WASHINGTON - The presidents of the three West African countries most affected by Ebola implored world leaders on Thursday to increase their support to fight the disease, saying that while the international response has expanded, it has been slow to be felt on the ground.
The African heads of state spoke at the World Bank headquarters here, where the world's top financial and economic development leaders have gathered for annual meetings of the bank and the International Monetary Fund.
No new money was committed, but the United States and the European Commission pledged to provide medical evacuation services for health workers deploying to the countries, removing a major obstacle to larger flows of skilled medical professionals to Guinea, Liberia and Sierra Leone.
'The fight on the ground in Sierra Leone urgently needs the help of the people gathered here today,' that country's president, Ernest Bai Koroma, said via video link. 'Commitment on paper and during the meetings are good. But commitments as physical facts on the ground are best.'
The aim of the meeting was to place the leaders of the three countries in front of the world's most influential economic and political leaders to plainly state their case.
The president of the monetary fund, Christine Lagarde, attended, as did Secretary General Ban Ki-moon of the United Nations. President Alpha Condé of Guinea attended in person, while President Ellen Johnson Sirleaf of Liberia and Mr. Koroma appeared by video link.
'Today I'd like to invite the three heads of state to be very frank,' said Jim Yong Kim, the president of the World Bank. 'We're still way behind the curve.'
Mr. Koroma ticked off a long list of needs: treatment centers with 1,500 more beds; an additional 5,250 medical workers, including 750 doctors, 3,000 nurses and 1,500 support staff members; 200 ambulances; 1,000 motorcycles for workers tracking people exposed to Ebola; five new Ebola testing laboratories; and 200 vehicles for burial teams and other workers.
'We have clearly stated what is required, and what is required is required yesterday,' Mr. Koroma said.
Mr. Condé appealed to donors to work directly with each country's government. A representative of Japan said his government's shipment of 20,000 sets of protective gear left Japan on Sept. 18, but was stuck in an airport in Abidjan, a city in the Ivory Coast. Mr. Condé said he had raised this problem with the Ivorian prime minister.
'We get lost in bureaucracy and what is needed doesn't get to the end user,' he said in an interview. The only protective gear that Guinea is now receiving comes from Unicef, he said.
Dr. Bruce Aylward, who began coordinating the Ebola response for the World Health Organization on Oct. 1, reported that although a lot of international workers are reaching cities in the region, yawning gaps remained at the district level, with very little coordination. He said he spent his first week in the region figuring out what each of the 45 affected districts in the three countries needed. He said that responders were trying to build a campaign against Ebola in weeks - in contrast to another ambitious push, the global effort to eradicate polio, which he said took a decade and 7,000 workers.
He said he aimed to have a full inventory of each district's capacities and systems for logistics and transfer of information within 60 days. He told the meeting that his goal was to ensure that 70 percent of burials were safe and 70 percent of Ebola cases were isolated within 60 days.
He set those goals because, as he put it, 'I want people really scared every day.'
In a reminder of the pressing needs, Doctors Without Borders announced on Thursday that the number of Ebola cases in Conakry, Guinea's capital, had suddenly spiked.
The aid group said in a news release that there had been 22 new patients admitted to the Ebola management center at Donka on Monday alone, and that the center is now exceeding capacity. Stephane Hauser, the group's field coordinator at Donka, noted that cases had increased steadily since August and that there were new transmission chains 'whose origins we don't know at the moment.'
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