Skip to main content
Part of complete coverage on

What Obama can do about Ebola

By Laurie Garrett
July 31, 2014 -- Updated 2331 GMT (0731 HKT)
Ebola health care workers carry the body of a man suspected of dying from the Ebola virus in a small village on the outskirts of Monrovia, Liberia, on Friday, December 5. Health officials say the Ebola outbreak in West Africa is the deadliest ever. More than 6,000 people have died there, <a href='http://www.who.int/csr/disease/ebola/situation-reports/en/' target='_blank'>according to the World Health Organization.</a> Ebola health care workers carry the body of a man suspected of dying from the Ebola virus in a small village on the outskirts of Monrovia, Liberia, on Friday, December 5. Health officials say the Ebola outbreak in West Africa is the deadliest ever. More than 6,000 people have died there, according to the World Health Organization.
HIDE CAPTION
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
The Ebola epidemic
<<
<
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
>
>>
STORY HIGHLIGHTS
  • President Obama's Africa summit does not have Ebola epidemic on agenda
  • Record-breaking epidemic hits poverty-stricken Liberia, Guinea and Sierra Leone
  • Laurie Garrett: We need to make long-term commitment to Ebola-struck nations
  • Garrett: Summit urgently needs to address this and plan for the worst if it hits populous Nigeria

Editor's note: Laurie Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize-winning journalist.

(CNN) -- President Barack Obama will convene a summit Monday at the White House of the heads of every key African nation -- except three: Ebola-plagued Liberia, Guinea and Sierra Leone. And as of now, the African Ebola epidemic, the largest on record, is not officially on the summit agenda.

As their epidemics spin out of control in a contagion more than three times larger than any prior Ebola outbreak, Presidents Ellen Johnson-Sirleaf of Liberia, Alpha Condé of Guinea and Ernest Bai Koroma of Sierra Leone are staying home. They are taking drastic measures in hopes of slowing the spread of the deadly hemorrhagic disease: Banning public gatherings, closing schools, deploying their armies to stop attacks on health workers and maintain quarantines.

Laurie Garrett
Laurie Garrett

It is tragic that Sirleaf, Condé and Koroma will not be able to plead their nations' cases at the White House summit because their countries desperately need help.

There is great danger that the fear of the virus spreading globally will stigmatize Liberians, Sierra Leonians and Guineans, and that their West African neighbors -- especially Nigeria -- will try to ward off Ebola by isolating the countries in ways that will hurt their fragile economies, further imperiling the health of their people.

It is time to take a cold, clear look at the implications of this out-of-control epidemic and think carefully about what steps the international community should take next.

Map: The Ebola outbreak
Map: The Ebola outbreak

The outbreak began in Guinea in March and has spread slowly, inexorably in the three desperately poor countries for months. It reached dangerous epidemic scale in June, but only as July draws to its end has it registered with urgency with international media and political leaders. Why now? Because two Americans volunteers are fighting for their lives in the region, and a third American succumbed to Ebola in Lagos, Nigeria, having acquired his infection in Liberia.

The specter of Ebola spreading via air travel to Nigeria, the most populous African nation, prompted the UK government to issue a national medical alert this week. The fear also threatens the creation of a vast cordon sanitaire -- or barrier -- around the three afflicted countries.

Short-term focus on Ebola control cannot be disconnected from a longer term commitment to economic and technical support of these nations' health care systems, roads, schools and general development.

These countries face Ebola today, but they also contend with Lassa fever virus, which also causes hemorrhagic disease. There also are mosquitoes carrying yellow fever and malaria, and a long list of microbial dangers are always lurking in their rainforests.

Ebola: Denial turning to fear and panic
Sick doc. gives Ebola serum to friend
Ebola triggers CDC travel warning
Why no cure or prevention for Ebola?

To show how ill-equipped these nations are to battle disease, per capita spending on health care, combining personal and governmental, amounts to only $171 a year in Sierra Leone, $88 a year in Liberia and $67 a year in Guinea, according to the Kaiser Foundation.

There is also a dire shortage of health care workers. Before the Ebola epidemic claimed the lives of several of the nations' leading physicians and nurses, Liberia had 0.014 physicians per 1,000 people; Sierra Leone's doctor-to-patient ratio was 0.022 and Guinea's was 0.1. To put that in perspective, rich countries have a thousand times more physicians per capita. In the United States, there are 2.5 doctors per 1,000 people.

When this Ebola epidemic eventually ends, the health budgets of these nations will have been bankrupted, and many of their most skilled and courageous physicians, nurses, Red Cross volunteers and hospital workers will have perished.

Nigeria is the tipping point.

Were Ebola to take hold in that country, spreading from person-to-person in a densely populated, chaotic city such as Lagos, the worldwide response would swiftly spin into uncharted political and global health territory.

Consider the following: Nigerian physicians are on strike nationwide; hundreds of girls have been kidnapped from their schools and villages over the past six months by Boko Haram Islamist militants -- and none has been successfully freed from their captors by the Abuja government.

Nigeria is in the midst of national election campaigning. President Goodluck Jonathan's government is, at best, weak. The nation is torn apart by religious tension, pitting the Muslim north against the Christian south. Islamists in the north have long distrusted Western medicine. They have opposed polio vaccination and have kidnapped and assaulted central government health providers.

Nigeria, the most populous nation in Africa, has just surpassed South Africa as its richest. It has a large, elite class that is highly mobile. Its international airports buzz with activity as hundreds of thousands of Nigerians travel all over Africa, take college studies in Europe and North America, visit second homes in London, New York, Toronto and other cities, and conduct business on the international stage.

Sierra Leone, Guinea and Liberia are three of the poorest, most remote nations on Earth while Nigeria is Africa's muscle, hustle and oil.

One way or another, Obama must take advantage of Monday's Africa summit to press the case for calm and appropriate responses. These would include specific post-Ebola financial commitments to Liberia, Sierra Leone and Guinea.

The possibility that the epidemic might take hold in Nigeria must be confronted, and plans of action must be considered. The world cannot afford to make decisions in the heat of panic about such things as international airport closures, withdrawal of foreign oil workers, negotiations for outbreak responses with northern imams, hospital and clinic infection control training across thousands of Nigerian health facilities, deployment of international assistance teams for rapid diagnostics and lab assistance and countless other contingencies.

Roughly 70% of diagnosed Ebola patients in this epidemic have perished. The potential for global panic is genuine. If responsible leaders worldwide hope to stave off hysterical reactions to the virus and bring this epidemic to a halt, serious contingencies and agreements must be reached immediately.

Please, President Obama, do not squander the opportunity to place such contingency planning on your Monday summit agenda.

As NPR talk show host Diane Rehm asked me on her show, "Can't the White House put Presidents Sirleaf and Koroma on Skype, to plead their case to the summit?"

That would be a start.

Read CNNOpinion's new Flipboard magazine

Follow @CNNOpinion on Twitter.

Join us on Facebook/CNNOpinion.

ADVERTISEMENT
Part of complete coverage on
December 20, 2014 -- Updated 0242 GMT (1042 HKT)
Conservatives know easing the trade embargo with Cuba is good for America. They should just admit it, says Fareed Zakaria.
December 20, 2014 -- Updated 0112 GMT (0912 HKT)
We're a world away from Pakistan in geography, but not in sentiment, writes Donna Brazile.
December 19, 2014 -- Updated 1709 GMT (0109 HKT)
How about a world where we have murderers but no murders? The police still chase down criminals who commit murder, we have trials and justice is handed out...but no one dies.
December 18, 2014 -- Updated 2345 GMT (0745 HKT)
The U.S. must respond to North Korea's alleged hacking of Sony, says Christian Whiton. Failing to do so will only embolden it.
December 19, 2014 -- Updated 2134 GMT (0534 HKT)
President Obama has been flexing his executive muscles lately despite Democrat's losses, writes Gloria Borger
December 18, 2014 -- Updated 1951 GMT (0351 HKT)
Jeff Yang says the film industry's surrender will have lasting implications.
December 18, 2014 -- Updated 2113 GMT (0513 HKT)
Newt Gingrich: No one should underestimate the historic importance of the collapse of American defenses in the Sony Pictures attack.
December 10, 2014 -- Updated 1255 GMT (2055 HKT)
Dean Obeidallah asks how the genuine Stephen Colbert will do, compared to "Stephen Colbert"
December 18, 2014 -- Updated 1734 GMT (0134 HKT)
Some GOP politicians want drug tests for welfare recipients; Eric Liu says bailed-out execs should get equal treatment
December 18, 2014 -- Updated 1342 GMT (2142 HKT)
Louis Perez: Obama introduced a long-absent element of lucidity into U.S. policy on Cuba.
December 16, 2014 -- Updated 1740 GMT (0140 HKT)
The slaughter of more than 130 children by the Pakistani Taliban may prove as pivotal to Pakistan's security policy as the 9/11 attacks were for the U.S., says Peter Bergen.
December 17, 2014 -- Updated 1600 GMT (0000 HKT)
The Internet is an online extension of our own neighborhoods. It's time for us to take their protection just as seriously, says Arun Vishwanath.
December 16, 2014 -- Updated 2154 GMT (0554 HKT)
Gayle Lemmon says we must speak out for the right of children to education -- and peace
December 17, 2014 -- Updated 1023 GMT (1823 HKT)
Russia's economic woes just seem to be getting worse. How will President Vladimir Putin respond? Frida Ghitis gives her take.
December 17, 2014 -- Updated 0639 GMT (1439 HKT)
Australia has generally seen itself as detached from the threat of terrorism. The hostage incident this week may change that, writes Max Barry.
December 12, 2014 -- Updated 2020 GMT (0420 HKT)
Thomas Maier says the trove of letters the Kennedy family has tried to guard from public view gives insight into the Kennedy legacy and the history of era.
December 15, 2014 -- Updated 1456 GMT (2256 HKT)
Will Congress reform the CIA? It's probably best not to expect much from Washington. This is not the 1970s, and the chances for substantive reform are not good.
December 15, 2014 -- Updated 2101 GMT (0501 HKT)
From superstorms to droughts, not a week goes by without a major disruption somewhere in the U.S. But with the right planning, natural disasters don't have to be devastating.
December 15, 2014 -- Updated 1453 GMT (2253 HKT)
Would you rather be sexy or smart? Carol Costello says she hates this dumb question.
December 14, 2014 -- Updated 2253 GMT (0653 HKT)
A story about Pope Francis allegedly saying animals can go to heaven went viral late last week. The problem is that it wasn't true. Heidi Schlumpf looks at the discussion.
December 14, 2014 -- Updated 1550 GMT (2350 HKT)
Democratic leaders should wake up to the reality that the party's path to electoral power runs through the streets, where part of the party's base has been marching for months, says Errol Louis
December 13, 2014 -- Updated 2123 GMT (0523 HKT)
David Gergen: John Brennan deserves a national salute for his efforts to put the report about the CIA in perspective
December 12, 2014 -- Updated 1426 GMT (2226 HKT)
Anwar Sanders says that in some ways, cops and protesters are on the same side
December 11, 2014 -- Updated 1439 GMT (2239 HKT)
A view by Samir Naji, a Yemeni who was accused of serving in Osama bin Laden's security detail and imprisoned for nearly 13 years without charge in Guantanamo Bay
December 14, 2014 -- Updated 1738 GMT (0138 HKT)
S.E. Cupp asks: How much reality do you really want in your escapist TV fare?
ADVERTISEMENT