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May 24, 2018

Rethinking Trump's Proposal: The Effect of Rescinding Ebola Emergency Funds on Public Perception

By Emily Graul (NHS'20)

On May 8, the Democratic Republic of the Congo (DRC) declared a new outbreak of Ebola. According to Gavi, the Vaccine Alliance, the new Ebola vaccine, rVSV-ZEBOV, will be used for the first time after being declared 100 percent effective in 2016. Just before the formal declaration of the outbreak, President Trump proposed to rescind $252 million in emergency funds remaining from the original $5.4 billion allocated to fight the disease in 2015.

More recently, on May 17 the DRC confirmed the first urban case of Ebola in the port city of Mbamdaka, 150 kilometers from the initial outbreak. On May 19, a total of three cases in Mbamdaka were confirmed, which has the potential to slow control efforts.

While the DRC enters the current outbreak better equipped, it could take three to four months to control the outbreak, according to a statement by the country’s top virologist. The timely response of the DRC to the current Ebola outbreak demonstrates the ability of all countries to develop the capacity to prevent, detect, and respond to infectious disease outbreaks.

Although the DRC appears capable of controlling the new Ebola outbreak, the Trump administration’s reductions in response to “excessive spending” are at a time when such actions need to be the opposite. The way in which we respond to a "well-prepared" outbreak such as that in the DRC has the potential to influence recognition of the need for prevention, detection, and response in the future.

Trump’s proposal temporarily halts the use of the Ebola emergency funds. Congress has 45 days to act and vote on the proposal. If the funding is voted down or ignored, it will be used as planned. If Congress votes for Trump’s proposed funding changes, according to Ron Klain, the former Ebola Response coordinator, USAID will not have the funding to respond to the next crisis. 

According to Rebecca Katz, co-director of the Georgetown University Center for Global Health Science and Security, “investments in core capacities to prevent, detect, and respond to outbreaks are far less than the cost of responding to a large scale public health emergency.” 

Both Katz and Klain emphasize the effect of changes to cost-effective investments in infectious disease control. Moreover, the effect of such changes on public understanding as a factor in future mobilization is also important when weighing the impact of Trump’s proposal. If we rescind our efforts now to a well-coordinated outbreak response as in the case of the current administration, in the next crisis the gravity of the situation could potentially be lowered. 

Diminishing the seriousness in which we react to a future outbreak is concerning as this could lead to reduced sensitivity of the situation by the public, particularly when the next crisis involves a novel strain of disease. Additionally, it influences not only whether the communities, institutions, and health systems both recognize and engage in the investments in core capacities, but whether broader society has an awareness of the need for prevention preceding a coordinated outbreak response.

It is not if, but when, the next infectious disease outbreak will occur—and next time it could not be recurring Ebola, but a new, high virulent, strain. Regardless if the outbreak occurs in a declared "well-prepared" country or not, our reactions of an outbreak now have the potential to influence the actions we take in the future. 

Emily Graul (NHS'20) is a global health major and a student fellow with the Global Health Initiative.

EDITOR'S NOTE: This post was written May 19 and due to the story’s developing nature details on the status of the outbreak may not be current.