The UN Ebola chief has said it will take several more months before the outbreak in West Africa is under control, an assessment that makes clear the UN's goal of isolating 100% of Ebola cases by January 1 will not be met.
Dr David Nabarro said there has been "a massive shift" over the last four months in the way affected governments have taken the lead in responding to the epidemic, communities are taking action and the international community has pitched in.
But he said greater efforts are needed to combat Ebola in western Sierra Leone and northern Mali, to reduce the number of new cases in Liberia and to limit transmission to Mali.
The World Health Organisation (WHO) conceded that it did not meet an interim December 1 target of isolating 70% of Ebola patients and safely burying 70% of victims in hardest-hit Sierra Leone.
But it has not made clear what that means for the January 1 goal of 100% of cases isolated and bodies buried safely.
The WHO has acknowledged that its patchy data could compromise the goal, since the agency does not know how many Ebola patients there actually are and is unable to track all of their contacts.
UN secretary general Ban Ki-moon said last month the outbreak might not be contained until sometime next year.
"We must be prepared for ups and downs, difficulties and successes," Nabarro told a meeting promoting greater collaboration between the U.N. and the business community in responding to Ebola. "And it's going to take, I'm afraid, several more months before we can truly declare that the outbreak is coming under control."
More than 18,100 people have been infected and more than 6,500 have died in West Africa since the initial case in Guinea a year ago, in an area bordering Sierra Leone and Liberia. Unlike previous Ebola outbreaks, which had been confined to faraway villages in the rain forests of Central Africa, this one quickly spread to capital cities in all three West African nations and has become the worst in history.
Dr Nabarro told a news conference that "the outbreak is actually a collection of a large number of small outbreaks all over the affected countries, possibly as many as a hundred different outbreaks, all at varying stages of evolution, all with different intensity".
The number of Ebola cases is now stabilising in Liberia and Guinea but continues to spread rapidly in Sierra Leone, where Dr Nabarro said the country's president is leading "an intensified surge operation" in the capital Freetown and hard-hit western areas.
"It will come under control - it's, I think, a matter of weeks," Dr Nabarro said.
In Sierra Leone yesterday, President Ernest Bai Koroma implored the country's traditional leaders to stop cultural practices blamed for spreading Ebola, including funerals that involve touching corpses that are highly contagious.
Mr Koroma said he hoped to end all Ebola transmissions in the next 21 days, but that goal seems unrealistic in a country where 400 to 500 cases a week have recently been reported.
Dr Nabarro, the UN special envoy for Ebola, said the UN and experts responding to the outbreak are also disturbed by the 10-20 new cases daily in Liberia and want the number reduced to zero.
Mr Ban announced yesterday that the Ebola operations chief in West Africa, Anthony Banbury, will be replaced by veteran UN official Ismail Ould Cheikh Ahmed of Mauritania when he returns to UN headquarters in January.
Mr Ahmed, who is currently the UN deputy special representative in Libya, will work closely with Dr Nabarro and governments in the region when he takes over as head of the UN Mission for Emergency Response in West Africa.
The Mali Health Ministry later said that the last Ebola patient being treated in the country has survived the disease and been released.
The ministry said in a statement posted on its website that the patient was discharged yesterday after several Ebola tests came back negative.
Mali has recorded eight cases of Ebola, all of them linked to people who crossed from neighbouring Guinea. The ministry said the country now has no confirmed or suspected cases, but authorities are still monitoring 26 people who had contact with the sick.