By reversing course on Ebola funding, Trump brings compromise

On the August 1, 2014, when the deadly Ebola virus outbreak was at its peak in West Africa, and the Center for Disease Control (CDC) was projecting that hundreds of thousands could be infected, then-businessman Donald Trump tweeted the following:

“The U.S. cannot allow EBOLA infected people back. People that go to far away places to help out are great-but must suffer the consequences!”

I was working in the sub-region at that time, fearful that Ebola, one of the most lethal-known pathogens, might destroy much of what a decade of peace and democratic governance had given back to Guinea, Liberia and Sierra Leone. I was actively advocating, along with a chorus of other stakeholders, for the U.S. to bring its military and civilian expertise in disease containment to Africa.  

Hence, Trump’s unsolicited advice was most unwelcome.

{mosads}He gave an elevated voice to a reaction propagating on social media, driven by fear and ignorance, that the best way to protect the U.S. was to shut its doors. When, conversely, the solution lied in deploying to the source of the outbreak, and assisting the African responders with treating the victims, tracing the contacts, and encircling and killing the outbreak.

And that’s exactly what the United States did, led by the Center for Disease Control, the National Institute of Health (NIH), the 101st Airborne and supported by bipartisan Congressional leadership which passed a $5.4 billion urgent supplemental appropriations.  

The CDC, responding to anxieties of a U.S. contagion, established an enhanced Ebola screening tracking program at five airports for all people entering the U.S. from Ebola-affected countries, allowing borders to stay open, and enabling the movement of people and supplies.

Within a year, the disease was contained.

Approximately 11,300 people died and 28,000 infected, a trauma that the three affected countries are still grappling with today, but far less than the hundreds of thousands predicted. While a number of U.S. healthcare workers became infected treating victims, there was not a single American casualty.

It came as no surprise to me, four years later with President Donald Trump in office, that neither he, nor his Office of Budget and Management (OMB), felt compelled to preserve an emergency outbreak response fund included in the 2015 supplemental appropriations.  On May 8, 2018, Trump rescinded $252 million dollars from the International Disaster Assistance account, as part of 38 rescissions of budget authority, totaling $15.4 billion.

But this Ebola sequel, fortunately, does not have the predictable no-Washington-political-compromise ending.  

On May 22 of this year, in light of new Ebola cases reported in Mbandaka, a city of nearly 1.2 million in the Democratic Republic of the Congo, some of the same legislators who passed the 2015 appropriation bill, sent a letter to President Trump, advocating for the restoration of the emergency fund.

The letter reads:

“When Congress appropriated these funds in 2015, it did so to address an existing health crisis and to respond to Ebola or other deadly infectious diseases in the future. The funds will help respond to this latest outbreak in the (Democratic Republic of Congo), and it will enable other countries vulnerable to future outbreaks to be better prepared to respond – thereby saving lives and limiting the immense costs to taxpayers of trying to contain infectious diseases.”

Concurrent with the Congressional outreach, a number of opinion pieces argued vociferously against the “Ebola amnesia” in the Trump administration. The Dallas Morning News editorial board, representing the single U.S. city which saw a death from Ebola (of a non-U.S. citizen), weighed in:

“Back in 2014 in the thick of the Ebola crisis, such an expenditure ($252 million) would have felt cheap. Now it looks like a smart investment against future risk. Preventing such a disease from reaching an American city requires investing now, before a crisis is again upon us.”

And on cue, the front-line healthcare workers who deployed in 2014 appealed to the world to learn from the lethargy of the outbreak in West Africa, and respond with urgency in the Congo.

Administration officials paid heed, with USAID releasing $8 million to combat the Ebola outbreak in the DRC, including $5 million released by the Secretary of State from the international health emergency reserve fund.

And on June 5th, the White House reversed course, and restored the $252 million leftover funding. The letter of notification to Congress was signed by President Trump. In confirming the rare political do-over, an OMB official told the HuffPost that return of the global health funds were part of, “several technical and policy updates based on continued Administration analysis and discussions with Members of Congress.”

“The decision is something to be celebrated,” said Congressman Ami Bera (D-Calif.), a physician by training, who had grilled Secretary of State Mike Pompeo on the Ebola rescission in a recent Congressional hearing.

There were many lessons learned from the initial mishandling of the deadly 2014 Ebola outbreak, among them, that the best offense in protecting U.S. and global health security is the rapid mobilization of resources to ground-zero. This requires early warning systems, standby assets and personnel, on-going technical assistance to source countries, and close international coordination.  

And there are some important take-aways four years later in the recovery of the 2018 Ebola contingency fund, including that institutions can self-correct, even if our politicians cannot.

K. Riva Levinson is the president and CEO of KRL International LLC, a DC-based consultancy that works for the world’s emerging markets and the award-winning author of Choosing the Hero: My Improbable Journey and the Rise of Africa’s First Woman President. (Kiwai Media, June 2016). Follow her on Twitter @rivalevinson.