Combating the Ebola Threat

Bisa Williams
Deputy Assistant Secretary, Bureau of African Affairs
Testimony Before the House Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations
Washington, DC
August 7, 2014

Thank you very much Chairman Smith, Ranking Member Bass, and Members of the Committee, for the chance to testify before you on this important topic. The evolving Ebola crisis in Guinea, Liberia, Sierra Leone, and now Nigeria is one of the most daunting challenges those countries, and the region, have faced in decades. To date, more than 1,600 suspected and confirmed cases of Ebola have been reported, including over 900 total deaths.

Although these affected countries are home to many heroic and dedicated health workers, the rapid spread of the disease reflects the lack of national capacity, particularly in the three epicenter countries of Liberia, Guinea, and Sierra Leone, to limit the spread of the disease and to treat patients. The NGO community, which has played a significant role in the response effort by providing front line medical care to patients, is hard-pressed to continue to provide care in all affected regions. Compounding the issue, affected populations’ lack of understanding of the virus and widespread mistrust of healthcare providers and treatment methods have further hampered response efforts. In significant portions of the affected regions, local traditions such as public funerals and cultural mourning customs including preparing bodies of the deceased for burial have contributed to the spread of the virus, and have led locals to block access to patients, and in some places have led to attacks on healthcare providers.

Following one such incident in Liberia, major care providers like Samaritan’s Purse have begun pulling out of the region due to concerns for the safety of their staff. Thus, in addition to proper medical care, there is an urgent need for effective health messaging campaigns and public outreach as an integral and crucial component of these response efforts. We are reaching out to ensure our response is coordinated with the WHO and other countries that can assist, both through our representatives at WHO headquarters in Geneva and direct discussion with other governments.

Guinea, Liberia, and Sierra Leone are still rebounding from lengthy conflict. These conflicts destroyed lives, institutions, and infrastructure. This was especially acute in Liberia and Sierra Leone where the fighting went on for years. These countries have taken important steps to reverse the effects of deterioration and neglect, and build lasting security and stability. Border control and other factors key to checking Ebola’s spread also are challenging for the countries in this region. Aside from our interest in making sure this Ebola virus does not spread to the United States or farther in Africa, we do not want the virus to erode the capacity of African countries to address other important national and regional challenges. We want to ensure these countries remain strong, strategic allies to the United States in a region facing serious development and security challenges. Sadly, this virus already has impacted peacekeeping in Somalia. The African Union cancelled a planned deployment of a Sierra Leonean peacekeeping force due to fears that the virus could be introduced into the country. Given the critical importance of this issue, we are fully committed to doing everything possible to shore up each government’s efforts to combat the viral outbreak and control its spread. We are confident that through the concerted and coordinated efforts of our government, and our international partners, we can contain and stop this virus.

1. Diplomatic Outreach and Host Government Efforts

Since the beginning of this crisis, the Department has maintained close contact and coordination with the governments of all the affected countries, and has closely monitored their operational plans to combat the viral outbreak. In Sierra Leone, President Koroma directed government officials to make containment of the virus their top priority, and set up a presidential task force to lead the government’s efforts. In Guinea, improved messaging to the populace helped healthcare providers gain access to infected regions. And in Liberia, President Johnson-Sirleaf announced a national task force to combat the spread of virus. On August 1, the three presidents detailed their collective strategy for eradicating the virus in a joint communique following a meeting of the Mano River Union. We commend all three countries for taking this outbreak seriously, and for taking these concrete steps to address it. This week's news of new cases in Lagos, Nigeria - a city of over 20 million people - makes the need for an effective, well-supported, and well-coordinated national and international response more important than ever before.

Assistant Secretary Linda Thomas-Greenfield has spoken to the presidents of Guinea, Liberia, and Sierra Leone to express support and assure them of our assistance to stop the spread of the virus. On August 4, the Department hosted and moderated a meeting on Ebola on the sidelines of the U.S.-Africa Leaders’ Summit to discuss the next steps for controlling and ending the virus. HHS Secretary Sylvia Burwell, CDC Director, Dr. Thomas Frieden, NIH Director, Dr. Francis Collins, USAID Assistant Administrator for Global Health Dr. Ariel Pablos-Mendez, President Alpha Condé of Guinea, the Liberian Minister for Foreign Affairs, Sierra Leone’s Ambassador to the United States, and Professor Tomori Oyewale, the President of the Nigerian Academy of Science participated in the meeting. Representatives from, DOD, the NSC, the World Bank, as well as private partners like the GE Foundation, and Becton, Dickinson, & Co. also joined. In addition to emphasizing the need to focus on detection, isolation, and adequate training for health workers in the field, we also emphasized our long term commitment to building the health care capacities of individual West African nations beyond this immediate crisis intervention.

We continue to work with our international partners and the WHO to assess what is needed to properly treat patients and mount a sustainable response. Such support has included providing financial and technical assistance to properly equip treatment centers and supporting communications efforts to help health workers access affected communities. The WHO Sub-Regional Coordination Center opened in Conakry on July 23, and is coordinating all surveillance efforts, harmonizing technical support, and mobilizing resources being provided to the affected countries. The organization has also launched a $100 million emergency response plan to surge resources to mount a more effective response. We are in continuous discussions to find new ways to provide assistance. My colleagues from the CDC and USAID can provide you with additional details about our assistance to and support of the WHO during this crisis.

2. Protection of U.S. Citizens

The Department of State has no higher priority than the protection of U.S. citizens. We extend our deep sympathies to the family of Patrick Sawyer, a U.S. citizen who died in Nigeria after contracting the virus in Liberia. At least two additional citizens affiliated with response organizations have been infected in Liberia and are currently undergoing treatment. We are in close contact with the sponsoring organizations of those two individuals, and our thoughts and prayers go out to them and their families.

U.S. Embassies in the affected countries have disseminated security messages, including the CDC’s warnings, to resident and traveling U.S. citizens. We continue to take steps to educate citizens about the virus, dispel rumors, and provide information on preventive methods.

3. Safety of Chief of Mission Personnel

We also take the safety and well-being of our staff very seriously. To that end, the Department’s Chief of Infectious Disease traveled to West Africa to provide embassy staff with assistance regarding protection measures and case recognition. Additionally, embassies in the affected regions have organized regular town hall meetings to answer the questions and concerns of mission personnel and U.S. citizens. Embassies in neighboring countries, like Mali, Senegal and Togo, have also held meetings to assess the capabilities of their host governments, and to make contingency plans for embassy personnel and resident citizens in the event of an outbreak. In closing, I would like to reiterate and assure this committee that the Department of State takes the Ebola threat very seriously and we are fully dedicated to working with our governmental and nongovernmental allies, the interagency community, and host governments in the affected countries to respond to this crisis, prevent its spread, and restore stability to the region. Thank you for your attention to this issue. I look forward to answering your questions.