Former ‘Ebola czar’ on the current outbreak in Africa

0:00It's Consider This, where every day we go deep on one big news story. Today, Ebola. In just a matter of days, public health officials went from announcing a new outbreak in the Democratic Republic of Congo to declaring the outbreak an international public health emergency. That is incredibly fast. This already makes it, on day one, one of the largest Ebola outbreaks ever recorded. Dr. Craig Spencer knows firsthand the damage Ebola can cause. He helped fight a different strain in West Africa just over a decade ago and also contracted Ebola himself while caring for patients. The death toll and infection rate in this current outbreak continues to climb with more than 130 deaths and over 500 cases linked to the virus.

0:44What concerns me the most is we learned too much, too quickly for this to be anything but really bad. All of this is unfolding at a time when the Trump administration has disrupted or dismantled public health infrastructure at home and abroad. Those all have dramatic impacts. Look, we lost a lot of CDC staff and a lot of our CDC staff are now in Nebraska helping with Hantavirus. We lost USAID that was responsible for helping be our eyes and ears and detecting outbreaks like this. And we withdrew from the WHO, which is already pretty thin in terms of dealing with Hantavirus and other outbreaks.

1:18Those cuts over the last year have definitely had an impact, and unfortunately, we're seeing the fallout from that right now. Consider this. As Ebola spreads across Central and East Africa, how will those cuts to public health organizations affect the response?

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2:58It's Consider This from NPR. The death toll of the Ebola outbreak in the Democratic Republic of Congo and Uganda continues to climb. days after the World Health Organization declared it a public health emergency of international concern. I'm deeply concerned about the scale and speed of the epidemic. That is WHO Director General Tedros Adadam Gabrielsso speaking earlier today in Geneva. Joining me now to talk about the global response to this outbreak is Ron Klain. He is the former White House Ebola response coordinator under President Obama and of course, later, President Biden's White House Chief of Staff.

3:35Ron, thanks for joining us. Thanks for having me. Look, a lot to talk about with the government response, but let's start with the outbreak itself. Based on what you are seeing and hearing, what to you is similar to the situation you helped coordinate in 2014? And what is different? Well, what's similar is it's Ebola, and it's in Africa. What's different is it's a different part of Africa, and it's a different strain of Ebola. This is a strain of Ebola for which we We have no vaccine and no treatments. And it's a part of Africa which is conflict laden and is adjacent to massive gatherings of refugees in South Sudan.

4:13So it's a highly dangerous place for this to happen. And what's also similar is we're behind. And so the response is starting off in deficit. Yeah. And of course, to to deal with an outbreak like this, you need a coordinated government response. You need a lot of coordination and conversation among governments. You need the U.S. to play a leading role in international health organizations. What role specifically did USAID play in dealing with Ebola in 2014? USAID played a critical role in the Ebola response in West Africa in 2014 and 2015. Particularly their DART teams, their emergency response teams were really the leaders of the on-the-ground response from the donor nations and played a key role in helping local communities stand up their responses and to build local Ebola treatment units and to handle the burial of the dead, which is really critical in stopping the spread of the disease since people are maximally infectious when they die.

5:14And I think that that is a big, big gap in the response. The lack of USAID to lead, coordinate, and empower this response is a giant gaping hole. So that's been dismantled. And of course, President Trump has also withdrawn the U.S. from the World Health Organization. Does that matter or is that mostly symbolic? I think it will matter in the long run. I think the WHO is going to do whatever it's going to do. They're an international regulatory organization. They declare public health emergencies, and they urge other countries to respond, but the WHO does not have a response capacity. So that really relies on, in the past, historically, things like USAID and the United States and our allies in Western Europe to provide key elements as a response.

5:59You have said a lot of things that are kind of troubling to hear, and I'm wondering what you are most worried about as somebody who sat in these meetings a decade ago. I think there's less danger from this outbreak to Western nations in the U.S., but I think there's greater danger for the people in Africa. I think the part of Africa where this is broken out, as I said, is conflict-laden, and that makes a medical response very difficult. You can't send doctors and nurses in places where people are firing bullets. It's a very hard thing to do. And I would also say the proximity to South Sudan and the large number of refugees there is a very, very scary scenario.

6:38If Ebola started spreading refugee camps in South Sudan, the death toll could be just chilling. Can you explain why you don't think it's as big of a threat to Western countries right now? Because the number of people who travel from the DRC and Uganda to Western countries is relatively small. You know, in West Africa in 2014, the three countries where this broke out were countries with serious historical and current ties to the U.S. and Western Europe. And so there's a lot of migration back and forth and, you know, a lot of interconnection. Yeah. I want to ask about I want to ask a broader question about public trust in government.

7:18And you were, you know, as I mentioned, a close advisor, White House chief of staff to President Biden. And a lot of people seem to think that we have gotten to this point in part because of the way that public trust in government and health officials and scientific experts broke down during the COVID pandemic. And I'm wondering what you think about that, whether you think any way the Biden administration responded to COVID played a role in some part in paving the way for the Trump administration to come in and just disrupt public health infrastructure. No, I reject that. I mean, first of all, President Trump withdrew from the World Health Organization in his first term before Joe Biden was ever president.

7:59And, you know, I think so I think the idea that somehow what happened under President Biden led to this is just there's just no causal link at all. And and in the end, I will say our President Biden's response to covid was highly effective. and obviously the decision to dismantle USAID had nothing to do with all that. But regardless, I feel like you would probably agree that we are at a point right now where a lot of people in the United States do not want to hear what scientific experts have to say and now we have people in the administration undermining those experts in a whole bunch of different ways.

8:35So given all of that, how are you thinking about the right global health response and public health response and new challenges that might create as public officials are trying to give messages about safety and statistics during an outbreak like this? Well, I think it is a challenge. You're absolutely right on that. I think that, you know, I hope that the U.S. government will help respond to this epidemic on the ground in East Africa, because in the end, no one is safe until these epidemics are extinguished. And though the risk of transmission to the U.S. is low, it's not zero. and the longer it goes on and the more it spreads, the more that risk goes up.

9:12We're all interconnected, and the more the U.S. does to help extinguish this epidemic in East Africa will not only save lives there, which is vitally important in and of itself, but will also help protect Americans too. That is Ron Klain, former White House Ebola response coordinator under President Obama. Thanks so much for talking to us about this. Thank you. Take care. This episode was produced by Christopher Harlan Dunaway, Catherine Fink, and Karen Zamora. It was edited by Christopher Intagliotta and Giselle Grayson. Our executive producer is Sammy Yenigan.

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