Ebola is back. May’s outbreak in the Democratic Republic of the Congo has resulted in 58 confirmed cases and 27 deaths so far, with public health officials anxiously tracking the disease as it threatens Mbandaka, a city of nearly 1.2 million people.
Though the virus remains a global threat, President Donald Trump recently proposed cutting $252 million in Ebola response funding from the federal budget. President Barack Obama asked Congress for $1 billion in emergency funds back in 2015 to address Ebola’s growing national security threat. The $252 million is what remains from that fund, money that was reserved to build local capacities to identify and treat Ebola cases throughout Africa. The U.S. can still give money; we pledged to give $8 million to the Democratic Republic of the Congo in May. But this is an acute response, not a long-term plan.
In the U.S., Dallas is ground zero for Ebola. Thomas Eric Duncan flew to Dallas from Liberia in 2014 to marry his fiancée who lived here, and he became the first person in America to contract, and die of, the virus. For fiancée Louise Troh, this was the beginning of a nightmare that continues as Ebola creeps back into headlines.
“He did not do anything wrong to be gone today,” Troh said. “And it keeps tormenting me.”
Diseases don’t respect borders, and pulling up the drawbridge only puts more Americans at risk for Ebola in the long run. But even more worrisome is how easily we as a country can retreat from pressing global health needs.
Dallas received a crash course in the importance of global health. We learned about Ebola’s incubation period (two to 21 days) and the difference between an outbreak (few infections) and an epidemic (more widespread). Four years later, we should translate our brush with Ebola into a long-term commitment to fight overlooked diseases.
Ebola virus disease is known as a neglected tropical disease, meaning it is underfunded relative to its impact and primarily affects people who live in tropical or semitropical developing countries. This classification of bacterial and parasitic diseases afflicts more than a billion people every year, wreaking havoc on life and livelihood.
Until Duncan fell ill, Ebola remained faceless for many Americans. TV clips of gowned and protected health officials seemed more like an unusually realistic medical thriller than real life. That changed in 2014. American media coverage of the patient, his family and the two Texas Health Presbyterian Hospital in Dallas nurses who contracted Ebola highlighted the human loss behind every statistic, as well as the uncertain futures of those who survive an under-researched disease.
Dallas represented a foreign plague’s local reach.
The U.S. led the (financial) charge against Ebola and, according to the World Health Organization, by April 2016 the U.S. Agency for International Development was the largest donor to West African Ebola response, contributing $74 million. Other countries followed suit. As a result, public officials are facing this month’s outbreak with better diagnostic tools and even a new experimental vaccine put to work in recent days.
Ebola response still has a long way to go. Widespread poverty and weak health systems remain underlying causes of most neglected tropical diseases, including Ebola. These systemic problems sound daunting, but strong public will and U.S. leadership can make a world of difference.
Consider guinea worm. The parasite enters the body from freshwater and grows up to a meter long inside a person’s abdomen before pushing through the skin and returning to water. Yes, it’s as painful and gross as it sounds. The insidious parasite caught the attention of former President Jimmy Carter, and in 1986 the Carter Foundation and the WHO began an international campaign for eradication, launching massive education and clean water programs.
In 1986, there were 3.5 million reported cases of guinea worm. By 2016, that number had diminished to just 25. Just two weeks ago, the WHO declared Kenya guinea-worm free, and guinea worm is on track to be the second disease to be fully eradicated, after smallpox. Long-term U.S. commitment led to a global health win.
Ebola isn’t the only neglected tropical disease that has threatened Texas. Guinea worm’s transformation is reminiscent of another wriggly plague, this one in the South. Hookworm caused distended bellies and lethargy that once incapacitated entire communities and led to the stereotypes of “lazy” Southerners. Hookworm lurked in Texas soil well into the 1940s, and was finally eliminated in 1985 — just as the Carter Foundation turned its sights to the hookworm’s cousin. Neglected diseases are closer to us in time and place than most might think.
“All health is global health;” it’s a public health mantra that succinctly highlights the lessons of Ebola. Americans must continue to fight the deadly virus, but also commit to long-term investments in health systems. If we don’t, then we have forgotten our city’s past.
“Ebola is not just Eric,” Troh said “Kids are going to die, parents are going to die.”
“I don’t want the world to forget.”