When Jean-Bosco Ndihokubwayo reported back to headquarters in April 2014, the World Health Organization Ebola expert did the electronic equivalent of shouting. “WE NEED SUPPORT,” he wrote in the subject line of an email to Geneva describing a ballooning epidemic at a major public hospital in the Guinean capital of Conakry. The Ebola cases there were “the tip of an iceberg,” as the health care workers themselves threatened to become vectors spreading the disease, he warned in the email, later obtained by the Associated Press.
Ndihokubwayo’s message was the latest of many warnings that the epidemic was spreading. Ebola was new to the region, had reached urban centers, and was overwhelming already weak health systems.
It would be another four months before WHO declared Ebola an emergency, at which point the crisis was out of control. Despite increasing evidence of the disease’s rapid cross-border spread, the organization waffled, as the AP emails and other subsequent reports have shown.