The first case of Ebola struck Lagos, Nigeria in July of 2014. A serious outbreak of this highly lethal infectious hemorrhagic fever in a megalopolis connected to points around the globe would have been catastrophic. American diplomats in Nigeria had a mission: convince local authorities of the gravity of the situation and give them the tools to shut the disease down.
Shortly after the first case of Ebola appeared, coauthor Jeff Hawkins, the American Consul General, drawing on close ties built up over years, called on the Lagos governor on a Sunday afternoon with an urgent message, “Governor, fighting this disease, now, has to be your number-one priority.”
The governor picked up his phone and ordered his finance minister to put millions of dollars at the disposal of his health officials. Lagos State, working with the Nigerian Federal Government, the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC) and international NGOs sprang into action educating the public, organizing contact tracing and setting up treatment and isolation wards. By the end of September, after only eight deaths, Nigeria declared that it had no further cases and the epidemic there was over. With considerable assistance from the international community, Nigerians stopped the raging spread of Ebola nearly before it started.
As this real-life example shows, American diplomacy is a vital component of effective response to infectious disease.
American embassies are like forward-deployed diplomatic aircraft carriers. Instead of dispatching fighter jets, embassies coordinate the action of public health officials from the CDC, development specialists from the U.S. Agency for International Development (USAID), representatives of the Office of the Global AIDS Coordinator and economic, political, public affairs and consular officers who build contacts, serve as eyes and ears and get our message out. Diplomats negotiate bilateral and multilateral arrangements, like the Global Health Security Agenda, represent America in the UN and other bodies devoted to securing public health and assist individual Americans overseas stricken by disease or stranded because of epidemics. U.S. embassies address the “pan” and pandemics.
These activities are essential not just in time of crisis, as the COVID-19 outbreak has made clear. The day-to-day exchange between U.S. officials abroad and their local interlocutors create invaluable partnerships and build the “muscle memory” desperately needed when a disease like COVID-19 appears. In the Nigerian example, the CDC was particularly effective during the Ebola outbreak because it already had a long history working in the country on polio and other diseases.
The Ebola outbreak across West Africa demonstrated just how powerful and effective American health diplomacy and assistance can be. Over 1,000 CDC staff eventually deployed to Africa, including surveillance, contact tracing, data management, laboratory testing and health education officials. American diplomats pressed allies to share the financial and operational burdens. The U.S. military provided logistics and set up isolation wards. Although several thousand Africans died of Ebola, global catastrophe was averted, thanks in large part to U.S. leadership.
The Trump administration has abandoned this emphasis on health diplomacy, and it showed in the disastrous U.S. response to the COVID-19 pandemic. Trump eschewed American leadership of the worldwide COVID-19 response, withdrew from the primary international body devoted to epidemic response — the WHO — and abdicated leadership on equity in vaccine access to others. Malignant neglect and politicization have undermined critical U.S. health agencies.
It is time for a course correction.
First, the U.S. must recognize that global engagement on health is not a partisan issue but a matter of security for all Americans. As we learned through the President’s Emergency Program for AIDS Relief (PEPFAR), we are most effective when American health leadership enjoys full bipartisan support in Congress.
Second, the Biden administration must restore and enhance engagement with key global institutions and commit to significant and consistent investments in health programs and capabilities around the world.
Third, the U.S. should up its investment in American global health diplomacy by deploying more science and health diplomats to our embassies and elevating our U.S. special representative for global health diplomacy to a deputy undersecretary position with clout and resources to lead.
Finally, we must commit to a whole of government effort coordinated by an effective global health mechanism in the National Security Council (NSC) to ensure that American diplomats, scientists and aid experts pull together to keep America safe from deadly contagions in the future.
If we take these and other steps, our diplomats will have the influence and expertise necessary they need to blunt the next global health crisis.
Jeff Hawkins is a retired U.S. diplomat and researcher at the French Institute for International and Strategic Affairs and teaches Sciences Po. Mark C. Storella is a retired U.S. diplomat and professor of the Practice of Diplomacy at the Frederick S. Pardee School of Global Studies at Boston University.