Stop the Ebola crisis in the Congo before it turns into global disaster

With the Ebola outbreak in the northeastern region of the Democratic Republic of Congo now a year old and nearly 2,000 dead as a result, with the bustling border city of Goma now witnessing its first victims, and with the World Health Organization finally declaring the current situation an international public health emergency, it is time for the world to get much more serious in responding to the second worst Ebola crisis of all time.

Some international organizations have bravely addressed this health crisis for months, while others have lagged, and there is a good deal more that the United States can do. The response should include not only public health care assistance but support for the United Nations peacekeeping mission in that part of the Congo. This could include sending a group of advisers and trainers for the armed forces of the Congo, so that the area can be better stabilized and proper health care treatment can take place.

The alternative to getting this problem under control promptly could be devastating. It is worth running some plausible worst case analysis to challenge the somewhat casual and relaxed attitude that the world has effectively adopted to this slow motion crisis. Right now, it is affecting a general area of the northeastern Congo, where a few million people live. But within roughly 200 miles of the current extent of the outbreak zone, which is itself about 200 miles in dimension, live several tens of millions of people in the remainder of the Congo, as well as Uganda and Rwanda.

So what if the contagion grew to extend into other parts of the Congo and these two other countries? At some point now, it could become necessary to quarantine the affected region and to protect health workers operating throughout it, lest the problem metastasize further and turn into a global crisis. Once we got to that point, an international military response that includes United States units might become the only viable recourse.

For those who doubt this claim, it is worth recalling how unpredictable epidemics can be. In September 2014, during the West Africa outbreak, the World Health Organization estimated that Ebola could infect up to 20,000 people, with about half of all victims dying. The same month, however, the Centers for Disease Control offered a separate estimate of 1.4 million potentially infected. An epidemic on that scale would have put at risk the whole broader region, along with Europe and other continents.

Thankfully, the Centers for Disease Control estimate proved wrong, and the international response improved enough in ensuing weeks that the World Health Organization numbers wound up much closer to the actual toll. The Centers for Disease Control methodologies, however, were not sloppy or indefensible. Its higher end number could have happened if a number of dynamics in the region had evolved somewhat differently.

This brings us back to the area of the northeastern Congo. If a region of, say, 10 million people became so dangerous that it was necessary to isolate it physically, as much as possible, and then to work intensively to control the epidemic within it, force requirements would be daunting. Moreover, those force requirements could only be realistically achieved if Western militaries, including that of the United States, offered up some of their considerable capacities to help address this spreading problem.

In theory, using official counterinsurgency doctrine developed by former United States commanders, namely Army General David Petraeus and Marine Corps Generals James Mattis and James Amos, just before the 2006 surge in Iraq, it would take some 250,000 troops to stabilize and control such a region. Of course, establishing a quarantine and then protecting health workers working within it is certainly not the same as counterinsurgency warfare. But it is a related military mission given its focus on population security. Indeed, in some ways, it could be harder.

The total strength of armed forces of the Congo, Rwanda, Uganda, and United Nations forces in the Congo is about 225,000 soldiers. But most troops would not be available for the hypothetical military mission, given their responsibilities for other parts of their own countries, which have a combined population of well above 100 million. Perhaps 50,000 troops, or more than 20 percent of that 225,000 total, could be devoted to the affected area. The indigenous and United Nations contribution would cover only about a fifth of the quarantine requirement, leaving behind a need for 200,000 troops from the broader international community.

Even if a more clever method could be found to deploy these forces tactically, reducing requirements accordingly, the central point remains that several tens of thousands of foreign troops would likely be needed. Given the European military limitations, which President Trump is mostly right about even if his methods of addressing the burden sharing issue leave much to be desired, there would be no way to address a mission of this scale without a couple divisions or more of American ground forces that are able to draw on the huge United States military transportation and logistics capacities that could get forces and supplies there fast.

To be sure, my scenario is contrived and notional. However, the basic geographic, demographic, epidemiological, and military elements that I have invoked all follow directly from real world conditions in and around northeastern Congo today. Even if the scenario is artificial, it is plausible. Thus, we need to address this crisis now before it evolves and escalates into something truly horrible, like a global contagion of the first order.

Michael O’Hanlon is a senior fellow at Brookings Institution and a former Peace Corps volunteer in the Democratic Republic of Congo. He is the author of “The Future of Land Warfare” from which this piece is adapted.