Defense In Depth
Why U.S. Security Depends on Alliances—Now More Than Ever
Earlier this month, U.S. President Barack Obama released a video statement on the Ebola virus outbreak in West Africa. In the video, Obama directed his comments to West Africans navigating the epidemic. He explained how Ebola is -- and isn’t -- spread and reiterated the United States’ commitment to providing assistance. “You are not alone,” he commented in closing. “Together we can treat those who are sick with respect and dignity. We can save lives. And our countries can work together to improve public health. . . .”
We’re now learning more about what that American response entails and how much U.S. support West Africans can really expect. A recent U.S. Agency for International Development (USAID) press release commits to “providing resources for 1,000 new beds, 130,000 sets of personal protective equipment, and 50,000 hygiene kits.” The U.S. Department of Defense will also pitch in. During a Sunday interview on Meet the Press, Obama explained that the U.S. military would set up isolation units and equipment in disease-ridden areas to provide security to “health workers surging from around the world.” Department of Defense personnel will build a $22 million, 25-bed field hospital in Liberia to provide care for Ebola-stricken health workers.
Analysts have panned the 25-bed field hospital as a paltry response, where Doctors Without Borders have estimated that 800 beds would be needed in the capital city alone. Patients are being turned away from hospitals for lack of beds -- a problem that has been ongoing since at least late July. The West African Ebola virus outbreak has already claimed 2,226 lives, including many doctors, nurses, and other health care workers caring for the infected. And it shows no signs of slowing down. Rather, the infection rate looks to be increasing exponentially -- meaning that many more lives will be lost before the epidemic is brought under control. More than half of those who have contracted the Ebola virus in the current outbreak have died.
Although the Ebola epidemic in West Africa has been raging since March 2014, the international community -- Obama included -- has only recently started paying attention. Indeed, international concern (and American concern in particular) came after two Americans, Kent Brantly and Nancy Writebol, contracted the Ebola virus during a humanitarian mission in Liberia. For some, their sickness highlighted the West’s shared humanity with West Africans at risk of infection. But for many others, the transport of the infected Americans back to the United States for treatment (alongside the widely publicized spread of the disease to Nigeria via an air traveler from Liberia) raised fears about a potential outbreak stateside. Although the virus has not spread from medically evacuated health workers in the United States, 40 percent of Americans think a large outbreak is likely sometime this year.
These fears have colored the kind of attention the Ebola virus has received and the way the United States has responded. In their coverage of Ebola, multiple Western media outlets have engaged in “othering,” or portraying and treating a group of people as intrinsically different -- in this case, West Africans. Whereas American aid workers infected with the Ebola virus are portrayed as unlucky heroes, ordinary West Africans navigating the Ebola outbreak are seen as fearful and ignorant deniers clutching to traditional practices. And one thing lesson from the global AIDS epidemic is that framing health issues this way can stigmatize affected populations, which will only inhibit an effective public health response.
Fear of the Ebola virus and an out-of-control epidemic also make it easier for governments around the world to focus on security and military responses to public health solutions. Already, international aid is starting to be channeled through the military -- not just aid from the United States but also that from the United Kingdom. Brice de le Vingne, the director of operations for Doctors Without Borders, welcomed the United States’ increased aid for Ebola but raised concerns about the use of the military for security purposes. Meredith Stakem, West African aid coordinator for Catholic Relief Services, likewise welcomed U.S. provision of much-needed supplies but cautioned against U.S. military forces providing security, as “the mere presence of men with weapons could undermine the entire mission.” Indeed, given the failure of military-enforced quarantines in Liberia and the relatively recent war in two of the heavily affected countries, any military involvement in the epidemic should be cautious.
And here, Obama might look to how the United States has responded to Ebola-infected citizens. With the exception of Patrick Sawyer, a Liberian American, Americans were medically evacuated and given health care; two of them received the experimental treatment ZMapp. Brantly and Writebol’s doctors attribute their recovery to “aggressive supportive care,” including careful monitoring and replacement of lost fluids and minerals. Aggressive supportive care is exactly what the West Africans infected with the Ebola virus need. And to provide it, they need better health systems, the lack of which in Guinea, Liberia, and Sierra Leone -- where there are few health workers and a lack of basic supplies -- has contributed to the spread of the disease.
USAID has made statements about financial commitments and provision of supplies but has fallen short of providing support for what even USAID admits is needed in response to the Ebola virus: a strengthening of health systems. Although the 62-bed treatment center promised by the United Kingdom for Sierra Leone isn’t much more than the 25-bed field hospital promised by the United States, the British plan to staff their treatment center and draw up a long-term plan for its operation, whereas the United States intends to hand over responsibility of its field hospital to the Liberian government once it is built. The slow trickle of already committed funding to Ebola-stricken countries, coupled with the demonstrated weak capacity of West African governments in responding to the virus, gives little confidence that USAID funding and supplies will yield recognizable outcomes in the short term.
Another useful contrast is between Obama’s video statement about the transmission of the Ebola virus and the decision to remove American Peace Corps volunteers -- not just those working in health, but all Peace Corps volunteers, including teachers -- from the most heavily affected countries. In the video, Obama reminded West Africans that they couldn’t catch Ebola “from casual contact, like sitting next to someone on a bus. . . . The most common way you can get Ebola,” he explained, “is by touching the body fluids of someone who’s sick or has died from it.” Apparently, U.S. officials believed that Peace Corps volunteers were not as equipped as the West Africans they lived among to heed Obama’s advice.
Much of the American response -- both in the media and by the U.S. government -- has been about protecting Americans, signaling something about the way the United States values lives. Obama has called the response to Ebola a “national security priority,” raising the alarm that if the United States doesn’t respond now in West Africa, the Ebola virus could mutate and become “a serious danger to the United States.” But the disease is already a serious danger to the many West Africans who are exposed to it.