The Trump administration has walked back its proposal to reclaim $252 million in unspent Ebola funds on Tuesday, which experts lauded as a welcome shift in the administration’s approach to global health leadership ― especially amid the new Ebola outbreak.
Amid the “steady drumbeat of new global epidemic threats,” the turnaround on Ebola funding is a “great development,” said Dr. Thomas Inglesby, director of the Johns Hopkins Center for Health Security. He told HuffPost that the U.S. government needs all the resources it can get to help stop such outbreaks before they take off.
The administration deserved kudos for listening to the outrage over the last few weeks, said Rep. Ami Bera (D-Calif.), the vice ranking member of the House Foreign Affairs Committee.
Last month, the administration had suggested a rescission of the unspent money, which was left over from the $5.4 billion in U.S. funds designated to fight the deadly 2014-2016 Ebola outbreak in West Africa that killed 11,300 people. While the remaining funds were technically allocated to preparing for the next major outbreak of the hemorrhagic fever, officials have actually been directing the money toward other public health emergencies, such as the 2016 outbreak of Zika virus.
When President Donald Trump moved to cut the money the same week the current Ebola outbreak was announced in the Democratic Republic of the Congo, the public outcry from global health experts and Congress was swift. They argued that Trump was undermining the U.S. leadership role in world health issues.
Their concerns were compounded by the early May departure of Rear Adm. Tim Ziemer, formerly the National Security Council’s head of global health security; the breakup of his team into other divisions; and the April departure of White House homeland security adviser Tom Bossert, another champion of global health investment.
As Ronald Klain, the former Ebola czar under President Barack Obama, told HuffPost at the time: “Proposing a rescission of Ebola contingency funds on the very day that a new Ebola outbreak is announced is badly misguided; forcing out the two top officials in charge of epidemic response at the White House ― Tom Bossert and Tim Ziemer ― is even worse. Doing it all at the same time shows a reckless disregard for the dangers we face.”
Also disquieting was the fact that the U.S. waited a full two weeks after the first announcement of U.K. funds for the latest Ebola outbreak to announce its own full contribution of $8 million from the U.S. Agency for International Development.
But the contribution of $8 million and the withdrawal of the rescission proposal are quelling some fears that the U.S. is ceding health security leadership on the global stage.
It’s a recognition by the administration that we do have a crisis.
Rep. Ami Bera
Despite the Trump administration’s isolationist tendencies, retracting the planned rescission of funds and unlocking $8 million would suggest it realizes that fighting disease abroad is paramount to protecting those back home, according to Dr. Ashish Jha, director of the Harvard Global Health Institute.
Bera had been pushing the administration to reconsider what he sees as its previous missteps on global health. He had questioned Secretary of State Mike Pompeo about the Ebola funding at a Foreign Affairs Committee hearing, and Pompeo said he would personally review the rescission. Along with Rep. Gerry Connolly (D-Va.), Bera had also sent a letter to national security adviser John Bolton about Ziemer’s departure. Sens. Elizabeth Warren (D-Mass.) and Patty Murray (D-Wash.) wrote to Bolton as well.
This rescission reversal is something to be celebrated, Bera said.
“It’s a recognition by the administration that we do have a crisis and the original intent of the funds that were set aside was for that pandemic preparedness,” the congressman said. He added that the administration’s move “also sends a message to the rest of the world that the U.S. is interested in global health, is interested in pandemic preparedness and does not change that intent.”
The revisions to the rescissions proposal take out $515 million from the originally proposed $15.2 billion. An Office of Management and Budget official told HuffPost in an email that the global health funding changes were part of “several technical and policy updates based on continued Administration analysis and discussions with Members of Congress.”
Yes, we’ve done some things, but we haven’t done enough.
Dr. Daniel Lucey, a Georgetown University infectious disease specialist
It’s a precarious time for global health. In addition to the Ebola outbreak ― which has killed 25 people since April 4 ― the World Health Organization has identified cases of two other “Blueprint priority diseases,” meaning pathogens with the potential to grow into deadly pandemics for which doctors have few or no countermeasures.
Over the past few weeks, the brain-damaging Nipah virus, which quickly plunges its victims into a coma, has killed 17 out of 18 people infected in Kerala, India. More than 2,379 people have been quarantined in their homes in that southern state.
The constellation of three deadly pathogens reported at the same time is a reminder that “the factors that lead to the emergence of infectious diseases are increasing, not decreasing,” said Anne Schuchat, principal deputy director at the U.S. Centers for Disease Control and Prevention.
Experts warn that dangerous infections can spread easily and quickly, and they do not respect country boundaries. According to the CDC, an outbreak could travel from the most remote of villages to all major cities on all continents in 36 hours.
“You have the environmental access of our dense populations living in close proximity to animals, population changes in travel and trade, different kinds of habits around wildlife and agriculture, and just the migration that we see around the world ― these factors can lead to the emergence of so-called exotic infectious disease,” Schuchat told HuffPost last week.
She pointed to additional diseases that also need global attention ― diphtheria spreading in refugee camps in Bangladesh and outbreaks of cholera around the world.
Viruses do not infect only supporters of one party or the other.
Ronald Klain, former Ebola czar under President Barack Obama
Dr. Daniel Lucey is a Georgetown University infectious disease specialist who has worked on numerous outbreaks, including the 2014 Ebola epidemic. What keeps him up at night, he said, is the lack of preparedness and countermeasures amid the rising threat of pandemics.
“We know what needs to be done [when it comes to pandemic preparedness], but we haven’t done it,” Lucey said. “Yes, we’ve done some things, but we haven’t done enough,” he said.
For Klain, the next step in pandemic prevention should be to move the remaining money into a standing public health emergency fund that the president could use while waiting for Congress to act. He pointed to the slow release of Zika funds in 2016 and said there’s support for such a fund on both sides of the aisle.
“This should not be a partisan issue ― viruses do not infect only supporters of one party or the other,” Klain said.
Jha, the Harvard expert, and Bera, the congressman, agreed that the creation of a public health emergency fund would allow the U.S. to act quickly and decisively.
“This is the kind of thing that would save us money in the long run,” Jha said.
For the moment, there are promising signs in the Ebola outbreak, experts say, with the number of cases holding somewhat steady over the past two weeks. But Schuchat cautioned against celebrating too soon, pointing to the 2003 SARS outbreak resurgence in Canada after health authorities had sounded the all-clear.
“We really try to make sure that we have extinguished every ember in these very contagious infections,” she said, “because an ember that’s still out there can be the spark that starts the new big wave.”