The heads of state from Liberia, Sierra Leone and Guinea have requested debt relief of $3.2 billion and $8 billion in donor aid to rebuild social infrastructure such as health care [“Rebuilding after Ebola,” editorial, April 18].

In 2011, the World Health Organization listed country health expenditures relative to gross domestic product. Liberia ranked first with 19.5 percent of health expenditures against gross domestic product, and Sierra Leone ranked second with 18.9 percent. The United States, which is always taken to task for its level of health spending relative to outcomes, was ranked third at 17.9 percent. Yet, when Ebola struck Liberia and Sierra Leone, their health systems collapsed.

Two things are certain from the WHO rankings: Liberia and Sierra Leone’s health expenditures come from donor aid rather than domestic resources; and the poor in these countries weren’t the beneficiaries of that donor aid.

Jeremiah Norris, Washington

The writer is a senior fellow at the Hudson Institute.