Ebola outbreak: Why the U.S. is taking the lead

U.S. President Barack Obama warned in a speech Tuesday in Atlanta, "We have to act fast" to deal with the Ebola virus ravaging West Africa. Earlier, the White House unveiled plans for the Obama government to take the lead in efforts to end the epidemic.

While Obama labelled Ebola a national security priority, dealing with an epidemic in Africa wouldn't normally be a campaign that the U.S. government would lead.

Obama called it "an epidemic of the likes we have not seen before." Nevertheless, it should be the governments in the countries affected taking the lead, notes Josh Michaud, associate director for global health policy at the Kaiser Family Foundation.

But Guinea, Sierra Leone and Liberia are extremely poor, post-conflict nations with other issues and problems, he adds. They were also caught off guard when the outbreak began, as this is the first outbreak in West Africa and Michaud says they had no plan in place and no materials ready to go.

"They haven't been able to mount the response necessary as the number of cases has grown."

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In Liberia, which has a population of just over four million, there was one doctor for every 100,000 people before the outbreak. By Sept. 15, Ebola had killed 85health-care workers in Liberia.

Early warning, late response

Doctors Without Borders, which has about 1,850 staff on the ground in West Africa, began to sound the alarm about Ebola getting out of control in April.

They called on the UN's World Health Organization to lead the global effort against Ebola. The WHO wouldn't declare the Ebola outbreak a "public health emergency of international concern" until early August.

Michaud notes, "WHO has been labouring under some difficulties of its own." Their two-year budget had been cut by almost $1 billion and key staff with expertise on emergency response had left as priorities shifted away from potential threats like Ebola.

WHO's epidemic and pandemic response department was dissolved and the outbreak and emergency response section at WHO's Geneva headquarters looked like a ghost town, a WHO consultant told the New York Times.

WHO cut almost all its emergency outbreak experts in Africa to just three before the current Ebola outbreak.

"All of us underestimated this unprecedented, unusual outbreak," WHO director general Margaret Chan told the Times.

U.S. has the capacity

In the U.S., the Centers for Disease Control and Prevention has a budget three times the size of the WHO budget. And while WHO has about 170 foreign medical staff working on the Ebola outbreak in West Africa, the CDC alone has over 100 personnel on the ground in West Africa, with many more from other government agencies and more to come as the U.S. ramps up its efforts.

Last week, Liberia's president, Ellen Johnson-Sirleaf, sent a personal plea to Obama, writing, "Without more direct help from your government, we will lose this battle against Ebola." She noted that only Doctors Without Borders had "responded robustly" in Liberia and they had reached their limits.

While the U.S. government will now take the lead in the Ebola battle, Obama asked the military to coordinate that effort.

"The U.S. military is really the only organization, perhaps in the entire world, that could provide the support and the resources at the pace necessary to fully respond to the growing outbreak of Ebola," Michaud says.

He also teaches at the Johns Hopkins University School of Advanced International Studies and is considered an authority on the role of the U.S. Department of Defense in global health.

After pointing out that the chances of an Ebola outbreak in the U.S. "are extremely low," Obama said the outbreak is not just a medical emergency faraway in Africa but a crisis with political, economic and security implications if the epidemic is not stopped soon.

While warning the epidemic will get worse before it gets better, he characterized it as "a potential threat to global security."

Turning the tide?

"There seems to be agreement on all sides that more needs to be done," Michaud told CBC News after following the debates at two congressional hearings Tuesday in Washington."

He says, "This is a moment when the tables could be turned on Ebola." And not solely because of the U.S. effort.

In the past week, Canada, China, Cuba, France and the U.K. were among the countries announcing additional commitments to West Africa, as did foundations and charitable organizations, including $50 million from the Bill & Melinda Gates Foundation, its largest donation to a single outbreak.

"If all of these resources are mustered and 3,000 troops are sent out there, and if ... all of the various constellations of organizations that are helping respond also are catalyzed to do more, then this could be the point where the global community really does take this head-on and turns the tide," Michaud says.

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