The Obama administration didn’t get everything right during the 2014 Ebola outbreak, especially at the beginning. Our response was way too slow at first and didn’t really start until an infected traveler arrived in Dallas, sparking public interest in the local threat and exposing gaps in domestic hospital readiness.
But once the Obama administration got their act together it was all-hands-on-deck. The response became a cross-government effort with the US Public Health Service commission corps, CDC, the now nonexistent USAID, the Department of Defense, NIH, and the State Department all playing important roles focusing on the things each organization does best.
By early 2015 more 3,500 U.S. personnel from DoD, CDC, USPHS, USAID and NIH had deployed to West Africa where the outbreak was focused.
USAID was central to that work. It helped with logistics, supplies, coordination, and support for local and international partners. The Department of Defense brought the ability to build infrastructure quickly, including treatment units and logistics systems.
The U.S. Public Health Service Commissioned Corps deployed officers to Liberia, including staffing the Monrovia Medical Unit, which treated health workers who became infected while responding to the outbreak.
The Trump administration’s response to the epidemic in the eastern part of the Democratic Republic of Congo is close to nonexistent so far. Near as I can tell the only thing they’re doing is starting to set up a treatment facility in Kenya for US citizens (presumably for any self-presenting health care workers with US passports). They’ve also made some travel restrictions.
Travel restrictions may have a role at the margins, but travel bans don’t get to the source. They don’t run field logistics. They don’t replace experienced outbreak staff. They don’t conduct laboratory diagnostic tests (a real sticking point right now in the DRC). They don’t make up for the loss of the USAID logistical work.
USAID wasn’t just a grant-making agency. In outbreaks and disasters, it was a logistics and coordination juggernaut. It knew how to move supplies, support field operations, and work with partners on the ground. That capacity is now completely gone.
Additionally, we’re no longer even members of the WHO. That alone says a lot about the current administration’s view of global health.
Obama was late to respond but ultimately provided the critical work that ended the 2014 epidemic. They used USAID, DoD, CDC, NIH, State, and the U.S. Public Health Service to help stop the outbreak at the source.
Trump’s approach is limited to border controls, travel restrictions and a potential quarantine facility for exposed people who have US passports in Kenya (a thousand Km away). A trivial intervention.
Note: There isn’t a vaccine for this version of the Ebola virus Bundibugyo, the rare virus causing a deadly new Ebola outbreak, has no vaccine yet.
Ebola is controlled by detailed field work. It is controlled by people in protective equipment doing contact tracing, lab testing, isolation, safe transport, safe burials, community outreach, and clinical care. It is controlled by logistics. It is controlled by trust.
The United States used to lead that kind of work. Not anymore.
Note: The EU is providing money, logistics, technical coordination, and preparedness. They’ve announced an additional €15 million in humanitarian aid for the Ebola response for emergency operations, prevention, and preparedness. It also organized an EU Humanitarian Air Bridge with UNICEF to move 100 metric tons of supplies to DRC, including medicines, PPE, infection-control materials, tents, and operational equipment.
