Mecanismos lesivos en accidentes de tráfico.

109. Several regional and sub-regional organizations took action to support the response to the 2014 Ebola outbreak. Most prominently, on 19 August 2014, the African Union (AU) Peace and Security Council authorized the deployment of an AU-led Military-Civil Humanitarian Mission comprising medical doctors, nurses and other medical and para- medical personnel. From December 2014 until May 2015, the African Union Support to Ebola Outbreak in West Africa (ASEOWA) effort supported the deployment of 720 qualified volunteers from 12 AU Member States. Doctors and responders who had worked on previous Ebola outbreaks brought valuable experience. The AU also convened a series of political meetings to highlight the need for assistance, advocate for a lift of travel bans and restrictions, and request that the AU Commission establish an African Centre for Disease Control and Prevention (ACDCP). The AU further organized an African Business Roundtable with the private sector—at which $32 million was raised from the private business and the African Development Bank (AfDB)—and worked with mobile phone operators to channel private donations by SMS. The AfDB also provided more than $223 million by December 2014 to support emergency operations in the three Ebola-affected countries.

110. The Economic Community of West African States (ECOWAS) deployed a further 115 medical staff and other responders to assist the affected countries. In addition, ECOWAS convened an Extraordinary Summit on Ebola and set up the ECOWAS Solidarity Fund for Ebola that raised more than $7 million in contributions. Furthermore, the West African Health Organization and the ECOWAS Commission trained and sensitized health officers on infection prevention and control.

111. The Mano River Union (MRU) organized regular summit meetings among the Heads of State of its four member Nations (Guinea, Liberia, Sierra Leone and Côte d’Ivoire) to discuss greater collaboration in the Ebola Response. The MRU also provided the framework for the regional recovery plan for the three affected countries that was presented at the International Ebola Recovery Conference in New York City in early July 2015.

112. While the support provided by regional and sub-regional organizations represented a significant strengthening of their engagement and operational capacities in the health sector, the assistance nonetheless took a long time to arrive, and was not always well coordinated. The Ebola outbreak therefore highlighted the need to strengthen regional collaboration in public health. While the primary responsibility for disease surveillance and outbreak detection and response lies at the national level, cooperation at the regional or sub-regional level offers significant value-added in several areas.

113. A regional perspective allows for a more comprehensive analysis of regional dynamics, including population movement patterns, trends in disease hotspots, and response needs. This perspective can help inform decisions about the most efficient allocation of response assets across countries. For example, the creation of UNMEER as a regional mission allowed for the cross-border allocation of funding and response assets to take place.

114. Regional cooperation can help to sustain improved cross-border surveillance, case monitoring and contact tracing by ensuring regular information exchange among public health officials on both sides of a border. The Panel heard that early on in the Ebola outbreak, cross-

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border information sharing was inadequate. Regional cooperation can also lower the cost of surveillance measures at borders or reduce the need for such measures through the establishment of regional border surveillance protocols and standards.

115. Regional or sub-regional groups of countries may also share key preparedness or response assets, such as laboratories, medical R&D efforts, or medical evacuation facilities for crisis responders. Whereas the significant cost of these assets may render them difficult to sustain in one country, their establishment on a cost-sharing basis at the regional or sub- regional level may make them feasible for all participating countries.

116. Furthermore, regional organizations can play an important role in the provision of response expertise and tools that are adapted to local conditions.

117. These advantages are also leveraged by regional organisations in other contexts. In Asia, the Association of Southeast Asian Nations (ASEAN) has played an important role in regional responses to HIV/AIDS, SARS and H5N1 influenza, including by jointly negotiating with pharmaceutical companies to reduce the price of HIV drugs. Efforts in Europe have focused on the value of shared assets, with the European Union (EU) establishing the European Centre for Disease Prevention and Control (ECDC) to analyse surveillance data, advise, provide training, support preparedness and deploy expert field missions in case of an outbreak. Following the Ebola outbreak, the EU and its Member States are also creating joint response capacities by assembling a pool of medical and logistical experts with crisis experience. In Latin America, both the Union of South American Nations (UNASUR) and the Members of the Common Market of the South (MERCOSUR) have demonstrated the value of technical and operational assistance that regional organizations can provide to their members in addressing public health threats.

118. Against this backdrop, the Panel is of the view that regional organizations should develop or strengthen standing capacities to assist in the prevention of and response to health crises, with particular emphasis on areas where they can offer significant value-added to national responses.

Recommendation 5: Regional and sub-regional organizations develop or strengthen standing capacities to monitor, prevent and respond to health crises, supported by the WHO. This includes:

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Chapter IV