Washington Post: New Ebola outbreak tests weak US system

A new Ebola outbreak in the Democratic Republic of the Congo and Uganda has become a direct test of the United States’ ability to manage global health crises, the Washington Post said, at a time when Washington is facing a decline in the coordination system that guided its successful response in the 2014 Ebola crisis.

The newspaper said the current crisis exposes how much the American outbreak-response structure has changed after several institutions and teams that played central roles in earlier health emergencies were dismantled or reduced. It added that concerns are growing over weak government coordination in dealing with an outbreak seen as more complex than the 2014 wave.

The Trump administration is now relying heavily on scattered interagency meetings rather than a central command room or a broad government coordination structure like the one used during the earlier Ebola crisis, the paper reported. Citing six people familiar with internal discussions, it said there is still no formal integrated framework for managing the current crisis.

Ron Klain, who led President Barack Obama’s response during the 2014 crisis, said: "The response plan is still there, but the real question is: are the players still there?"

The paper said signs of confusion appeared early after the US State Department announced it was helping set up 50 treatment centers in outbreak areas inside Congo and Uganda, before Uganda’s health ministry said it had not been consulted on those plans. White House spokesman Kush Desai said the US administration moved quickly from the first hours of the crisis, deploying aid and medical equipment, tightening screening and monitoring measures, and imposing travel restrictions.

Desai added that the National Security Council, the Homeland Security Council and the Domestic Policy Council are coordinating efforts with the health, state, homeland security and defense departments. The newspaper also said the administration is seeking to appoint a senior official to lead the response, similar to the "Ebola czar" post created during the 2014 outbreak.

A source familiar with the matter was quoted as saying: "We are trying to find the right person." The State Department also said the Centers for Disease Control and Prevention, CDC, remains the main federal agency handling the file, while the department has set up a round-the-clock task force to coordinate aid, consular steps, health screening programs and traveler monitoring.

How the outbreak is spreading

The current outbreak has already become one of the largest Ebola waves in recent years, with the World Health Organization recording about 750 suspected cases and 177 deaths in Congo so far. Unlike the "Zaire" strain that drove the 2014 outbreak, the current "Bondebougio" strain does not yet have an approved vaccine or treatment, making containment more difficult.

The spread of the disease in remote areas with weak infrastructure, along with armed groups and a lack of trust in local authorities, adds to the challenges facing response teams. Ron Klain warned of a scenario in which the virus reaches refugee camps in South Sudan, saying that spread inside crowded camps with weak health services could lead to "spread like wildfire" with huge human losses.

Ebola is known to spread through contact with the body fluids of infected people, which makes crowded hospitals and care and burial operations among the most dangerous infection points during uncontrolled outbreaks. The Washington Post also said the outbreak is testing not only Africa’s ability to contain the disease, but also the readiness of the United States and the world to deal with new epidemic waves in a period marked by a decline in international health cooperation systems formed after the coronavirus pandemic.

US health system under strain

The report described what it called an institutional decline in the US health security system in recent years, saying the Trump administration abolished the Office of Global Health Security and Pandemic Response inside the National Security Council, and that USAID, which played a central role in previous health disaster management, was dismantled.

Beth Cameron said the current administration does not appear committed to the response plans drawn up by previous administrations, while Stephanie Psaki said the sweeping changes in institutions and staff have created confusion over who is actually responsible for managing the crisis. Despite the State Department’s defense of the current level of coordination, public health experts say the absence of USAID teams reduces the United States’ ability to handle the logistics and humanitarian operations tied to large-scale outbreaks.

The report said USAID contributed about $324 million during the 2018 Ebola outbreak in Congo, while current pledges so far amount only to "tens of millions of dollars." Infectious disease experts said the best way to protect the United States from the virus remains containing the outbreak inside Africa before it spreads internationally, a view reinforced after Ebola reached the United States in 2014 and infected several Americans, including two nurses in Dallas.

US Secretary of State Marco Rubio said the administration’s priority is to prevent Ebola from reaching American soil, adding: "We do not want anyone to be affected by the virus, but our top priority will remain making sure it does not reach the United States." In eastern Congo, Robert Batosa, programs director at World Relief in the Democratic Republic of the Congo, warned of the possibility of thousands of undetected cases, given limited medical resources and shortages of basic equipment such as gloves, disinfectants and body bags after aid cuts reduced support for local health clinics.