The United States has pledged to provide $8 million to support the global response to the growing Ebola outbreak in Congo, officials said Tuesday. Health and Human Services Secretary Alex Azar announced a $7 million commitment Tuesday at the World Health Assembly in Geneva that added to an initial $1 million pledge last week.
The outbreak, the most serious since the 2014 West Africa epidemic that killed more than 11,000 people, does not yet meet the criteria to be declared an international public health emergency, the World Health Organization said Friday. But in a statement, the WHO said that “a vigorous response” from the international community is needed to prevent a sharp escalation in the outbreak.
The discovery of at least one case in Mbandaka, a densely populated port city on the eastern bank of the Congo River, has raised concerns about the potential for rapid spread of the disease, which had previously been limited to a remote area in the rain forest of Congo’s Equateur province. As of late Friday, the Congolese health ministry reported four confirmed cases in the Mbandaka area.
At the World Health Assembly in Geneva on Tuesday, WHO officials said that there are 51 confirmed or probable cases of Ebola in the outbreak, and that 27 of those people have died. Hundreds of people have been in contact with infected people and are being monitored, and they are candidates for the first round of an experimental vaccination campaign that began Monday.
WHO officials estimate that outbreak-control efforts will cost $26 million over the next three months. As of Friday, the WHO had received commitments for about $9 million.
“So we are about 17 million short,” Peter Salama, the WHO’s lead official in charge of epidemic response, said at a news conference in Geneva on Friday. That may sound like a considerable amount, he said, but not compared with the Ebola epidemic in West Africa, which cost between $3 billion and $4 billion. “So this is a relatively small investment to stamp out a small outbreak quickly, for a major gain in lives saved, but also in dollars saved,” he said.
Some global health experts have expressed concern privately that the U.S. response would be minimized given President Trump’s disparaging and isolationist comments about Ebola during the 2014 epidemic. He complained about two sick American health workers being flown back to the United States for treatment and said they should not be brought into the country.
But the U.S. response appears to be appropriate for this outbreak, experts say.
“I don’t see any evidence that the president’s former comments about Ebola have impacted the U.S. response,” said one global health expert, who spoke on the condition of anonymity.
Thomas Inglesby, director of the Johns Hopkins Center for Health Security, said: “My sense is that while they have not been too public with what they are doing yet, they are in fact doing a lot and will be sending teams into the field as per the requests of DRC and WHO.”
On Friday, the U.S. Agency for International Development said that it had provided an initial $1 million to the WHO to combat the outbreak, and Azar pledged up to $7 million in additional funding in Geneva Tuesday during the World Health Assembly meeting.
The money would be separate from the $252 million in unused funding remaining from U.S. reaction to the 2014 Ebola epidemic — money the administration wants Congress to cut.
Azar, in prepared remarks, urged all member states to contribute to “WHO’s flash appeal to ensure we defeat this outbreak.” He also commended the Congolese government for “responding to this outbreak with such vigor.”
This complements the work of American technical experts deployed to the DRC, and, combined with the $1 million announced last week, brings the U.S. commitment to up to $8 million.
Global health advocacy groups praised the U.S. decision, but also criticized the Trump administration for seeking to claw back unused Ebola funding from the West Africa epidemic.
Carolyn Reynolds, a vice president at PATH, a global health technology nonprofit, said the additional U.S. funding should not come at the expense of other lifesaving global health programs, but should enable all U.S. government agencies, as needed, to accelerate and scale up their response to the epidemic.
“This is exactly what the international disaster assistance funding allocated by the Congress as part of the Ebola supplemental was intended to do, and further underscores why it makes no sense for Congress to cut this funding” as was proposed by the administration, she said.
USAID is also sending 2,000 personal-protective-equipment kits, laboratory materials for diagnostic testing and other technical support. The Centers for Disease Control and Prevention has already mobilized its country office in Congo, which includes several experts who had extensive experience handling the 2014 West Africa epidemic. The CDC has also assembled a team of about a dozen experts who are planning to deploy to Congo within days. Their expertise includes infection control, contact tracing and emergency operations management.
Pierre Rollin, one of the agency’s senior Ebola experts, said in an interview last week that multiple CDC teams are preparing to deploy if needed, with each shift in the Congo expected to last four to six weeks.
“We have intensified our support to the response,” Anne Schuchat, the CDC’s principal deputy director, said in an interview Friday. Because the WHO and Congolese officials have responded quickly so far, the CDC has not yet needed to send in large teams. But the next few days will be critical, she said, to prevent the virus from spreading to another country, and for personnel on the ground in the outbreak areas to keep up with contact tracing. But unlike the West Africa epidemic, she said, “this is not thousands of new cases, which is what we were dealing with in the [West African] capitals.”
The National Security Council, which two weeks ago lost its top official responsible for leading the U.S. response to pandemics and split up the global-health-security team he oversaw, is managing the overall response in coordination with the CDC and USAID, a spokesperson said.