Lena H. Sun and Juliet Eilperin, Washington Post, September 16, 2014
President Obama will announce Tuesday that the U.S. military will take the lead in overseeing what has been a chaotic and widely criticized response to the worst Ebola outbreak in history, dispatching up to 3,000 military personnel to West Africa in an effort that could cost up to $750 million over the next six months, according to senior administration officials.
By the end of the week, a general sent by U.S. Africa Command will be in place in Monrovia, Liberia–the country where transmission rates are increasing exponentially–to lead the effort called Operation United Assistance. The general will head a regional command based in Liberia that will help oversee and coordinate U.S. and international relief efforts while a new, separate regional staging base will help accelerate transportation of urgently needed equipment, supplies and personnel.
In addition, the Pentagon will send engineers to set up 17 treatment centers in Liberia–each with a 100-bed capacity–as well as medical personnel to train up to 500 health-care workers a week in the region.
The president’s decision to enlist the U.S. military, whose resources are already under strain as it responds to conflicts in the Middle East, reflects the growing concern of U.S. officials that, unless greater force is brought to bear, the epidemic could wreak havoc on the continent.
Global health experts and international aid groups who have been urging the White House to dramatically scale up its response praised the plan as described. They have said charities and West African governments alone do not have the capacity to stem the epidemic.
“This is a really significant response on the military side,” said Laurie Garrett, senior fellow for global health at the Council on Foreign Relations and author of a book about the first Ebola outbreak in 1976 and another on the global public-health system. “This is really beginning to seem like a game-changer.”
But much depends on how quickly personnel and supplies can get there.
“The problem is, for every single thing we’re doing, we’re racing against the virus, and the virus has the high ground right now,” she said. “I would hope this would reduce transmission, but it’s all about how fast people can get there and get the job done. If it takes weeks to mobilize, the strategy won’t even be within reach.”
Although the official death toll is at least 2,400 people in five African countries, officials say it vastly underestimates the true caseload. Garrett, who has been talking to health-care workers in the region, said the cumulative total, including deaths, could reach 250,000 by Christmas.
Washington has come under fire from African officials–especially in the hardest-hit countries of Liberia, Sierra Leone and Guinea–and on Capitol Hill for not marshaling more of its resources to combat the epidemic.
The United States has already spent $175 million responding to the outbreak and has dispatched 100 CDC experts, among the largest deployments of agency personnel in its history. The administration has sought an additional $88 million and may ask for more, according to a senior administration official. “I don’t want to close the door to potential additional funding,” the official said. Separately, the Pentagon wants to take up to $500 million from existing funds within the Pentagon’s budget that have not yet been spent and use it for the plan to fight Ebola.
The Pentagon announced last week that it would send a 25-bed hospital to Liberia. The hospital is designed to care for health-care workers who become ill, and eventually will be turned over to the Liberian government. It will be at least a month before the hospital is up and running. The United States Public Health Service Commissioned Corps is preparing to deploy 65 Commissioned Corps officers to Liberia to manage and staff the hospital.
The United States has already set up one mobile laboratory, and another two are on the way.
In addition to expanding treatment and training facilities, the United States will send enough basic Ebola response kits to supply 400,000 households in Liberia, according to a senior administration official. That is intended to address an increasingly common phenomenon in which sick patients are being denied access to overflowing treatment centers and being sent home.
The packages, which include sanitizers, will help curb transmission of the disease among family members and expand access to ambulances and treatment centers so those infected can be isolated. As part of this effort, the U.S. Agency for International Development this week will airlift 50,000 home health-care kits from Denmark to Liberia to be hand-delivered to distant communities by trained youth volunteers.
While the world’s largest international health organizations, several governments and many nonprofits have already devoted significant resources to addressing the virus outbreak, administration officials said Monday that they had concluded that the United States would have to lead more aggressively in order to check Ebola’s spread. In Liberia’s capital, patients are dying on the street because there aren’t enough beds in treatment centers.
“Our concern is if we do not arrest that growth, and we don’t arrest that growth now, we could be looking at hundreds of thousands of cases” in Africa, the official said, noting that it will still take “months” to reduce the numbers of illnesses and deaths from the disease.