Outbreaks of Ebola, A Polio-like Disease Demand Proactive Responses By Trump and Other World Leaders

​The Democratic Republic of the Congo faces its tenth Ebola outbreak in forty years.  Although just over a hundred people have died from the infamous disease, which causes nightmarish symptoms that are highly lethal, and the World Health Organization does not yet consider the recent outbreak to be a global threat, the disease, which propagates via the bodily fluids of the infected, can quickly spread without proper containment measures in place.  Not only is the Democratic Republic of the Congo riddled with poverty and violent rebellion, it lacks much of the civil and healthcare infrastructure needed to provide the sanitation needed to stem an epidemic.  As demonstrated by the 2014 Ebola Outbreak, Africans, who hid the bodies of Ebola-infected relatives, fear ulterior motives at work while there is a curious disconnect between the International Community and the plight of Africans.  Today, the same issues are in play, but the Trump Administration’s preference for weaker government interventions and minimal international engagement adds a new dimension to the unfolding threat.

​Government exists to address certain basic needs of communities.  Although some people prefer more government than others, security is, generally, considered a basic function of all governments.  Another basic function of all modern governments is emergency management.  When natural and man-made disasters strike, government is expected to coordinate the mobilization of public and private resources in order to mitigate the fallout of a crisis as well as facilitate the recovery from the devastation.  It is why people will judge the success and value of a government based on its responses to crises like epidemics.  When it comes to disease, the best medicine is prevention.  Because disease knows no political boundaries, disease control is both an issue of public policy and international governance  This means the quality of any modern government, in terms of both domestic and foreign affairs, is judged on the ability and willingness of that government to confront and mitigate a disease outbreak.  The Trump Administration will be judged no differently.
 
The Trump Administration has barred officials from the Centers for Disease Control from traveling to the Ebola epicenter in the town of Beni due to security concerns.  It appears the Trump Administration fears a “Benghazi-like situation,” which refers to the deaths of four Americans during an incident when Islamic militants stormed US diplomatic facilities in Benghazi, Libya.  The US President has been particularly critical of how then-Secretary of State Hillary Clinton handled the situation.  His Administration, therefore, fears any political backlash that might result from any similar scenario occurring under his watch.  In other words, the safety of US officials and political considerations are higher priorities than public health and scientific considerations.  Although seemingly prudent on the surface, this type of political paralysis could easily become the catalyst for a pandemic.  The CDC is, after all, far more suited to deal with an Ebola outbreak than the local or national healthcare professionals of Congo.
 
It is essential to recognize that past Ebola epidemics have been blunted by international responses, often lead by US exerts.  Many of the governments in Africa, including that of the Congo, are not functional enough to mobilize and coordinate the resources needed to address the outbreak of a disease.  International aid and interventions have given governments facing Ebola outbreaks a fighting chance.  Past and present efforts to fight Ebola have not been successful in eradicating the disease, but they have been enough to prevent outbreaks from reaching the magnitudes of the Bubonic Plague or any of the other most lethal outbreaks seen throughout human history.  It can be hard for those living in the modern world to imagine the possibility of an Ebola outbreak killing millions.  In the developed world, someone with Ebola can be cured, the infected isolated, and the contaminated areas sterilized in an effective and timely manner.  Even the healthcare infrastructure of the wealthiest countries can, however, be overwhelmed, which is evident by the prevalence of illnesses like the flu and the common cold.
 
Given Donald Trump’s preference for protecting US interests at all costs to others, his most likely response to a true Ebola epidermic would be to embargo all nations impacted by the disease.  The thinking is that countries like the Congo can be sacrificed for the good of the many.  Outside of the humanitarian implications, the problem with this thinking is that the failure to prevent the spread of Ebola in the Congo and the spread of the disease throughout the Congo create new vectors for the disease to spread to the rest of the world.  In other words, there are more opportunities for the disease to spread beyond the borders of Congo when there are more causes of Ebola in the Congo.  A “hands-off” approach to disease control via isolation will not prevent an epidemic.  It will help cultivate the disease.  Containment of the inflected is a key component to disease control, but isolating geographic areas instead of devoting resources to the containment and treatment of the disease will create more opportunities for containment breaches while it will blunt efforts to find effective treatment and cures.
 
Ebola is a foreign disease in a far away place, so it is difficult for Americans and the citizens of other developed countries to imagine a massive Ebola outbreak.  It is a distant threat that can be ignored.  There has, however, been an outbreak of acute flaccid myelitis in the West.  The causes of AFM are unknown and the number of victims remain in the hundreds, but the outcome of the disease mirrors that of Polio while the CDC is puzzled by the disease.  Polio is now a rare disease regarded as a minor third world problem thanks to massive international vaccination efforts, but the devastating potential continues to stoke fears.  Also causing paralysis in children, AFM is today’s polio.  Although the developed world has the capacity to prevent the spread of AFM, the lack of political will to confront the public health concern could easily leave the disease unchecked.  Like Ebola in Africa, AFM could easily reach the critical infection rates needed to produce an unstoppable epidemic.  Government officials, no matter their political views, need to recognize their role in preventing the spread of diseases and take proactive measures to blunt the spread of disease throughout the world.