02.05.15

Statement of Senator Patrick Leahy (D-Vt.) On Lessons from the Ebola Epidemic

Mr. LEAHY.  Mr. President, not long ago Liberia, Sierra Leone, and Guinea, the World Health Organization (WHO) and the United Nations, and the United States, Great Britain, France, and other countries, were frantically trying to bring the Ebola crisis in West Africa under control.

Thousands of people died due to a disastrous failure by WHO’s Africa regional representative, serious miscalculations by local officials and global health experts, and a myriad of other problems ranging from weak local health systems that were quickly overwhelmed to a lack of accurate information and cultural practices that helped spread the disease rather than contain it.

But in the past few weeks there has been some good news about progress in stopping Ebola.   According to WHO, Liberia, Sierra Leone, and Guinea recorded their lowest weekly numbers of new cases in months.  The United Nations special envoy on Ebola stated that the epidemic appears to be slowing down, and the Government of Liberia has set a target of zero new Ebola cases by the end of February.

It is heartening to see that the hard work by Liberia, Sierra Leone, Guinea, and the international community are bringing results.  But we are not out of the woods yet and there are important lessons to be learned from the mistakes and lost opportunities in the early response to this disease outbreak.

Ebola pushed governments, international organizations, and the private sector and health care responders into unknown territory, forcing everyone to think and act in new ways.  Unfortunately, with the exception of the nongovernmental organization Doctors Without Borders, we were all too slow to recognize this.  The initial response missed key opportunities to prevent the crisis from becoming an epidemic, and as a result thousands of people died who might have avoided infection.  The symptoms of the initial victims were not recognized as Ebola, signs that the epidemic was spreading rather than receding as some believed, were misinterpreted, and governments and international organizations did not effectively communicate or coordinate with local communities impacted by the virus.  Nor were the necessary resources to combat the disease available in-country early enough.

As work was done to overcome these missteps and challenges, the epidemic spread further across borders as did rumors, and fear increased, people in the affected areas became increasingly distrustful of those who were trying to help, and already scarce health care workers became harder to recruit. 

The consequences of not containing the disease in the early stages have been catastrophic.  As of January 28, WHO estimates that 8,795 people have died from the Ebola virus, and according to UNICEF’s preliminary estimates as of December 29 at least 3,700 children in Guinea, Liberia, and Sierra Leone have lost one or both parents to the disease.  The children of those countries have not attended school since mid-2014.  While Guinea re-opened their schools in mid-January, attendance has remained low.  Liberia is preparing to reopen schools in mid-February, and Sierra Leone hopes to reopen its schools by the end of March.

Unemployment and business closures have increased, cross border trade has plummeted, and there are concerns that food shortages and malnutrition will increase because food stock that would normally be kept for next year is already being eaten. 

According to the World Bank’s December estimates, the growth in GDP in 2014 for Liberia and Sierra Leone fell by over 60 percent in each country and Guinea’s GDP growth in 2014 is down by 89%. 

Much of our investments in the rebuilding of Liberia and Sierra Leone since the civil wars there have been obliterated by Ebola.  These countries are back at square one. 

The world’s initial response to the Ebola crisis illustrates how unprepared we are for future global health crises which may be far more devastating and fast spreading than Ebola, if that is possible to imagine. 

                                       

How can we avoid repeating our mistakes?  Are we going to provide our own government agencies like the Centers for Disease Control and Prevention and the U.S. Agency for International Development, and international organizations like WHO the resources they need?  Can we count on them to take the steps to ensure that the right people are in the right places with the authority to make the necessary decisions in a timely manner?

Too often it seems that we have to relearn the same lessons each time for different situations and countries.  There are already reports, including a January 19th article in the Washington Post that describes newly-built Ebola response centers, paid for by the United States government, that stand empty or have closed because the number of new Ebola cases has dropped sharply.  It is far better to be prepared than unprepared, but we need to reassess the situation and be sure that we are adjusting our response appropriately.

The fiscal year 2015 consolidated appropriations act includes $2.5 billion for the Department of State and USAID response to the Ebola crisis.  As ranking member of the appropriations subcommittee that funds those agencies I hope they will ensure that we use these funds to avoid past mistakes, by improving flexibility to respond to the crisis as it changes; relying less on international nongovernmental organizations and foreign contractors and increasing support for building local public health capacity and a sustainable and resilient private sector; increasing awareness and sensitivity to cultural norms of those impacted by the crisis; and improving communication and coordination among local communities, local and national governments, and the international community.  These are not new ideas but they emerge time and again.

Finally, we need to be far better prepared for protecting American citizens from contagious diseases that can spread like wildfire from a single health care worker, or other infected individual, who returns from an affected country.  Fortunately, only one death from Ebola occurred in the U.S., but it could have been far worse. 

Now is the time to reassess how we should respond, domestically and internationally, to regional epidemics, and prepare accordingly.  We cannot afford to waste time and resources making the same mistakes and relearning old lessons. 

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