Five steps the US could take on Ebola

Five steps the US could take on Ebola
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Health officials are making desperate calls for help as the Ebola epidemic in West Africa reaches crisis proportions.

The United Nations (U.N.), the World Health Organization (WHO) and the U.S. government have said that without a significant increase in the world's response, the outbreak will reach the point of no return.

These pleas, intensified by a rising death rate and worsening humanitarian strife, have put pressure on government to step up efforts to fight the virus.


The United States is already doing much to help, including sending experts from the Centers for Disease Control (CDC) to help track the virus and coordinate efforts on the ground.

U.S. health agencies have also accelerated work on Ebola treatments and vaccines, and USAID announced $75 million for clinics, medical gear and doctor recruitment on Thursday.

Further efforts, particularly in West Africa, would come with political, financial or logistical challenges of their own, but experts surveyed by The Hill said there is more that agencies could do, particularly if the crisis gets worse.

1) Use the Pentagon.

There is no part of the U.S. government better equipped to deal with large-scale crises than the military.

Even without sending troops, the Department of Defense (DOD) could use its vast resources to set up healthcare facilities, establish chains of transport and deploy medical equipment on the ground.

A response could be coordinated through the U.S. Africa Command, which is responsible for military relations with African countries.

While those resources may be stretched thin, the Pentagon's enormous capacity for logistics could work wonders in affected areas, experts said.

"It is hard to overstate how crucial the Department of Defense was in Haiti" after the 2010 earthquake, said Thomas Inglesby, director of the Center for Health Security at the University of Pittsburgh Medical Center.

"For Ebola, we're going to need sustained logistical transport of both people and materials in and out of the affected countries. It's hard to imagine a force more prepared to handle that than DoD."

2) Reassure volunteers.

Health officials are calling for a dramatic surge in volunteers to join the fight against Ebola.

Just this week, the U.N. said the number of healthcare workers on the ground must triple or quadruple in short order in order to make a difference.

But it's unlikely that more doctors and nurses will sign up without a system in place to monitor their health and treat them if they get sick themselves.

The U.S. government has played a role in coordinating care for American doctors who contracted the virus, two of whom were cured. Experts said guaranteeing protections will be essential to assembling new medical teams.

"There are people around who can help, but you're hard-pressed to recruit them unless you can ensure their safety. That part is crucial," said Jeffrey Koplan, former director of the CDC and a vice president at Emory University.

Others underscored the difficulty, given that anti-Ebola drugs are still scarce and unproven.

"Even if we knew [the drugs] were effective, it would require a massive undertaking to manufacture sufficient quantities," said Leonard Cole, adjunct professor at Rutgers New Jersey Medical School.

3) Send food.

There is a significant risk of food shortage in West Africa as the epidemic rages, the U.N. has warned.

But the lack of food is also felt on a smaller scale, as quarantined families and neighborhoods struggle to access the supplies they need.

This is an area where USAID could focus its response, experts said.

"It's harder to contain the virus if people are leaving home in search of food," said Inglesby. "We're telling people to stay home because they're sick, so we have to think about food before it becomes a problem."

4) Intensify diplomacy.

The number of countries and institutions involved in the Ebola response is staggering.

While groups like Doctors Without Borders led the charge in patient care, the U.N., the WHO and the U.S. government are working at a high level to coordinate and recruit help.

CDC Director Tom Frieden has become a key diplomat in that effort, working to convince the African Union to deploy a force of "healthkeepers" to affected countries.

He also helped land a commitment from the World Bank of more than $200 million to alleviate funding shortages.

Diplomacy is one area where U.S. officials can use their clout to help efforts on the ground, experts said.

"Part of the challenge is that you're dealing with sovereign nations [that are affected by Ebola]," said Margaret Kosal, assistant professor at Georgia Tech.

"Those nations have to ask for help that can be provided and is politically viable. ... That's where health diplomacy comes in."

5) Earmark funds.

If Congress decides to get involved — and that's a big "if" — advocates said there's nothing that would be more helpful than appropriating funds.

Money could go to the WHO, which is dependent on donors, or to any of the myriad U.S. agencies with the capacity to respond to Ebola.

Experts argued that new streams of funding are needed because most of the resources to fight epidemics were depleted during the recession.

Earmarked for Ebola or not, new funds could bring the agencies back to a level of readiness seen after 9/11 and the 2002 SARS outbreak, they argued.

"The ideal way that Congress can help is to sustain programs that respond to public health crises and sustain research, particularly basic disease research," Kosal said.