Sustained Response to Ebola Still Needed

Dr Kilmarx
Dr Kilmarx

The world is facing the largest outbreak of Ebola it has ever known. Already, more than 14,000 cases of Ebola have been diagnosed in West Africa – and with sustained transmission in multiple countries and urban areas that number is only going to multiply.

As part of the U.S. government’s comprehensive strategy to combat the spread of Ebola, I spent four weeks in Sierra Leone as the Ebola Response Team Leader for the U.S. Centers for Disease Control and Prevention (CDC).

The CDC, along with other U.S. government agencies, plays a critical role in providing direction, technical assistance and funding to countries affected by the Ebola outbreak. To date, more than 160 CDC staff members have been deployed to Sierra Leone to combat and contain Ebola. These staff members work alongside their regional counterparts to address issues such as epidemiology and surveillance, infection control and health communications among other critical activities.

In Sierra Leone, we are striving to interrupt the transmission of Ebola and to prevent its export into other countries like the United States and Zimbabwe. To achieve these objectives, we are working with the government of Sierra Leone to strengthen its emergency response management; to ensure safe, dignified medical burials for all victims; to isolate and treat suspected and verified cases; and to contact trace and quarantine any potential cases.

But our efforts extend beyond Sierra Leone – and it’s not just the CDC who is responding.

Since the first cases of Ebola were reported in West Africa in March 2014, the United States has mounted a whole-of-government strategy to halt the Ebola epidemic. That strategy includes controlling the spread of Ebola at its source in West Africa; managing the secondary consequences of the outbreak such as reduced economic growth; building coherent leadership and operations across governments and international organizations; and ensuring health security around the world.

This strategy also includes the deployment of more than 36 U.S. Agency for International Development (USAID) personnel, 163 U.S. Health and Human Services personnel and 3,200 U.S. Department of Defense personnel to West Africa – the largest-ever U.S. government response to a global health crisis.

U.S. military personnel, working with the Armed Forces of Liberia, are overseeing the construction of at least 10 Ebola Treatment Units (ETUs) while USAID-funded partners are constructing an addition five ETUs in Liberia. Each will have 100 beds, and the first ETU, built in northwest Monrovia, is already preparing to receive patients. U.S. Naval Medical Research Center personnel are operating three mobile labs to provide 24-hour turnaround results on samples. And U.S. Public Health Service personnel are staffing a new hospital the U.S. Department of Defense constructed to care for infected medical workers.

Meanwhile, CDC and USAID personnel are conducting contact tracing; training and mobilizing healthcare workers and safe burial teams; facilitating social mobilization and community outreach programs; and providing logistical support and supplies.

USAID, along with the U.S. Department of State, also provided up to $10 million to support the African Union’s deployment of trained and equipped medical workers to West Africa.

To ensure these efforts are sustained, the White House announced last week that it is requesting an additional $6.18 billion in emergency funding to continue our efforts to contain and eliminate Ebola.

But as U.S. Secretary of State John Kerry said, “No one country, no individual group of nations is going to resolve this problem by themselves. This is going to take a collective, global response.”

The United States is working with the World Health Organization and other international partners to help West African Governments respond to and contain the outbreak of the Ebola virus.

We’ve also galvanized support from other international partners, securing pledges of more than $800 million in financial backing in addition to significant contributions of personnel, aircraft and other resources.

In Zimbabwe, we’re working with the Ministry of Health and Child Care to support Zimbabwe Infection Prevention and Control Project (ZIPCOP). This partnership is helping to improve infection control in healthcare facilities across Zimbabwe and to prevent the transmission of infectious diseases among patients and staff.

Through CDC and the President’s Emergency Plan for AIDS Relief (PEPFAR), we have allocated $4.8 million yearly to support ZIPCOP. The program’s progress toward a healthcare system with robust transmission infection control policies is promising. Because of this program, patients with transmissible infections can be identified quickly and accurately; precautions to prevent transmission can be taken swiftly; and healthcare workers have the training and equipment needed to protect themselves.

Through PEPFAR, the U.S. government has also been supporting human capacity development here through programs like the University of Zimbabwe’s Masters of Public Health; health informatics systems with initiatives like the District Health Information System; and laboratory quality improvement. All these efforts put Zimbabwe in a relatively good position to respond to Ebola and other health threats. Despite the United States’ unprecedented response to the Ebola outbreak, critical gaps in our global response remain. We need more beds with high quality care and safe transport for patients – just to name a few.

The outbreak of Ebola has highlighted how connected we are as a global community – and how we must sustain our response to its outbreak with urgency and improved coordination if we are to stop its spread.