October 12, 2018

The Best Biodefense is a Good Offense

By Zach Cohen

In August, a major outbreak of Ebola was reported in the Democratic Republic of the Congo— the 10th in the country’s history—and while it appeared to be contained, recent new cases have raised concerns that it could escalate on the scale of the 2014 outbreak, which killed over 11,000 people. Moreover, the current outbreak is in a conflict zone, where several rebel groups are vying for power – and the World Health Organization is now warning that the outbreak is a “perfect storm” that could quickly spiral out of control.

Against this backdrop, National Security Advisor John Bolton and Secretary of Health and Human Services Alex Azar announced a new National Biodefense Strategy, directing the Administration’s focus towards prevention. Bolton noted that the strategy is not a “counter-response” to epidemics, but rather “what we would do here in the United States with our friends and allies” to proactively address the root causes of biological threats. For this strategy to work, it will surely also require strengthening our forward presence around the world in the U.S. Agency for International Development (USAID) to reinforce local health systems where these pandemics may originate. When it comes to preventing an outbreak, the best defense is a good offense.

Preventing Global Health Crises

Preventing global health crises is not just a matter of containing them at the source, but of improving conditions to prevent large-scale outbreaks entirely. If countries do not have proper infrastructure, from roads to hospitals, containment becomes difficult. Moreover, in places where political violence overlaps with an epidemic – such as in the DRC – healthcare workers have an even tougher time safely reaching victims, and a disease can spread regardless of preparations.

The 2014 Ebola outbreak was projected to spread to as many as 550,000 people and cost more than $32 billion. But the United States responded, working alongside international organizations and other governments, and these worst-case scenarios were avoided. While many U.S. agencies including the Centers for Disease Control (CDC), the State Department, and the Pentagon were involved in containing the crisis, USAID and its implementing partners led the on-the ground response to provide immediate assistance and stabilize communities.

To more effectively prevent future outbreaks, it is critical that global health infrastructure is strengthened across the board – and that is just what USAID is doing. Today USAID is active in Guinea, Sierra Leone, and Liberia— the three countries affected by the 2014 Ebola outbreak— supporting more than 500 health facilities, helping to restore their patient capacities, train staff in handling diseases, distribute vaccines, and educate the public about sanitation and healthcare practices. USAID is also working to alleviate food insecurity, rebuild civil societies, and create better technological infrastructure that will allow for faster responses in the future. Taken together, USAID’s global health and development programs make it less likely for diseases like Ebola to spread rapidly – and make it easier to respond if they do.

Biodefense without a Budget

In announcing the Administration’s new biodefense strategy, Secretary Azar said that “the best way to stop a disease outbreak in the United States is by stopping it before it ever comes to our border by being engaged abroad.” Yet, the Administration has proposed slashing the International Affairs Budget by more than 30 percent, raising questions about how it will be possible for America to remain engaged abroad.

Future epidemics are estimated to cost the global economy $60 billion each year – or $6 trillion by the end of the century. Moreover, epidemics will continue to exacerbate conflict in unstable regions such as the DRC, and will pose threats to us here at home if we are ill-prepared. Thus, prevention and early investments made now are far more cost-effective than responding when it is too late. In Liberia, for example, USAID helped save thousands of lives by spending a relatively small amount on a sanitation project in 284 communities, which made Ebola infections 17 times less likely.

That’s why it’s vital that our National Biodefense Strategy be complemented with a robust International Affairs Budget and support for agencies like USAID and the critical divisions of the CDC focusing on global health protection. These resources are critical for making the world—and our country—a safer and healthier place. Without them, the next outbreak could spread to our shores.