Ebola, amnesia and Donald Trump
On Monday, a team led by the World Health Organization began inoculating people in the Democratic Republic of Congo against the Ebola virus with an experimental vaccine in an attempt to quell an outbreak of the disease that began in early May.
If the effort succeeds, and maybe even if it doesn’t, it will go down in history as the first time Ebola was met with more than just the crude tools of quarantine and hospice care.
That medical aid workers could begin such a campaign so quickly — within just two weeks of the earliest reported cases of the disease — is a testament to how well the lessons of the 2014 Ebola outbreak have been learned. That crisis raged across West Africa for more than a year, growing into a full-blown epidemic, claiming 11,300 lives — and yes, reaching American shores — before it was finally halted at a cost that exceeded $5.6 billion for the United States alone. Experts blamed the slow, uncoordinated response for the high death toll and steep price tag.
This time, things appear to be different: Doctors and scientists were deployed to the threatened region within days of the earliest reports of the disease, and by all accounts, global, national and nonprofit organizations have coordinated their efforts well.
To be sure, this latest resurgence of Ebola is still cause for concern. Forty-six cases have been reported so far, with 26 deaths, and the disease has already spread from the country’s remote northern reaches to a populous port city. But so far, the World Health Organization has not declared the crisis a “public health emergency of international concern,” the agency’s most serious designation. If efforts succeed, health officials say, the scourge could be eradicated by summer’s end.
“A lot of what’s working now is the result of remembering and learning from previous failures,” said Jeremy Konyndyk, a senior policy fellow at the Center for Global Development and the director of foreign disaster assistance at the U.S. Agency for International Development during the Obama administration.
The Trump White House, however, appears to be uniquely amnesiac. On the same day that officials in the Democratic Republic of Congo reported the new Ebola cases, the administration sought to rescind $252 million in Ebola response funds left over from the earlier epidemic.
Before Congress acts on that request, members should recall how those funds came to be. Public health officials confirmed the 2014 outbreak at the end of a fiscal year, when most agency budgets — at the Centers for Disease Control and Prevention, USAID and elsewhere — were tapped out. The search for additional funding delayed the American response, which in turn led to more lives lost and, ultimately, more money spent. To prevent the same thing from happening next time, the White House Office of Management and Budget agreed to leave these funds in USAID’S budget so they would be on hand to combat the next emergency. Rescinding that money brings us back to where we started — ill prepared to mount a rapid response to a new infectious disease threat.
Around the same time that the administration proposed rescinding the funds, the National Security Council dissolved its biosecurity directorate, a small team focused exclusively on global health security threats and led by a director often referred to as the Ebola czar. Again, it’s worth remembering why that office came into existence — a hard lesson. Without a central office to coordinate federal efforts by many agencies, progress was slow the last time the world confronted Ebola. “It took months of wrangling to put things in place,” Konyndyk said. “If the only way to get resources is through long negotiations with committees, you are giving disease a head start.” It was based on that realization that the Obama administration established the biosecurity directorate and named the first Ebola coordinator.
The Trump administration has also failed to seek renewed funding from Congress for a global health security initiative begun after the 2014 epidemic. The goal of that initiative was to help high-risk countries prepare for future disease outbreaks in order to prevent pandemics. The White House has touted the success of those efforts but has done nothing to keep them going. And as funds have dried up, the CDC has been forced to scale back or discontinue programs in some of the most vulnerable countries.
Those changes may please Trump supporters who want fewer entanglements abroad. They are certainly in line with views expressed by President Donald Trump himself, who tweeted during the last Ebola crisis that infected Americans should not be allowed to return to the United States.
But whether and how these policy shifts will affect the current Ebola response remains to be seen. Though the outbreak seems to have been quickly contained, it involves a disease that we have fresh and terrifying experience with, in a country that has seen this particular foe nine times in living memory. The next outbreak may not offer such a head start. And when it comes, Trump’s shortsightedness, if it is not corrected, will have left us far less prepared.