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Since last August, an Ebola outbreak in the eastern Democratic Republic of the Congo has left over 1,400 people dead. Militia attacks, misinformation, and human displacement have frustrated attempts to contain the epidemic. Two weeks ago, the first Ebola victim died in Uganda. The United States should lead the effort to contain the outbreak before it spirals out of control.
Ebola’s spread is accelerating. From August to March, there were 1,000 cases. There were 1,000 more by June. The weekly rate of new infections has quadrupled in three months, from 25 to 100. Militia attacks regularly displace the local population and spread the disease. Local people attack health workers who they believe brought the disease. According to the WHO, dozens of such attacks have left over 85 dead and injured.
Beyond humanitarian concerns, policy makers should consider the costs of the last major Ebola outbreak, in Western Africa from 2014 to 2016. That epidemic spread from Guinea to Sierra Leone and Liberia, killing over 11,000 people and costing local economies billions of dollars. The United States contributed over $110 million and 3,000 troops. A 2018 study in the Journal of Infectious Diseases estimated the total economic, social, and human cost of the epidemic at $53 billion.
But this epidemic could be far worse. Over ten million people live in the affected Congolese provinces, while the population of Uganda is nearly twice that of Guinea, Liberia, and Sierra Leone combined. This month alone, ethnic violence has displaced over 300,000 in an infected province bordering Uganda and South Sudan. The Ugandan government has already reported two deaths and several suspected cases. Once the WHO considers the disease to have spread outside of the Congo, trade and travel restrictions could come into place. Economic costs would pile up rapidly.
The first pillar of the National Security Strategy calls for the United States to address Ebola outbreaks at their source. USAID has led such efforts by generating awareness and providing medical support. Since September, a US Government Disaster Assistance Response Team has provided further assistance and expertise. This month, the CDC activated its Emergency Operations Center to combat the outbreak. Yet USAID chief Mark Green is calling for a “reset” in containment attempts. Ron Klain, the “Ebola czar” during the 2014 epidemic, has said that health workers have “no capacity” to confront regional instability and violence.
Fighting the outbreak needs more than money, but the US can start there. Klain, a harsh critic of the WHO during the 2014 Ebola outbreak, now describes it as a “fast,” “transparent,” and “candid” organization. Yet it has under a third of the necessary resources for containment through July. Providing the remaining two thirds would cost just $54 million, a paltry sum for Western governments.
More challenging than securing funding is providing security for health workers. Militias regularly attack peacekeeping missions. Sending American troops would be dangerous and messy. Ron Klain has called for an EU-led security contingent, but it isn’t clear how or when this would happen. In the short term, policy should cultivate trust among local communities to address threats from misinformation.
The United States need not fight Ebola alone, but it should not expect other countries to lead the effort. During the last Ebola crisis, WHO response funding from the US dwarfed that of any other country, but it was just 25% of the total. Multilateral organizations and American allies donated most of the rest. The United States should enlist these same allies to fight this outbreak while leveraging international organizations to make significant contributions.
Bearing in mind humanitarian obligations and economic costs, the United States should lead the effort against Ebola. It must do so immediately to prevent this outbreak from becoming a catastrophe.
The United States must act quickly to prevent the Democratic Republic of the Congo’s Ebola outbreak from becoming an international crisis.
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