On Tuesday, as the World Health Organization announced that Ebola had broken out in the Democratic Republic of Congo for the second time in a year, and the ninth time since the discovery of the disease there in the late 1970s, the White House released one more proposal to to cut funding for global and domestic health security efforts.
Both events were predictable, and together indicate a growing disconnect between shifting federal spending goals and ongoing global realities. That indication was reinforced the next day with legislators’ introduction of House Resolution 3, backing the administration’s proposal to rescind $252 million of USAID funding to combat infectious disease threats that include Ebola through the Global Health Security Agenda.
Launched shortly before the Ebola crisis in West Africa was recognized in 2014, the mission of the Global Health Security Agenda had been spurred by recognition a few years earlier that only a handful of countries had capacities to detect, prevent and respond to disease outbreaks within their borders in keeping with International Health Regulations. What happened during the West African Ebola crisis, in the seven months alone between the day a child playing in a remote Guinea rain forest, bitten by a fruit bat became the first casualty, to the day a traveler brought the virus to Lagos, Nigeria, Africa’s most densely populated city, only added urgency to the Global Health Security Agenda’s mission.
Since then, that urgency has been underscored by the toll of the West Africa Ebola crisis, which by the time it was over in late 2016 had taken more than 11,000 lives, those of more than 500 health workers among them. The costs of unpreparedness — to respond or fund responses to infectious diseases — was demonstrated again, as Zika traveled to the Western hemisphere with devastating results, and as urban outbreaks of yellow fever erupted in Angola and Brazil.
Congress recognized that urgency by directing part of the remaining emergency funding allocated in response to the West Africa Ebola crisis to global health security efforts in 2018, supporting surveillance, laboratory building, and public health training in countries with limited resources. The proposals this week indicate a belief that the work is done. The news from the Democratic Republic of Congo indicate that it is not.
The savings that would be derived from the cuts proposed this week have been noted to be negligible. The enormity of the costs of failures to stop infectious diseases where they originate, remains to be seen.