U.S. Response to Ebola in West Africa

Dr. Peter Kilmarx, Country Director for Zimbabwe-Centers for Disease Control and Prevention (CDC- Zimbabwe)
Dr. Peter Kilmarx, Country Director for Zimbabwe-Centers for Disease Control and Prevention (CDC- Zimbabwe)

Q & A with Dr. Peter Kilmarx

Since 2011, Dr. Peter Kilmarx has been the Country Director for Zimbabwe office of the United States Centers for Disease Control and Prevention (CDC- Zimbabwe). He recently returned from a six week tour of duty as Team Leader for the CDC Sierra Leone Ebola Response in Freetown. To date, as part of the United States government response to the Ebola outbreak in West Africa, more than 100 CDC staff members have deployed to Sierra Leone; over 50 are there currently, providing direction, technical assistance, and funding at a national level in Freetown and in seven of the most affected districts. The U.S. government is also providing substantial additional funding for the Ebola response in West Africa through USAID. The following is an excerpt of an interview with Dr Kilmarx.

Question: Would you say Zimbabwe is prepared should there be a case of Ebola?

Kilmarx: It is obviously a challenge; even the U.S. has challenges with Ebola cases. There is a gentleman who recently passed away in Dallas. I think in terms of having the basic health care infrastructure, Zimbabwe is in relatively good shape. The U.S. government, through the U.S. President’s Emergency Plan for AIDS Relief and in collaboration with  other international and local  development partners in  Zimbabwe, have done quite a bit in strengthening Zimbabwe’s health system in recent years. We have information systems, we have got systems for distribution of commodities, laboratory strengthening and then of course since the West African outbreaks began, there have been a number of steps taken in the screening of airports in Zimbabwe.  The Ministry of Health and Child Care is currently tracking hundreds of people who travelled from West Africa doing follow ups daily to make sure that they don’t have symptoms.

Question: Would you say the 21-day surveillance that is in place works?

Kilmarx: That is the most effective way for tracking people. I think it is important for people to understand that we are globally connected and we can’t just close ourselves off.  The problem is, if we don’t get Zimbabwe and others to go to West Africa and help control the situation, it will continue to fester and spread. Several Zimbabweans are providing critical technical assistance in West Africa. The Ministry of Health and Child Care in Zimbabwe continues to follow the recommendations of the World Health Organization (WHO) and others that if we have had no significant exposure to an Ebola case, we can come right back to work in Zimbabwe and be properly monitored for any symptoms. That’s a very important policy and very important contribution for Zimbabwe.

Question: How is CDC working with the Zimbabwean government?

Kilmarx: CDC has had an office in Harare since the year 2000 and for those years we have been focused largely on implementing PEPFAR. We work together with the United States Agency for International Development (USAID) and other agencies in the Embassy. Our annual budget is over $100 million per year for HIV and AIDS relief as well as funding for malaria, tuberculosis, reproductive health and other conditions. We work very closely in technical working groups with the Ministry of Health and Child Care and other partners.

Question: Can you tell us briefly, what is the situation like in Sierra Leone at the moment?

Kilmarx: As of October 27, there have been over 4,000 cases. Initially there were more cases in the eastern part of the country, but at this time there is fewer cases there and more now in the Western part of the country including in Freetown.

Question: How is the treatment being administered? What are doctors doing there to try and cure those who would have tested positive?

Kilmarx: There is no specific treatment, there is work going on currently to develop and help supply medicines, but currently it’s experimental. So the care now is largely supportive care. One of the greatest challenges is to develop enough of Ebola treatment centres. In the meantime there are a number of other care centres being developed, and interim home-based protection and support are being offered in cases where there is no safe transport or a treatment bed available. That is not an ideal situation but there are currently more patients who have Ebola especially in Freetown and the neighboring district than the health system can currently handle.

Question: There has been concern about the level of assistance from the international community. Would you say there are enough resources to ensure that this disease does not continue to spread?

Kilmarx: There are resources, CDC is there, we have over 50 staff on the ground; we have staff out in seven of the most affected districts. There are also other U.S. government resources though USAID and especially the UK – DFID and the army, the Chinese, Cubans, and there is funding from UN agencies and a lot of WHO staff and other agencies involved. There are resources; the challenge is the health systems are not strong and actually just getting the funding in place, the resources out into the community, getting everything that we would like put in place just takes time.