[Congressional Record Volume 161, Number 19 (Wednesday, February 4, 2015)]
[Senate]
[Page S764]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    LESSONS FROM THE EBOLA EPIDEMIC

  Mr. LEAHY. Mr. President, not long ago Liberia, Sierra Leone, and 
Guinea, the World Health Organization, WHO, and the United Nations, and 
the United States, Great Britain, France, and other countries were 
frantically trying to bring the Ebola crisis in West Africa under 
control.
  Thousands of people died due to a disastrous failure by WHO's Africa 
regional representative, serious miscalculations by local officials and 
global health experts, and a myriad of other problems ranging from weak 
local health systems that were quickly overwhelmed to a lack of 
accurate information and cultural practices that helped spread the 
disease rather than contain it.
  But in the past few weeks there has been some good news about 
progress in stopping Ebola. According to WHO, Liberia, Sierra Leone, 
and Guinea recorded their lowest weekly numbers of new cases in months. 
The United Nations special envoy on Ebola stated that the epidemic 
appears to be slowing down, and the Government of Liberia has set a 
target of zero new Ebola cases by the end of February.
  It is heartening to see that the hard work by Liberia, Sierra Leone, 
Guinea, and the international community are bringing results. But we 
are not out of the woods yet and there are important lessons to be 
learned from the mistakes and lost opportunities in the early response 
to this disease outbreak.
  Ebola pushed governments, international organizations, and the 
private sector and health care responders into unknown territory, 
forcing everyone to think and act in new ways. Unfortunately, with the 
exception of the nongovernmental organization Doctors Without Borders, 
we were all too slow to recognize this. The initial response missed key 
opportunities to prevent the crisis from becoming an epidemic, and as a 
result thousands of people died who might have avoided infection. The 
symptoms of the initial victims were not recognized as Ebola, signs 
that the epidemic was spreading rather than receding, as some believed, 
were misinterpreted, and governments and international organizations 
did not effectively communicate or coordinate with local communities 
impacted by the virus, nor were the necessary resources to combat the 
disease available in-country early enough.
  As work was done to overcome these missteps and challenges, the 
epidemic spread further across borders, as did rumors, and fear 
increased, people in the affected areas became increasingly distrustful 
of those who were trying to help, and already scarce health care 
workers became harder to recruit.
  The consequences of not containing the disease in the early stages 
have been catastrophic. As of January 28, WHO estimates that 8,795 
people have died from the Ebola virus, and according to UNICEF's 
preliminary estimates, as of December 29 at least 3,700 children in 
Guinea, Liberia, and Sierra Leone have lost one or both parents to the 
disease. The children of those countries have not attended school since 
mid-2014. While Guinea reopened their schools in mid-January, 
attendance has remained low. Liberia is preparing to reopen schools in 
mid-February, and Sierra Leone hopes to reopen its schools by the end 
of March.
  Unemployment and business closures have increased, cross-border trade 
has plummeted, and there are concerns that food shortages and 
malnutrition will increase because food stock that would normally be 
kept for next year is already being eaten.
  According to the World Bank's December estimates, the growth in GDP 
in 2014 for Liberia and Sierra Leone fell by over 60 percent in each 
country and Guinea's GDP growth in 2014 is down by 89 percent.
  Much of our investments in the rebuilding of Liberia and Sierra Leone 
since the civil wars there have been obliterated by Ebola. These 
countries are back at square one.
  The world's initial response to the Ebola crisis illustrates how 
unprepared we are for future global health crises which may be far more 
devastating and fast spreading than Ebola, if that is possible to 
imagine.
  How can we avoid repeating our mistakes? Are we going to provide our 
own government agencies such as the Centers for Disease Control and 
Prevention and the U.S. Agency for International Development and 
international organizations such as WHO the resources they need? Can we 
count on them to take the steps to ensure that the right people are in 
the right places with the authority to make the necessary decisions in 
a timely manner?
  Too often it seems that we have to relearn the same lessons each time 
for different situations and countries. There are already reports, 
including a January 19 article in the Washington Post that describes 
newly built Ebola response centers, paid for by the United States 
Government, that stand empty or have closed because the number of new 
Ebola cases has dropped sharply. It is far better to be prepared than 
unprepared, but we need to reassess the situation and be sure that we 
are adjusting our response appropriately.
  The fiscal year 2015 Consolidated Appropriations Act includes $2.5 
billion for the Department of State and USAID response to the Ebola 
crisis. As ranking member of the appropriations subcommittee that funds 
those agencies, I hope they will ensure that we use these funds to 
avoid past mistakes, by improving flexibility to respond to the crisis 
as it changes, relying less on international nongovernmental 
organizations and foreign contractors, and increasing support for 
building local public health capacity and a sustainable and resilient 
private sector, increasing awareness and sensitivity to cultural norms 
of those impacted by the crisis, and improving communication and 
coordination among local communities, local and national governments, 
and the international community. These are not new ideas but they 
emerge time and again.
  Finally, we need to be far better prepared for protecting American 
citizens from contagious diseases that can spread like wildfire from a 
single health care worker or other infected individual who returns from 
an affected country. Fortunately, only one death from Ebola occurred in 
the U.S., but it could have been far worse.
  Now is the time to reassess how we should respond domestically and 
internationally to regional epidemics and prepare accordingly. We 
cannot afford to waste time and resources making the same mistakes and 
relearning old lessons.

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