the organisation. We make ourselves very easy targets, that is the problem."

"We make ourselves very easy targets, that is the problem."

-Margaret Harris, WHO

A source within WHO said she personally thought that the row comes from "a lot of angst and distress" suffered by the MSF on the ground and "how difficult it has been for these organisations to respond effectively".

"Even though the things that are said are not really in keeping with particularly balanced statements, I understand why MSF are so bitter as this is a devastating thing to go through and watch people die when you're medically trained or you're a nurse and the whole purpose of your work is to save lives," the source told IBTimes UK.

AP story was hearsay, says WHO

The MSF report came just days after emails, allegedly showing the WHO had intentionally delayed calling Ebola a PHEIC, were released by the AP.

The virus outbreak was first reported in the March 2014 in south-eastern Guinea, but it was not until 8 August that the WHO to raise the international alarm.

The reasons the United Nations agency cited in internal deliberations include worries that the PHEIC could anger the African countries involved, hurt their economies, or interfere with the Muslim pilgrimage to Mecca.

WHO denies that politics swayed its decision to declare an international emergency over the spread of the Ebola virus.

"The PHEIC informs countries that they need to be prepared, that they are at risk of international spread and, yes indeed, we would not do it lightly and only did it based on the evidence (but) that tends to make countries close their borders, and airlines stop flying to those countries," the WHO spokesperson explained.

"It's quite complicated and difficult, but they (the AP) chose to confuse some things," Harris said, claiming "there is a lot of hear-say about what was said and what was done" in the AP story.

'Shell-shocked' by WHO's decision

Despite WHO's comments, MSF maintains the UN's resistance to call the Ebola outbreak in West Africa a public health emergency until last summer hampered its ability to contain the epidemic.

"Not having the emergency situation declared immediately had an impact on human lives," Elisabetta Maria Faga, MSF' Emergency Coordinator in Guinea, where the virus killed 2261, told IBTimes UK.

"If the declaration had been done straight away, more people would have had the opportunity to learn about the illness and start working on it earlier. So, evidently, we could have limited the epidemic."

Faga confirms both MSF and the Guinean Ministry of Health called on the WHO to declare the emergency situation before the summer, and says WHO failed to act despite knowing how serious the situation was from the onset.

"MSF works with the WHO – so everyone knew about what was happening. MSF was sounding alarm bells – which were maybe poorly understood. Unfortunately, there was no immediate reaction [from the WHO]," Faga said. "I was shell-shocked by their response."

Insufficient reasons

"Sure, an emergency situation would have an economic impact but it is an impact that we can repair. Lost lives can't be recovered."

- Elisabetta Maria Faga, MSF' Emergency Coordinator in Guinea

For the head of operations in Guinea, the reasons supposedly put forward by the WHO, including the fear of catastrophic economic consequences, are poor.

"We speak about potential economic impacts; sorry but we are a medical organisation, so for us health comes first. Sure, an emergency situation would have an economic impact but it is an impact that we can repair. Lost lives can't be recovered," Faga said from Conakry.

"These were the reasons given for people to understand their decision. Personally, these reasons were not sufficient."

Failing DRC and Nigeria

When a declaration of emergency situation is delayed, available information on the virus is delayed, Faga says. This, she says, means that a number of states such as the Democratic Republic of Congo, Nigeria, Mali and Senegal have been failed by the delay in response from the WHO.

"A great number of actors were concentrating on the situation in Sierra Leone, Liberia and Guinea, the three countries most ravaged by the virus, but failed to look at the epidemic in DRC and Nigeria," the director said. "It was more controlled there and on a smaller scale, but there was also Ebola in the Congo and Nigeria, sadly."

She added: "It would have been good for them [WHO] to listen to people who've been working around Ebola for 20 years, like MSF."

While eight died of Ebola in Nigeria, DRC counts 49 deaths.