More than 10,000 people have been killed and some 25,000 infected since the Ebola epidemic was first identified in west Africa in March 2014, mostly in Guinea, Liberia and Sierra Leone.
But Doctors Without Borders -- known by its French initials MSF -- said "months were wasted and lives were lost" because the UN's World Health Organization, which is charged with leading on global health emergencies and "possesses the know-how to bring Ebola under control", failed to respond quickly or adequately.
Its report accused the WHO's Global Alert and Outbreak Response Network of ignoring desperate pleas for help from Liberia when it met in June.
"I remember emphasising that we had the chance to halt the epidemic in Liberia if help was sent now," said Marie-Christine Ferir, MSF emergency coordinator.
"It was early in the outbreak and there was still time. The call for help was heard but no action was taken."
The WHO did not set up a regional hub for coordinating the response until July, by which time a second wave of the epidemic had struck.
"All the elements that led to the outbreak's resurgence in June were also present in March, but the analysis, recognition and willingness to assume responsibility to respond robustly were not," the report said.
Particularly in the early months, it therefore fell to MSF to carry much of the response, but the organisation had only 40 staff with experience of Ebola when the outbreak began.
"We couldn't be everywhere at once, nor should it be our role to single-handedly respond," said Brice de le Vingne, MSF director of operations.
It was only when a US doctor and Spanish nurse were diagnosed with Ebola that the world woke up to the threat, MSF said.
The WHO did not immediately respond to a request for comment.
The aid agency also blamed the governments of Guinea and Sierra Leone for refusing to admit the scale of the epidemic, saying they put "needless obstacles" in the path of MSF teams.
One minute per patient
The crisis sparked the biggest training programme in MSF history, with 1,300 international staff and 4,000 locals deployed.
It was initially focused on Guinea and Sierra Leone but when aid agency Samaritan's Purse pulled out of Liberia after the US doctor's infection, MSF faced a wrenching decision: abandon the country or push its hugely over-stretched staff still further and risk major mistakes.
"We couldn't let (Liberia) sink further into hell," said de le Vingne. "We would have to push beyond our threshold of risk, and we would have to send coordinators without experience in Ebola, with only two days of intensive training."
MSF built a 250-bed centre in Liberia's capital Monrovia, but even that was far from enough. The centre able to open only 30 minutes each morning, filling beds vacated by deaths overnight.
The report describes people dying on the gravel outside the gates, and a father who brought his daughter in the boot of his car, begging MSF to take her in so as to not infect his other children at home, but who was turned away.
"It was an indescribable horror," said Rosa Crestani, Ebola task force coordinator.
There were so many patients and so few employees that the staff had on average only one minute per patient.
The report also points the criticism inward, saying it too should have mobilised faster.
"This Ebola outbreak has wrought an exceptionally heavy toll on MSF's staff, and particularly on our west African colleagues," it said.
"Not since the early days of HIV care have MSF staff sustained the loss of so many patients dying in our facilities and never in such an intense short period of time," the report concluded.
(AFP)
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