Charles W. King
The recent outbreak of Ebola in a remote part of Congo prompted a rapid and comprehensive response from the World Health Organization (W.H.O.) including the first time in its seventy year history that its Director has traveled into the midst of an active hotzone. The response from the United States has been decidedly muted, unlike the previous outbreak in West Africa that began in 2013 where thousands of U.S. Army troops were deployed to construct field hospitals and support aid efforts. In the years since the West African outbreak the Trump Administration has requested Congress roll back funding that had been allocated for addressing Ebola and other virulent outbreaks. While costly, the expenditures by the United States between 2014 and 2016 to combat Ebola in West Africa, primarily through the Centers for Disease Control and Prevention (C.D.C.) and U.S. Agency for International Development (U.S.A.I.D.), represent an important strategic deployment of American resources to address a national interest.
Like food aid, medical aid to foreign countries, especially to address potential epidemics, is not solely altruistic. Infectious diseases like Ebola and Marburg are easiest to contain when populations of infected are localized. The the outbreaks of SARS and Avian Flu, which are much less lethal to humans than Ebola or Marburg, demonstrate how difficult fighting a disease that has penetrated the international travel network. If the United States was attempting to prevent Ebola or a similar disease from making it through American border posts, seaports, and airports it would be significantly more costly and dangerous than the billions spent in the West African campaign. American support for the fight against Ebola in West Africa between 2014 and 2016 was ultimately a single-digit billions line item in a trillions of dollar budget. A medical quarantine of the United States would not only be a major federal expense, but would have a significant effect on gross domestic product and economic growth.
The relatively contained outbreaks close to their origin are also important for the development of medical remedies and vaccines. The WHO is now deploying a vaccine for Ebola that was first tested in the last months of the West African outbreak in the thousands of doses in Congo. Without international funds for fighting in West Africa or Congo Merck, the pharmaceutical giant who developed the vaccine, would not have been able to incentivized to do so, which would hamstring future responses whether the outbreak was in the developed world or the undeveloped world.
It is also in the long term interest of the United States that the developing be stable and prosperous world. Stable developing states are markets for American goods and services. Unstable ones are sources of not only misery and death, but dangerous pressures on the United States and its allies, the Syrian Refugee crisis being only the largest and most recent example. Civil strife has been simmering in Congo and among its neighbors for decades, the return of major conflict at the same time as an outbreak could be orders of magnitude deadlier than the 2013-2016 Ebola outbreak in West Africa which killed approximately eleven thousand people. Epidemics cause their own refugee crises, but combined with flight from conflict such an outbreak could be un-containable by current measures. Policy-makers in the United States and Europe have a good case for supporting medical aid to the rest of the world, both in crises and in times of relative calm. They simply need to make it.